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Item C18 Revised 2/95 BOARD OF COUNTY COMMISSIONERS AGENDA ITEM SUMMARY Meeting Date: October 16. 2002 Bulk Item: Yes IZI No D Division: Manaaement Services Department: Grants Administration AGENDA ITEM WORDING: Authorization for the Mayor to execute the fiscal year 2003 contracts with Human Service Oraanizations funded by the County, for which fundinq recommendations are made by the Human Services Advisory Board. ITEM BACKGROUND: Funds are provided to various human service oraanizations based upon the recommendations of the Monroe County Human Services Advisory Board. as approved by the BOCC annually. See attached list for amounts. PREVIOUS RELEVANT BOCC ACTION: Approval of boilerplate contract for HSO'S on April 18, 2001. Added 6.5% to the amounts recommended by the Human Services Advisory Board and increased Rural Health Network (now a budaet line item. instead of applyina to the Human Services Advisory Board), Bia Pine Athletic Assoc.. Wesley House, Carina Friends for Seniors, and Salvation Army on July 19, 2002. Instructed staff to distribute remainder of 36,703.00 to remainina aaencies on July 19. 2002; instructed staff to reverse distribution of 36.703.00 on July 24, 2002; approval of revised amounts on July 24. 2002. CONTRACT/AGREEMENT CHANGES: Chanaes as compared to last year's contracts are to amounts. dates. names and addresses, and description of services to be provided. Some of these oraanizations are beina funded for the first time. however. STAFF RECOMMENDATION: approval TOTAL COST: 1,128.250.00 COST TO COUNTY: 1.128.250.00 REVENUE PRODUCING: Yes D No IZI BUDGETED: Yes IZI No D AMOUNT PER MONTH YEAR APPROVED BY:COUNTY A TTY IZI OMB/PURCHASING IZI RISK MANAGEMENT IZI DIVISION DIRECTOR APPROVAL: J _ ~ James L. 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MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract # Contract with: American Red Cross Effective Date: 10/01102 Expiration Date: 9/30103 Contract Purpose/Description: Provide direct services to the citizens of Monroe County, such as disaster assistance, emergency communications, and health and safetv training. Contract Manager: David P. Owens (Name) 4482 (Ext. ) OMB/Grants (Department) for BOCC meeting on 10/16/02 Agenda Deadline: 10/02/02 CONTRACT COSTS Total Dollar Value of Contract: $19.590.00 Budgeted? Yesl2Sl No D Account Codes: Grant: $0.00 County Match: $ Current Year Portion: $19.590.00 001-03203-530340-_ - - - ---- - - - ---- - - - ---- ADDITIONAL COSTS Estimated Ongoing Costs: $_/yr For: (Not included in dollar value above) (eg. maintenance, utilities, ianitorial, salaries, etc.) CONTRACT REVIEW Changes Date In Needed ~ Division Director lo-).~ YesD N9I::::::J --L Risk Management ~ - {J.~'O?r YesD No5 o.M.B.lPurchasing'i>\z:uloz- YesD No~ ~ County Attorney 8/15/12- YesDNoQ/ ~ Date Out /t:>~L-l:n-- <g"d.l <.bl- ?S(tZcfV i/~~ Comments: OMB Form Revised 9/11/95 MCP #2 AGREEMENT This Agreement is made and entered into this day of , 2002, between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter referred to as "Board" or "County," and American Red Cross of Greater Miami and the Keys, hereinafter referred to as "PROVIDER." WHEREAS, the PROVIDER is a not-for-profit corporation established for the provision of disaster services and health, safety and community services, and WHEREAS, it is a legitimate public purpose to provide disaster services and health, safety and community services, now, therefore, IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed as follows: 1. AMOUNT OF AGREEMENT. The Board, in consideration of the PROVIDER substantially and satisfactorily performing and carrying out the duties of the Board as to providing disaster services and health, safety and community services to persons living in Monroe County, Florida, shall pay to the PROVIDER the sum of NINETEEN THOUSAND. FIVE HUNDRED, NINETY, AND NO/100 DOLLARS (19,590.00) for fiscal year 2002 - 2003. 2. TERM. This Agreement shall commence on October 1, 2002, and terminate September 30, 2003, 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 disaster services and health, safety and community services to persons living in Monroe County, Florida. PROVIDER shall provide services described in Attachment C, attached hereto and incorporated herein. 5. RECORDS. The PROVIDER shall maintain appropriate records to insure a proper accounting of all funds and expenditures, and shall provide a clear financial audit trail to allow for full accountability of funds received from said Board. Access to these records shall be provided during weekdays, 8 A.M. to 5 P.M., upon request of the Board, the State of Florida, or authorized agents and representatives of the Board or State. The PROVIDER shall be responsible for repayment of any and all audit exceptions which are identified by the Auditor General of the State of Florida, the Clerk of Court for Monroe County, an independent auditor, or their agents and representatives. In the event of an audit exception, the current fiscal year contract amount or subsequent fiscal year contract amounts shall be offset by the amount of the audit exception. In the event this agreement is not renewed or continued in subsequent years through new or amended contracts, the PROVIDER shall be billed by the Board for the amount of the audit exception and the PROVIDER shall promptly repay any audit exception. 6. INDEMNIFICATION AND HOLD HARMLESS. The PROVIDER covenants and agrees to indemnify and hold harmless Monroe County Board of County Commissioners from any and all claims for bodily injury (including death), personal injury, and property damage (including property owned by Monroe County) and any other losses, damages, and expenses (including attorney's fees) which arise out of, in connection with, or by reason of services provided by the PROVIDER occasioned by the negligence, errors, or other wrongful act or omission of the PROVIDER'S employees, agents, or volunteers. 7. INDEPENDENT CONTRACTOR. At all times and for all purposes hereunder, the PROVIDER is an independent contractor and not an employee of the Board. No statement contained in this agreement shall be construed so as to find the PROVIDER or any of its employees, contractors, servants or agents to be employees of the Board. 8. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement, the PROVIDER shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating the provision of such services, including those now in effect and hereinafter adopted. Any violation of said statutes, ordinances, rules and regulations shall constitute a material breach of this agreement and shall entitle the Board to terminate this contract immediately upon delivery of written notice of termination to the PROVIDER. 9. COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the COUNTY: (a) evidence of the organization's SOl(c)(3) status; (b) a list of the organization's Board of Directors of which there must be five or more; (c) evidence of annual election of Officers and Directors; (d) an annual audited financial report; (e) a copy the organization's Corporate Bylaws, which must address the organization's mission, board and membership composition, election of officers, and so on; (f) a copy of the organization's Corporate Policies and Procedures Manual which must include hiring policies for all staff, drug and alcohol free workplace provisions, equal employment opportunity provisions, and so on; (g) cooperation with County monitoring visits; (h) semi-annual performance reports. These reports should include performance measurements which will demonstrate the level of accomplishment of goals for which funding has been provided. (i) other reasonable reports and information related to compliance with applicable laws, contract provisions and the scope of services that the County may from time to time request. 10. PROFESSIONAL RESPONSIBILITY AND LICENSING. The PROVIDER shall assure that all professionals have current and appropriate professional licenses and professional liability insurance coverage. Funding by the Board is contingent upon retention of appropriate local, state and/or federal certification and/or licensure of the PROVIDER'S program and staff. 11. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services and/or reimbursement of services shall be accomplished by an amendment, which must be approved in writing by the COUNTY. 12. NO ASSIGNMENT. The PROVIDER shall not assign this agreement except in writing and with the prior written approval of the Board, which approval shall be subject to such conditions and provisions as the Board may deem necessary. This agreement shall be incorporated by reference into any assignment and any assignee shall comply with all of the provisions herein. Unless expressly provided for therein, such approval shall in no manner or event be deemed to impose any obligation upon the Board in addition to the total agreed upon reimbursement amount for the services of the PROVIDER. 13. NON-DISCRIMINATION. The PROVIDER shall not discriminate against any person on the basis race, creed, color, national origin, sex or sexual orientation, age, physical handicap, or any other characteristic or aspect which is not job-related in its recruiting, hiring, promoting, terminating or any other area affecting employment under this agreement. At all times, the PROVIDER shall comply with all applicable laws and regulations with regard to employing the most qualified person(s) for positions under this agreement. The PROVIDER shall not discriminate against any person on the basis of race, creed, color, national origin, sex or sexual orientation, age, physical handicap, financial status or any characteristic or aspect in its providing of services. 14. AUTHORIZED SIGNATURES. The signatory for the PROVIDER below, certifies and warrants that: (a) The PROVIDER'S name in this agreement is the full name as designated in its corporate charter, if a corporation, or the full name under which the PROVIDER is authorized to do business in the State of Florida. (b) He or she is empowered to act and contract for the PROVIDER; and (c) This agreement has been approved by the Board of Directors of the PROVIDER if the PROVIDER is a corporation. 15. NOTICE. Any notice required or permitted under this agreement shall be in writing and hand-delivered or mailed, postage pre-paid, by certified mail, return receipt requested, to the other party as follows: For Board: David P. Owens, Grants Administrator Gato Building 1100 Simonton Street Key West, FL 33040 For PROVIDER Mr. Winston Burrell American Red Cross of Greater Miami and the Keys 3132 Flagler Avenue Key West, FL 33040 305-296-4033 305-296-9388 FAX and Monroe County Attorney PO Box 1026 Key West, FL 33041 16. CONSENT TO JURISDICTION. This agreement shall be construed by and governed under the laws of the State of Florida and venue for any action arising under this agreement shall be in Monroe County, Florida. 17. NON-WAIVER. Any waiver of any breach of covenants herein contained to be kept and performed by the PROVIDER shall not be deemed or considered as a continuing waiver and shall not operate to bar or prevent the Board from declaring a forfeiture for any succeeding breach, either of the same conditions or covenants or otherwise. 18. AVAILABILITY OF FUNDS. If funds cannot be obtained or cannot be continued at a level sufficient to allow for continued reimbursement of expenditures for services specified herein, this agreement may be terminated immediately at the option of the Board by written notice of termination delivered to the PROVIDER. The Board shall not be obligated to pay for any services or goods provided by the PROVIDER after the PROVIDER has received written notice of termination, unless otherwise required by law. 19. PURCHASE OF PROPERTY. All property, whether real or personal, purchased with funds provided under this agreement, shall become the property of Monroe County and shall be accounted for pursuant to statutory requirements. 20. ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the parties hereto with respect to the subject matter hereof and supersedes any and all prior agreements with respect to such subject matter between the PROVIDER and the Board. IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed as of the day and year first written above. (SEAL) ATTEST: DANNY l. KOlHAGE, CLERK BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA By By Deputy Clerk Mayor/Chairman PROVIDER (Federal ID No. ) Witness By Witness President BY 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 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 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 2002 by who is personally known to me. Notary Public Notary Stamp ATTACHMENT C DESCRIPTION OF SERVICES TO BE PROVIDED Disaster Services Program - hurricane preparedness and assistance to victims of local disasters. Armed Forces Emergency Services - referral services and facilitation of emergency communications between members of the military and their families. Health, Safety, and Community Services - CPR, community first aid, babysitter training, standard first and and water safety instruction. 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.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 PERSONALL Y APPEARED BEFORE ME, the undersigned authority, who, after first being sworn by me, affixed hislher signature (name of individual signing) in the space provided above on this day of ,20_. NOTARY PUBLIC My commission expires: OMB - MCP FORM #4 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 3 6 months from the date of being placed on the convicted vendor list." MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract # Contract with: Big Brothers/Big Sisters Effective Date: 10/01102 Expiration Date: 9/30/03 Contract Purpose/Description; provides funding to perform and carry out children's services. including companionship and development services to young persons living in Monroe County. Contract Manager: David P. Owens (Name) 4482 (Ext.) OMB/Grants (Department) for BOCC meeting on 10/16/02 Agenda Deadline: 10/02/02 CONTRACT COSTS Total Dollar Value of Contract: $12.400.00 Budgeted? Yes[8J No D Account Codes; Grant: $0.00 County Match: $ Current Year Portion: $12.400.00 001-03001-530340-_ - - - ---- - - - ---- - - - ---- ADDITIONAL COSTS Estimated Ongoing Costs: $_/yr For: (Not included in dollar value above) (eg. maintenance, utilities, janitorial, salaries, etc.) CONTRACT REVIEW Changes Date In Needed _~'e r Division Director /0 -~- ~ YesD No~ . .' Risk Management 'frill I-Oo...YesO No8 '0() .. ~'" ) O.M.B./Purchasing CS'1'z.i)~y esO No~ ~ County Attorney g/,S/" z- YesD NoQ/' _ Date Out /0 -).- - c:2- 5!'~I-oa- 81qoc r;~l- Comments: OMB Form Revised 9/11/95 MCP #2 AGREEMENT This Agreement is made and entered into this day of , 2002, between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter referred to as "Board" or "County," and Big Brothers/Big Sisters of Monroe County, Inc., hereinafter referred to as "PROVIDER." WHEREAS, the PROVIDER is a not-for-profit corporation established for the provision of companion, mentoring, and tutoring services to the youth of Monroe County, and WHEREAS, it is a legitimate public purpose to provide facilities and services for the provision of companion, mentoring, and tutoring services to the youth of Monroe County, now, therefore, IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed as follows: 1. AMOUNT OF AGREEMENT. The Board, in consideration of the PROVIDER substantially and satisfactorily performing and carrying out the duties of the Board as to providing facilities and services for companion, mentoring, and tutoring services for young persons living in Monroe County, Florida, shall pay to the PROVIDER the sum of TWELVE-THOUSAND, FOUR HUNDRED, AND 00/100 DOLLARS (12,400.00) for fiscal year 2002-2003. 2. TERM. This Agreement shall commence on October 1, 2002, and terminate September 30, 2003, unless earlier terminated pursuant to other provisions herein. 3. PAYMENT. Payment will be paid periodically, but no more frequently than monthly as hereinafter set forth. Reimbursement requests will be submitted to the Board via the Clerk's Finance Office. The COUNTY shall only reimburse, subject to the funded amounts below, those reimbursable expenses which are reviewed and approved as complying with Florida Statutes 112.061 and Attachment A - Expense Reimbursement Requirements. Evidence of payment by the PROVIDER shall be in the form of a letter, summarizing the expenses, with supporting documentation attached. The letter should contain a certification statement. An example of a reimbursement request cover letter is included as Attachment B. The organization's final invoice must be received within sixty days after the termination date of this contract shown in Article 2 above. After the Clerk of the Board examines and approves the request for reimbursement, the Board shall reimburse the PROVIDER. However, the total of said reimbursement expense payments in the aggregate sum shall not exceed the total amount shown in Article 1, above, during the term of this agreement. 4. SCOPE OF SERVICES. The PROVIDER, for the consideration named, covenants and agrees with the Board to substantially and satisfactorily perform and carry out the duties of the Board in providing companion, mentoring, and tutoring services to the youth living in Monroe County, Florida. PROVIDER shall provide services described in Attachment C, attached hereto and incorporated herein. 5. RECORDS. The PROVIDER shall maintain appropriate records to insure a proper accounting of all funds and expenditures, and shall provide a clear financial audit trail to allow for full accountability of funds received from said Board. Access to these records shall be provided during weekdays, 8 A.M. to 5 P.M., upon request of the Board, the State of Florida, or authorized agents and representatives of the Board or State. The PROVIDER shall be responsible for repayment of any and all audit exceptions which are identified by the Auditor General of the State of Florida, the Clerk of Court for Monroe County, an independent auditor, or their agents and representatives. In the event of an audit exception, the current fiscal year contract amount or subsequent fiscal year contract amounts shall be offset by the amount of the audit exception. In the event this agreement is not renewed or continued in subsequent years through new or amended contracts, the PROVIDER shall be billed by the Board for the amount of the audit exception and the PROVIDER shall promptly repay any audit exception. 6. INDEMNIFICATION AND HOLD HARMLESS. The PROVIDER covenants and agrees to indemnify and hold harmless Monroe County Board of County Commissioners from any and all claims for bodily injury (including death), personal injury, and property damage (including property owned by Monroe County) and any other losses, damages, and expenses (including attorney's fees) which arise out of, in connection with, or by reason of services provided by the PROVIDER occasioned by the negligence, errors, or other wrongful act or omission of the PROVIDER'S employees, agents, or volunteers. 7. INDEPENDENT CONTRACTOR. At all times and for all purposes hereunder, the PROVIDER is an independent contractor and not an employee of the Board. No statement contained in this agreement shall be construed so as to find the PROVIDER or any of its employees, contractors, servants or agents to be employees of the Board. 8. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement, the PROVIDER shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating the provision of such services, including those now in effect and hereinafter adopted. Any violation of said statutes, ordinances, rules and regulations shall constitute a material breach of this agreement and shall entitle the Board to terminate this contract immediately upon delivery of written notice of termination to the PROVIDER. 9. COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the COUNTY: (a) evidence of the organization's SOl(c)(3) status; (b) a list of the organization's Board of Directors of which there must be five or more; (c) evidence of annual election of Officers and Directors; (d) an annual audited financial report; (e) a copy the organization's Corporate Bylaws, which must address the organization's mission, board and membership composition, election of officers, and so on; (f) a copy of the organization's Corporate Policies and Procedures Manual which must include hiring policies for all staff, drug and alcohol free workplace provisions, equal employment opportunity provisions, and so on; (g) cooperation with County monitoring visits; (h) semi-annual performance reports. These reports should include performance measurements which will demonstrate the level of accomplishment of goals for which funding has been provided. (i) other reasonable reports and information related to compliance with applicable laws, contract provisions and the scope of services that the County may from time to time request. 10. PROFESSIONAL RESPONSIBILITY AND LICENSING. The PROVIDER shall assure that all professionals have current and appropriate professional licenses and professional liability insurance coverage. Funding by the Board is contingent upon retention of appropriate local, state and/or federal certification and/or licensure of the PROVIDER'S program and staff. 11. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services and/or reimbursement of services shall be accomplished by an amendment, which must be approved in writing by the COUNTY. 12. NO ASSIGNMENT. The PROVIDER shall not assign this agreement except in writing and with the prior written approval of the Board, which approval shall be subject to such conditions and provisions as the Board may deem necessary. This agreement shall be incorporated by reference into any assignment and any assignee shall comply with all of the provisions herein. Unless expressly provided for therein, such approval shall in no manner or event be deemed to impose any obligation upon the Board in addition to the total agreed upon reimbursement amount for the services of the PROVIDER. 13. NON-DISCRIMINATION. The PROVIDER shall not discriminate against any person on the basis race, creed, color, national origin, sex or sexual orientation, age, physical handicap, or any other characteristic or aspect which is not job-related in its recruiting, hiring, promoting, terminating or any other area affecting employment under this agreement. At all times, the PROVIDER shall comply with all applicable laws and regulations with regard to employing the most qualified person(s) for positions under this agreement. The PROVIDER shall not discriminate against any person on the basis of race, creed, color, national origin, sex or sexual orientation, age, physical handicap, financial status or any characteristic or aspect in its providing of services. 14. AUTHORIZED SIGNATURES. The signatory for the PROVIDER below, certifies and warrants that: (a) The PROVIDER'S name in this agreement is the full name as designated in its corporate charter, if a corporation, or the full name under which the PROVIDER is authorized to do business in the State of Florida. (b) He or she is empowered to act and contract for the PROVIDER; and (c) This agreement has been approved by the Board of Directors of the PROVIDER if the PROVIDER is a corporation. 15. NOTICE. Any notice required or permitted under this agreement shall be in writing and hand-delivered or mailed, postage pre-paid, by certified mail, return receipt requested, to the other party as follows: For Board: David P. Owens, Grants Administrator Gato Building 1100 Simonton Street Key West, Fl33040 and Monroe County Attorney PO Box 1026 Key West, Fl 33041 For PROVIDER Carmen Turner, Executive Director Big Brothers/Big Sisters of Monroe County, Inc. POBox 505 Key West, FL 33041 305-294-9891 305-294-1551 FAX 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: DANNYl. KOlHAGE,ClERK BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA By By Deputy Clerk Mayor/Chairman PROVIDER (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 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 LETrERHEAD 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 2002 by who is personally known to me. Notary Public Notary Stamp ATTACHMENT C Companion, mentoring, and tutoring services to the youth of Monroe County. Program service operation, including the matching of clients with a Big Brother, Sister, or Buddy, monitoring, and evaluation of units of service. These services include the "Little" (child), their Parent (single parents with no contact with the absent parent), and the "Big" (volunteer Big Brother, Big Sister, or Big Buddy). SWORN STATEMENT UNDER ORDINANCE NO. 10-1990 MONROE COUNTY, FLORIDA ETHICS CLAUSE warrants that he/it has not employed, retained or otherwise had act on his/its behalf any former County officer or employee in violation of Section 2 of Ordinance No. 10-1990 or any County officer or employee in violation of Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the County may, in its discretion, terminate this contract without liability and may also, in its discretion, deduct from the contract or purchase price, or otherwise recover, the full amount of any fee, commission, percentage, gift, or consideration paid to the former County officer or employee. (signature) Date: STATE OF COUNTY OF PERSONAllY APPEARED BEFORE ME, the undersigned authority, who, after first being sworn by me, affixed his/her signature (name of individual signing) in the space provided above on this day of ,20~. NOTARY PUBLIC My commission expires: OMB - MCP FORM #4 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. II MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract # Contract with: Big Pine Athletic Assoc. Effective Date: I 0/01102 Expiration Date:9/30/03 Contract PurposelDescription: 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 10/16/02 Agenda Deadline: 10/02/02 CONTRACT COSTS Total Dollar Value of Contract: $40.000.00 Current Year Portion: $40.000.00 Budgeted? Yes~ No D 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 Date In Division Director /0_-).- ~ Changes Needed YesDN~ Date Out /.., _ l.. - C) ~ Risk Management <6''''~I-Od--YesD Nog/ O.M.B./Purchasing 'tJ,wlDLtesD Nag---- ~J County Attorney fllls-lol.. YesDNo~ ~ ~-~I-cY- z{Z1C) ~/~,- Comments: OMB Form Revised 9/11/95 MCP #2 AGREEMENT This Agreement is made and entered into this day of , 2002, 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 00/100 DOLLARS ($40,000.00) for fiscal year 2002-2003. 2. TERM. This Agreement shall commence on October 1, 2002, and terminate September 30, 2003, 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 claims for bodily injury (including death), personal injury, and property damage (including property owned by Monroe County) and any other losses, damages, and expenses (including attorney's fees) which arise out of, in connection with, or by reason of services provided by the PROVIDER occasioned by the negligence, errors, or other wrongful act or omission of the PROVIDER's employees, agents, or volunteers. 7. INDEPENDENT CONTRACTOR. At all times and for all purposes hereunder, the PROVIDER is an independent contractor and not an employee of the Board. No statement contained in this agreement shall be construed so as to find the PROVIDER or any of its employees, contractors, servants or agents to be employees of the Board. 8. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement, the PROVIDER shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating the provision of such services, including those now in effect and hereinafter adopted. Any violation of said statutes, ordinances, rules and regulations shall constitute a material breach of this agreement and shall entitle the Board to terminate this contract immediately upon delivery of written notice of termination to the PROVIDER. 9. COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the COUNTY: (a) evidence of the organization's SOl(c)(3) status; (b) a list of the organization's Board of Directors of which there must be five or more; (c) evidence of annual election of Officers and Directors; (d) an annual audited financial report ; (e) a copy the organization's Corporate Bylaws, which must address the organization's mission, board and membership composition, election of officers, and so on; (f) a copy of the organization's Corporate Policies and Procedures Manual which must include hiring policies for all staff, drug and alcohol free workplace provisions, equal employment opportunity provisions, and so on; (g) cooperation with County monitoring visits; (h) semi-annual performance reports. These reports should include performance measurements which will demonstrate the level of accomplishment of goals for which funding has been provided. (i) other reasonable reports and information related to compliance with applicable laws, contract provisions and the scope of services that the County may from time to time request. 10. PROFESSIONAL RESPONSIBILITY AND LICENSING. The PROVIDER shall assure that all professionals have current and appropriate professional licenses and professional liability insurance coverage. Funding by the Board is contingent upon retention of appropriate local, state and/or federal certification and/or licensure of the PROVIDER'S program and staff. 11. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services and/or reimbursement of services shall be accomplished by an amendment, which must be approved in writing by the COUNTY. 12. NO ASSIGNMENT The PROVIDER shall not assign this agreement except in writing and with the prior written approval of the Board, which approval shall be subject to such conditions and provisions as the Board may deem necessary. This agreement shall be incorporated by reference into any assignment and any assignee shall comply with all of the provisions herein. Unless expressly provided for therein, such approval shall in no manner or event be deemed to impose any obligation upon the Board in addition to the total agreed upon reimbursement amount for the services of the PROVIDER. 13. NON-DISCRIMINATION The PROVIDER shall not discriminate against any person on the basis race, creed, color, national origin, sex or sexual orientation, age, physical handicap, or any other characteristic or aspect which is not job-related in its recruiting, hiring, promoting, terminating or any other area affecting employment under this agreement. At all times, the PROVIDER shall comply with all applicable laws and regulations with regard to employing the most qualified person(s) for positions under this agreement. The PROVIDER shall not discriminate against any person on the basis of race, creed, color, national origin, sex or sexual orientation, age, physical handicap, financial status or any characteristic or aspect in its providing of services. 14. AUTHORIZED SIGNATURES. The signatory for the PROVIDER below, certifies and warrants that: (a) The PROVIDER'S name in this agreement is the full name as designated in its corporate charter, if a corporation, or the full name under which the PROVIDER is authorized to do business in the State of Florida. (b) He or she is empowered to act and contract for the PROVIDER; and (c) This agreement has been approved by the Board of Directors of the PROVIDER if the PROVIDER is a corporation. 15. NOTICE. Any notice required or permitted under this agreement shall be in writing and hand-delivered or mailed, postage pre-paid, by certified mail, return receipt requested, to the other party as follows: For Board: David P. Owens, Grants Administrator Gato Building 1100 Simonton Street Key West, Fl33040 and Monroe County Attorney PO Box 1026 Key West, Fl 33041 For PROVIDER Merideth Bliss-Troxel, President Big Pine Key Athletic Association P. O. Box 430089 Big Pine Key, Florida 33043 16. CONSENT TO JURISDICTION. This agreement shall be construed by and governed under the laws of the State of Florida and venue for any action arising under this agreement shall be in Monroe County, Florida. 17. NON-WAIVER. Any waiver of any breach of covenants herein contained to be kept and performed by the PROVIDER shall not be deemed or considered as a continuing waiver and shall not operate to bar or prevent the Board from declaring a forfeiture for any succeeding breach, either of the same conditions or covenants or otherwise. 18. AVAILABILITY OF FUNDS. If funds cannot be obtained or cannot be continued at a level sufficient to allow for continued reimbursement of expenditures for services specified herein, this agreement may be terminated immediately at the option of the Board by written notice of termination delivered to the PROVIDER. The Board shall not be obligated to pay for any services or goods provided by the PROVIDER after the PROVIDER has received written notice of termination, unless otherwise required by law. 19. PURCHASE OF PROPERTY. All property, whether real or personal, purchased with funds provided under this agreement, shall become the property of Monroe County and shall be accounted for pursuant to statutory requirements. 20. ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the parties hereto with respect to the subject matter hereof and supersedes any and all prior agreements with respect to such subject matter between the PROVIDER and the Board. IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed as of the day and year first written above. (SEAL) ATTEST: DANNY l. KOLHAGE, CLERK BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA By By Deputy Clerk Mayor/Chairman PROVIDER (Federal ID No. ) Witness to Provider Signature By Witness to Provider Signature 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 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 2002 by who is personally known to me. Notary Public Notary Stamp ATTACHMENT C The Big Pine Key Athletic Association is a SOl( 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. SWORN STATEMENT UNDER ORDINANCE NO. 10-1990 MONROE COUNlY, 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 COUNlY 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 , 20-,--. NOTARY PUBLIC My commission expires: OMB - MCP FORM #4 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. II MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract # Contract with; Boys and Girls Club Effective Date: 10/01/02 Expiration Date: 10/03/03 Contract Purpose/Description: Provides fundinq for facilities and services for recreational use and social functions of the community in a wholesome environment free from druQs and alcohol. Contract Manager: David P. Owens (Name) 4482 (Ext.) OMB/Grants (Department) for BOCC meeting on 10/16/02 Aqenda Deadline: 10/02/02 CONTRACT COSTS Total Dollar Value of Contract: $31.000.00 Current Year Portion: $31,000.00 Budgeted? Yes X No 0 Account Codes: 001-03707-530340-_ Grant: $ _-_-_-_ County Match: $ _-_-_-_ - - - ---- Estimated Ongoing Costs: $_/yr (Not included in dollar value above) ADDITIONAL COSTS For: (eQ. maintenance, utilities, ianitorial, salaries, etc.) CONTRACT REVIEW Changes Date In Neede~ Division Director '/o__...........-OL-. YesD Net:] ..:.....-- " Risk Management ~'~-C~ YesD NoQ- Yf). S~~uiL 1N1 m" O.M.B.lPurchasing E!JjVd' YesO No~ '-. . ') County Attorney ~l~ol 02- YesO NoW _ Date Out ?~ '\..--OL ~~}-Od- ,8\3v l c ~0L- Comments: OMB Form Revised 9/11/95 MCP #2 AGREEMENT Boys and Girls Club This Agreement is made and entered into this day of , 2002, between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, 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 WHI;REAS, 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 THIRTY-ONE THOUSAND, AND NO/lOa DOLLARS ($31,000.00) for fiscal year 2002-2003. 2. TERM. This Agreement shall commence on October 1, 2002, and terminate September 30, 2003, 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 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. S. RECORDS. The Provider shall maintain appropriate records to insure a proper accounting of all funds and expenditures, and shall provide a clear financial audit trail to allow for full accountability of funds received from said Board. Access to these records shall be provided during weekdays, 8 a.m. to 5 p.m., upon request of the Board, the State of Florida, or authorized agents and representatives of the Board or State. The Provider shall be responsible for repayment of any and all audit exceptions which are identified by the Auditor General of the State of Florida, the Clerk of Court for Monroe County, an independent auditor, or their agents and representatives. In the event of an audit exception, the current fiscal year contract amount or subsequent fiscal year contract amounts shall be offset by the amount of the audit exception. In the event this agreement is not renewed or continued in subsequent years through new or amended contracts, the Provider shall be billed by the Board for the amount of the audit exception and the Provider shall promptly repay any audit exception. 6. INDEMNIFICATION AND HOLD HARMLESS. The Provider covenants and agrees to indemnify and hold harmless Monroe County Board of County Commissioners from any and all claims for bodily injury (including death), personal injury, and property damage (including property owned by Monroe County) and any other losses, damages, and expenses (including attorney's fees) which arise out of, in connection with, or by reason of services provided by the Provider occasioned by the negligence, errors, or other wrongful act or omission of the Provider's employees, agents, or volunteers. 7. INDEPENDENT CONTRACTOR. At all times and for all purposes hereunder, the Provider is an independent contractor and not an employee of the Board. No statement contained in this agreement shall be construed so as to find the Provider or any of its employees, contractors, servants or agents to be employees of the Board. 8. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement, the Provider shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating the provision of such services, including those now in effect and hereinafter adopted. Any violation of said statutes, ordinances, rules and regulations shall constitute a material breach of this agreement and shall entitle the Board to terminate this contract immediately upon delivery of written notice of termination to the Provider. 9. COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the COUNTY: (a) evidence of the organization's SOl(c)(3) status; (b) a list of the organization's Board of Directors of which there must be five or more; (c) evidence of annual election of Officers and Directors; (d) an annual audited financial report ; (e) a copy the organization's Corporate Bylaws, which must address the organization's mission, board and membership composition, election of officers, and so on; (f) a copy of the organization's Corporate Policies and Procedures Manual which must include hiring policies for all staff, drug and alcohol free workplace provisions, equal employment opportunity provisions, and so on; (g) cooperation with County monitoring visits; (h) semi-annual performance reports. These reports should include performance measurements which will demonstrate the level of accomplishment of goals for which funding has been provided. (i) other reasonable reports and information related to compliance with applicable laws, contract provisions and the scope of services that the County may from time to time request. 10. PROFESSIONAL RESPONSIBILITY AND LICENSING. The Provider shall assure that all professionals have current and appropriate professional licenses and professional liability insurance coverage. Funding by the Board is contingent upon retention of appropriate local, state and/or federal certification and/or licensure of the Provider's program and staff. 11. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services and/or reimbursement of services shall be 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 Gato Building 1100 Simonton Street 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 and supersedes any and all prior agreements with respect to such subject matter between the Provider and the Board. IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed as of the day and year first written above. (SEAL) ATTEST: DANNY l. KOlHAGE, CLERK BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA By By Deputy Clerk Mayor/Chairman PROVIDER (Federal ID No. ) Witness to Provider Signature By Witness to Provider Signature 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 must define the sender, the intended recipient, the date, the number called, and the reason for sending the fax. Telephone Expenses A user log of pertinent information must be remitted including: the party called, the caller, the telephone number, the date, and the purpose of the call. Travel Expenses Travel expenses must be submitted on a State of Florida Voucher for Reimbursement of Travel Expenses. Travel must be submitted in accordance with Florida Statute 112.061. Credit card statements are not acceptable documentation for reimbursement. If attending a conference or meeting a copy of the agenda is needed. Airfare reimbursement requires the original passenger receipt portion of the airline ticket. A travel itinerary is appreciated to facilitate the audit trail. Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example, taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is considered a reimbursable travel expense at the destination. Airport parking during a business trip is not. A detailed list of charges is required on the lodging invoice. Balance due must be zero. Room must be registered and paid for by traveler. The County will only reimburse the actual room and related bed tax. Room service, movies, and personal telephone calls are not allowable expenses. Meal reimbursement is: breakfast at $3.00, lunch at $6.00, and dinner at $12.00. Meal guidelines state that travel must begin prior to 6 a.m. for breakfast reimbursement, before noon and end after 2 p.m. for lunch reimbursement, and before 6 p.m. and end after 8 p.m. for dinner reimbursement. Mileage reimbursement is calculated at .29 cents per mile for personal auto mileage while on County business. An odometer reading must be included on the state travel voucher for vicinity travel. Mileage is not allowed from a residence or office to a point of departure. For example, driving form one's home to the airport for a business trip is not a reimbursable expense. Non-allowable Expenses The following expenses are not allowable for reimbursement: capital outlay expenditures (unless specifically included in the contract), contributions, depreciation expenses (unless specifically included in the contract), entertainment expenses, fundraising, non-sufficient check charges, penalties and fines. . ATTACHMENT B ORGANIZATION LETTERHEAD Monroe County Board of County Commissioners Finance Department 500 Whitehead Street Key West, FL 33040 Date The following is a summary of the expenses for ( Organization name) for the time period of to Check # Payee Reason Amount 101 Company A Rent $ X,XXX.XX 102 Company B Utilities XXX.XX 104 Employee A P/R ending 05/14/01 XXX.XX 105 Employee B P/R ending OS/28/01 XXX.XX (A) Total $ X.XXX.XX (B) Total prior payments $ X,XXX.XX (C) Total requested and paid (A + B) $ X,XXX.XX (D) Total contract amount $ X,XXX.XX Balance of contract (D-C) $ X.XXX.XX I certify that the above checks have been submitted to the vendors as noted and that the expenses are accurate and in agreement with the records of this organization. Furthermore, these expenses are in compliance with this organizations_ contract with the Monroe County Board of County Commissioners and will not be submitted for reimbursement to any other funding source. Executive Director Attachments (supporting documentation) Sworn to and subscribed before me this _ day of 2002 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). SWORN STATEMENT UNDER ORDINANCE NO. 10-1990 MONROE COUNTY. FLORIDA ETHICS CLAUSE warrants that he/it has not employed, retained or otherwise had act on his/its behalf any former County officer or employee in violation of Section 2 of Ordinance No. 10-1990 or any County officer or employee in violation of Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the County may, in its discretion, terminate this contract without liability and may also, in its discretion, deduct from the contract or purchase price, or otherwise recover, the full amount of any fee, commission, percentage, gift, or consideration paid to the former County officer or employee. (signature) Date: STATE OF COUNTY OF PERSONALLY APPEARED BEFORE ME, the undersigned authority, who, after first being sworn by me, affixed his/her signature (name of individual signing) in the space provided above on this day of ,20~. NOTARY PUBLIC My commission expires: OMB - MCP FORM #4 PUBLIC ENTI1Y 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. II MONROE COUNTY SOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract # Contract with: Care Center for Mental Health Effective Date:10/01/02 Expirati0n Date:9/30/03 Contract Purpose/Description: Annual appropriation that provides fundinQ for mental health and Quidance services for Monroe County citizens. Contract Manager: David P. Owens (Name) 4482 (Ext. ) OMS/Grants (Department) for SOCC meetinQ on 10/16/02 Agenda Deadline: 10/02/02 CONTRACT COSTS Total Dollar Value of Contract: $195.189.00 Current Year Portion: $195.189.00 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: (eQ. maintenance, utilities, ianitorial, salaries, etc.) CONTRACT REVIEW Date Out Division Director /,;;,_.J...,--u,"--- ~-0-l-6 ~ Comments: OMB Form Revised 9/11/95 MCP #2 AGREEMENT This Agreement is made and entered into this day of , 2002, 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 2002-2003, 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 NINETY-FIVE-THOUSAND, ONE-HUNDRED-EIGHTY-NINE AND NO/lOO DOLLARS ($195,189.00) for rendering counseling services. 2. TERM. This Agreement shall commence on October 1, 2002, and terminate September 30, 2003, 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 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 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 Gato Building 1100 Simonton Street 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 By Deputy Clerk Mayor/Chairman (Federal ID No. ) CARE CENTER FOR MENTAL HEALTH OF THE LOWER KEYS, INC. By Director By President BY ATTACHMENT A EXPENSE REIMBURSEMENT REQUIREMENTS This document is intended to provide basic guidelines to Human Service Organizations, county travelers, and contractual parties who have reimbursable expenses associated with Monroe County business. These guidelines, as they relate to travel, are from Florida Statute 112.061. A cover letter summarizing the major line items on the reimbursable expense request needs to also contain a notarized certified statement such as: "I certify that the attached expenses are accurate and in agreement with the records of this organization. Furthermore, these expenses are in compliance with this organization's contract with the Monroe County Board of County Commissioners." Invoices should be billed to the contracting agency. Third party payments will not be considered for reimbursement. Remember, the expense should be paid prior to requesting a reimbursement. Only current charges will be considered, no previous balances. Reimbursement requests will be monitored in accordance with the level of detail in the contract. This document should not be considered all-inclusive. The Clerk's Finance Department reserves the right to review reimbursement requests on an individual basis. Any questions regarding these guidelines should be directed to 305-292-3534. Data Processing, PC Time, etc. The vendor invoice is required for reimbursement. Inter-company allocations are not considered reimbursable expenditures unless appropriate payroll journals for the charging department are attached and certified. Payroll A certified statement verifying the accuracy and authenticity of the payroll expense is needed. If a Payroll Journal is provided, it should include: dates, employee name, salary or hourly rate, total hours worked, withholding information and payroll taxes, check number and check amount. If a Payroll Journal is not provided, the following information must be provided: check amount, check number, date, payee, support for applicable payroll taxes. Postage, Overnight Deliveries,- Courier, etc. A log of all postage expenses as they relate to the County contract is required for reimbursement. For overnight or express deliveries, the vendor invoice must be included. Rents, Leases, etc. A copy of the rental or lease agreement is required. Deposits and advance payments are not allowable expenses. Reproductions, Copies, etc. A log of copy expenses as they relate to the County contract is required for reimbursement. The log must define the date, number of copies made, source document, purpose, and recipient. A reasonable fee for copy expenses will be allowable. For vendor services, the vendor invoice and a sample of the finished product are required. Supplies, Services, etc. For supplies or services ordered, a vendor invoice is required. Telefax, Fax, etc. A fax log is required. The log must define the sender, the intended recipient, the date, the number called, and the reason for sending the fax. Telephone Expenses A user log of pertinent information must be remitted including: the party called, the caller, the telephone number, the date, and the purpose of the call. Travel Expenses Travel expenses must be submitted on a State of Florida Voucher for Reimbursement of Travel Expenses. Travel must be submitted in accordance with Florida Statute 112.061. Credit card statements are not acceptable documentation for reimbursement. If attending a conference or meeting a copy of the agenda is needed. Airfare reimbursement requires the original passenger receipt portion of the airline ticket. A travel itinerary is appreciated to facilitate the audit trail. Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example, taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is considered a reimbursable travel expense at the destination. Airport parking during a business trip is not. A detailed list of charges is required on the lodging invoice. Balance due must be zero. Room must be registered and paid for by traveler. The County will only reimburse the actual room and related bed tax. Room service, movies, and personal telephone calls are not allowable expenses. Meal reimbursement is: breakfast at $3.00, lunch at $6.00, and dinner at $12.00. Meal guidelines state that travel must begin prior to 6 a.m. for breakfast reimbursement, before noon and end after 2 p.m. for lunch reimbursement, and before 6 p.m. and end after 8 p.m. for dinner reimbursement. Mileage reimbursement is calculated at .29 cents per mile for personal auto mileage while on County business. An odometer reading must be included on the state travel voucher for vicinity travel. Mileage is not allowed from a residence or office to a point of departure. For example, driving form one's home to the airport for a business trip is not a reimbursable expense. Non-allowable Expenses The following expenses are not allowable for reimbursement: capital outlay expenditures (unless specifically included in the contract), contributions, depreciation expenses (unless specifically included in the contract), entertainment expenses, fundraising, non-sufficient check charges, penalties and fines. - ATTACHMENT B ORGANIZATION LETTERHEAD Monroe County Board of County Commissioners Finance Department 500 Whitehead Street Key West, FL 33040 Date The following is a summary of the expenses for ( Organization name) for the time period of to Check # Payee Reason Amount 101 Company A Rent $ X,XXX.XX 102 Company B Utilities XXX .XX 104 Employee A P/R ending 05/14/01 XXX.XX 105 Employee B P/R ending OS/28/01 XXX. XX (A) Total $ X.XXX.XX (B) Total prior payments $ X,XXX.XX (C) Total requested and paid (A + B) $ X,XXX.XX (D) Total contract amount $ X,XXX.XX Balance of contract (D-C) $ X.XXX.XX I certify that the above checks have been submitted to the vendors as noted and that the expenses are accurate and in agreement with the records of this organization. Furthermore, these expenses are in compliance with this organizations_ contract with the Monroe County Board of County Commissioners and will not be submitted for reimbursement to any other funding source. Executive Director Attachments (supporting documentation) Sworn to and subscribed before me this _ day of 2002 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 Q'Bryant Middle School, Sugarloaf Middle School, Gerald Adams Elementary School, the Monroe County Detention Center, and the Douglass Community Center. SWORN STATEMENT UNDER ORDINANCE NO. 10-1990 MONROE COUNTY, FLORIDA ETHICS CLAUSE warrants that he/it has not employed, retained or otherwise had act on his/its behalf any former County officer or employee in violation of Section 2 of Ordinance No. 10-1990 or any County officer or employee in violation of Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the County may, in its discretion, terminate this contract without liability and may also, in its discretion, deduct from the contract or purchase price, or otherwise recover, the full amount of any fee, commission, percentage, gift, or consideration paid to the former County officer or employee. (signature) Date: STATE OF COUNTY OF PERSONALLY APPEARED BEFORE ME, the undersigned authority, who, after first being sworn by me, affixed his/her signature (name of individual signing) in the space provided above on this day of ,20~. NOTARY PUBLIC My commission expires: OMB - MCP FORM #4 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." MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract # Contract with: Caring Friends for Seniors Effective Date: 10/01102 Expiration Date: 9/30/03 Contract PurposelDescription: provides funding to perform companionship and related services to elderly persons living in Monroe County. Student organizations are matched with senior citizens to bridge the gap between generations. Contract Manager: David P. Owens (Name) 4482 (Ext.) OMB/Grants (Department) for BOCC meeting on 10/16/02 Agenda Deadline: 10/02/02 CONTRACT COSTS Total Dollar Value of Contract: $10,000.00 Budgeted? YeslZl No 0 Account Codes: Grant: $0.00 County Match: $ Current Year Portion: $10,000.00 001-00506-530340-_ - - - ---- - - ---- - - - ---- ADDITIONAL COSTS Estimated Ongoing Costs: $_/yr For: (Not included in dollar value above) (eg. maintenance, utilities, janitorial, salaries, etc.) CONTRACT REVIEW DivisionDirector /~~~~~ Ye~~~Er' ~. Risk Management ~'o-..\-OYYesDNoS -1:Jl.~ O.M.B./Purchasing sj'li)\oz...-YesD No~ ~ County Attomey 2/iS'/O'2..... YesDNo~_ Date Out 1'.:;, _)....-OL-.. ~c4-6d- 8IW)DC ~fdJ- Comments: OMB Form Revised 9/11/95 MCP #2 AGREEMENT : This Agreement is made and entered into this day of , 2002, between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter referred to as "Board" or "County," and Caring Friends for Seniors, Inc., hereinafter referred to as "PROVIDER." WHEREAS, the PROVIDER is a not-for-profit corporation established for the provision of companion services for senior citizens in Monroe County, and WHEREAS, it is a legitimate public purpose to provide facilities and services for companion services for senior citizens in Monroe County, now, therefore, IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed as follows: 1. AMOUNT OF AGREEMENT. The Board, in consideration of the PROVIDER substantially and satisfactorily performing and carrying out the duties of the Board as to providing facilities and services for the provision of companion services for senior citizens in Monroe County, Florida, shall pay to the PROVIDER the sum of TEN-THOUSAND AND 00/100 DOLLARS ($10,000.00) for fiscal year 2002-2003. 2. TERM. This Agreement shall commence on October 1, 2002, and terminate September 30, 2003, unless earlier terminated pursuant to other provisions herein. 3. PAYMENT. Payment will be paid periodically, but no more frequently than monthly as hereinafter set forth. Reimbursement requests will be submitted to the Board via the Clerk's Finance Office. The COUNTY shall only reimburse, subject to the funded amounts below, those reimbursable expenses which are reviewed and approved as complying with Florida Statutes 112.061 and Attachment A - Expense Reimbursement Requirements. Evidence of payment by the PROVIDER shall be in the form of a letter, summarizing the expenses, with supporting documentation attached. The letter should contain a certification statement. An example of a reimbursement request cover letter is included as Attachment B. The organization's final invoice must be received within sixty days after the termination date of this contract shown in Article 2 above. After the Clerk of the Board examines and approves the request for reimbursement, the Board shall reimburse the PROVIDER. However, the total of said reimbursement expense payments in the aggregate sum'shall not exceed the total amount shown in Article 1, above, during the term of this agreement. 4. SCOPE OF SERVICES. The PROVIDER, for the consideration named, covenants and agrees with the Board to substantially and satisfactorily perform and carry out the duties of the Board in providing companion services for senior citizens living in Monroe County, Florida. PROVIDER shall provide services described in Attachment C, attached hereto and incorporated herein. 5. RECORDS. The PROVIDER shall maintain appropriate records to insure a proper accounting of all funds and expenditures, and shall provide a clear financial audit trail to allow for full accountability of funds received from said Board. Access to these records shall be provided during weekdays, 8 A.M. to 5 P.M., upon request of the Board, the State of Florida, or authorized agents and representatives of the Board or State. The PROVIDER shall be responsible for repayment of any and all audit exceptions which are identified by the Auditor General of the State of Florida, the Clerk of Court for Monroe County, an independent auditor, or their agents and representatives. In the event of an audit exception, the current fiscal year contract amount or subsequent fiscal year contract amounts shall be offset by the amount of the audit exception. In the event this agreement is not renewed or continued in subsequent years through new or amended contracts, the PROVIDER shall be billed by the Board for the amount of the audit exception and the PROVIDER shall promptly repay any audit exception. 6. INDEMNIFICATION AND HOLD HARMLESS. The PROVIDER covenants and agrees to indemnify and hold harmless Monroe County Board of County Commissioners from any and all claims for bodily injury (including death), personal injury, and property damage (including property owned by Monroe County) and any other losses, damages, and expenses (including attorney's fees) which arise out of, in connection with, or by reason of services provided by the PROVIDER occasioned by the negligence, errors, or other wrongful act or omission of the PROVIDER'S employees, agents, or volunteers. 7. INDEPENDENT CONTRACTOR. At all times and for all purposes hereunder, the PROVIDER is an independent contractor and not an employee of the Board. No statement contained in this agreement shall be construed so as to find the PROVIDER or any of its employees, contractors, servants or agents to be employees of the Board. 8. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement, the PROVIDER shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating the provision of such services, including those now in effect and hereinafter adopted. Any violation of said statutes, ordinances, rules and regulations shall constitute a material breach of this agreement and shall entitle the Board to terminate this contract immediately upon delivery of written notice of termination to the PROVIDER. 9. COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the COUNTY: (a) evidence of the organization's SOl(c)(3) status; (b) a list of the organization's Board of Directors of which there must be five or more; (c) evidence of annual election of Officers and Directors; (d) an annual audited financial report; (e) a copy the organization's Corporate Bylaws, which must address the organization's mission, board and membership composition, election of officers, and so on; (f) a copy of the organization's Corporate Policies and Procedures Manual which must include hiring policies for all staff, drug and alcohol free workplace provisions, equal employment opportunity provisions, and so on; (g) cooperation with County monitoring visits; (h) semi-annual performance reports. These reports should include performance measurements which will demonstrate the level of accomplishment of goals for which funding has been provided. (i) other reasonable reports and information related to compliance with applicable laws, contract provisions and the scope of services that the County may from time to time request. 10. PROFESSIONAL RESPONSIBILITY AND LICENSING. The PROVIDER shall assure that all professionals have current and appropriate professional licenses and professional liability insurance coverage. Funding by the Board is contingent upon retention of appropriate local, state and/or federal certification and/or licensure of the PROVIDER'S program and staff. 11. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services and/or reimbursement of services shall be accomplished by an amendment, which must be approved in writing by the COUNTY. 12. NO ASSIGNMENT. The PROVIDER shall not assign this agreement except in writing and with the prior written approval of the Board, which approval shall be subject to such conditions and provisions as the Board may deem necessary. This agreement shall be incorporated by reference into any assignment and any assignee shall comply with all of the provisions herein. Unless expressly provided for therein, such approval shall in no manner or event be deemed to impose any obligation upon the Board in addition to the total agreed upon reimbursement amount for the services of the PROVIDER. 13. NON-DISCRIMINATION. The PROVIDER shall not discriminate against any person on the basis race, creed, color, national origin, sex or sexual orientation, age, physical handicap, or any other characteristic or aspect which is not job-related in its recruiting, hiring, promoting, terminating or any other area affecting employment under this agreement. At all times, the PROVIDER shall comply with all applicable laws and regulations with regard to employing the most qualified person(s) for positions under this agreement. The PROVIDER shall not discriminate against any person on the basis of race, creed, color, national origin, sex or sexual orientation, age, physical handicap, financial status or any characteristic or aspect in its providing of services. 14. AUTHORIZED SIGNATURES. The signatory for the PROVIDER below, certifies and warrants that: (a) The PROVIDER'S name in this agreement is the full name as designated in its corporate charter, if a corporation, or the full name under which the PROVIDER is authorized to do business in the State of Florida. (b) He or she is empowered to act and contract for the PROVIDER; and (c) This agreement has been approved by the Board of Directors of the PROVIDER if the PROVIDER is a corporation. 15. NOTICE. Any notice required or permitted under this agreement shall be in writing and hand-delivered or mailed, postage pre-paid, by certified mail, return receipt requested, to the other party as follows: For Board: David P. Owens, Grants Administrator Gato Building 1100 Simonton Street Key West, Fl 33040 For PROVIDER Barbara Fike, Executive Director Caring Friends for Seniors, Inc. POBox 1263 Key largo, FL 33037 305-453-1166 305-453-3773 FAX and Monroe County Attorney PO Box 1026 Key West, Fl 33041 16. CONSENT TO JURISDICTION. This agreement shall be construed by and governed under the laws of the State of Florida and venue for any action arising under this agreement shall be in Monroe County, Florida. 17. NON-WAIVER. Any waiver of any breach of covenants herein contained to be kept and performed by the PROVIDER shall not be deemed or considered as a continuing waiver and shall not operate to bar or prevent the Board from declaring a forfeiture for any succeeding breach, either of the same conditions or covenants or otherwise. 18. AVAILABILITY OF FUNDS. If funds cannot be obtained or cannot be continued at a level sufficient to allow for continued reimbursement of expenditures for services specified herein, this agreement may be terminated immediately at the option of the Board by written notice of termination delivered to the PROVIDER. The Board shall not be obligated to pay for any services or goods provided by the PROVIDER after the PROVIDER has received written notice of termination, unless otherwise required by law. 19. PURCHASE OF PROPERTY. All property, whether real or personal, purchased with funds provided under this agreement, shall become the property of Monroe County and shall be accounted for pursuant to statutory requirements. 20. ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the parties hereto with respect to the subject matter hereof and supersedes any and all prior agreements with respect to such subject matter between the PROVIDER and the Board. IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed as of the day and year first written above. (SEAL) ATIEST: DANNY l. KOlHAGE, CLERK BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA By By Deputy Clerk Mayor/Chairman PROVIDER (Federal ID No. ) Witness By Witness President ATTACHMENT A EXPENSE REIMBURSEMENT REQUIREMENTS This document is intended to provide basic guidelines to Human Service Organizations, county travelers, and contractual parties who have reimbursable expenses associated with Monroe County business. These guidelines, as they relate to travel, are from Florida Statute 112.061. A cover letter summarizing the major line items on the reimbursable expense request needs to also contain a notarized certified statement such as: "I certify that the attached expenses are accurate and in agreement with the records of this organization. Furthermore, these expenses are in compliance with this organization's contract with the Monroe County Board of County Commissioners." Invoices should be billed to the contracting agency. Third party payments will not be considered for reimbursement. Remember, the expense should be paid prior to requesting a reimbursement. Only current charges will be considered, no previous balances. Reimbursement requests will be monitored in accordance with the level of detail in the contract. This document should not be considered all-inclusive. The Clerk's Finance Department reserves the right to review reimbursement requests on an individual basis. Any questions regarding these gUidelines should be directed to 305-292-3534. Data Processing, PC Time, etc. The vendor invoice is required for reimbursement. Inter-company allocations are not considered reimbursable expenditures unless appropriate payroll journals for the charging department are attached and certified. Payroll A certified statement verifying the accuracy and authenticity of the payroll expense is needed. If a Payroll Journal is provided, it should include: dates, employee name, salary or hourly rate, total hours worked, withholding information and payroll taxes, check number and check amount. If a Payroll Journal is not provided, the following information must be provided: check amount, check number, date, payee, support for applicable payroll taxes. Postage, Overnight Deliveries, Courier, etc. A log of all postage expenses as they relate to the County contract is required for reimbursement. For overnight or express deliveries, the vendor invoice must be included. Rents, Leases, etc. A copy of the rental or lease agreement is required. Deposits and advance payments are not allowable expenses. Reproductions, Copies, etc. A log of copy expenses as they relate to the County contract is required for reimbursement. The log must define the date, number of copies made, source document, purpose, and recipient. A reasonable fee for copy expenses will be allowable. For vendor services, the vendor invoice and a sample of the finished product are required. Supplies, Services, etc. For supplies or services ordered, a vendor invoice is required. Telefax, Fax, etc. A fax log is required. The log must define the sender, the intended recipient, the date, the number called, and the reason for sending the fax. Telephone Expenses A user log of pertinent information must be remitted including: the party called, the caller, the telephone number, the date, and the purpose of the call. Travel Expenses Travel expenses must be submitted on a State of Florida Voucher for Reimbursement of Travel Expenses. Travel must be submitted in accordance with Florida Statute 112.061. Credit card statements are not acceptable documentation for reimbursement. If attending a conference or meeting a copy of the agenda is needed. Airfare reimbursement requires the original passenger receipt portion of the airline ticket. A travel itinerary is appreciated to facilitate the audit trail. Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example, taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is considered a reimbursable travel expense at the destination. Airport parking during a business trip is not. A detailed list of charges is required on the lodging invoice. Balance due must be zero. Room must be registered and paid for by traveler. The County will only reimburse the actual room and related bed tax. Room service, movies, and personal telephone calls are not allowable expenses. Meal reimbursement is: breakfast at $3.00, lunch at $6.00, and dinner at $12.00. Meal guidelines state that travel must begin prior to 6 a.m. for breakfast reimbursement, before noon and end after 2 p.m. for lunch reimbursement, and before 6 p.m. and end after 8 p.m. for dinner reimbursement. Mileage reimbursement is calculated at .29 cents per mile for personal auto mileage while on County business. An odometer reading must be included on the state travel voucher for vicinity travel. Mileage is not allowed from a residence or office to a point of departure. For example, driving form one's home to the airport for a business trip is not a reimbursable expense. Non-allowable Expenses The following expenses are not allowable for reimbursement: capital outlay expenditures (unless specifically included in the contract), contributions, depreciation expenses (unless specifically included in the contract), entertainment expenses, fundraising, non-sufficient check charges, penalties and fines. ATTACHMENT B ORGANIZATION LETTERHEAD Monroe County Board of County Commissioners Finance Department 500 Whitehead Street Key West, FL 33040 Date The following is a summary of the expenses for ( Organization name) for the time period of to Check # Payee Reason Amount 101 Company A Rent $ X,XXX.XX 102 Company B Utilities XXX.XX 104 Employee A P/R ending 05/14/01 XXX.XX 105 Employee B P/R ending OS/28/01 XXX.XX (A) Total $ X.XXX.XX (B) Total prior payments $ X,XXX.XX (C) Total requested and paid (A + B) $ X,XXX.XX (D) Total contract amount $ X,XXX.XX Balance of contract (D-C) $ X.XXX.XX I certify that the above checks have been submitted to the vendors as noted and that the expenses are accurate and in agreement with the records of this organization. Furthermore, these expenses are in compliance with this organizations_ contract with the Monroe County Board of County Commissioners and will not be submitted for reimbursement to any other funding source. Executive Director Attachments (supporting documentation) Sworn to and subscribed before me this _ day of 2002 by who is personally known to me. Notary Public Notary Stamp ATTACHMENT C Companion services to senior citizens, especially those who live alone, are homebound, or live in a nursing home, through one-on-one matches with volunteers and clients. SWORN STATEMENT UNDER ORDINANCE NO. 10-1990 MONROE COUNTY, FLORIDA ETHICS CLAUSE warrants that he/it has not employed, retained or otherwise had act on his/its behalf any former County officer or employee in violation of Section 2 of Ordinance No. 10-1990 or any County officer or employee in violation of Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the County may, in its discretion, terminate this contract without liability and may also, in its discretion, deduct from the contract or purchase price, or otherwise recover, the full amount of any fee, commission, percentage, gift, or consideration paid to the former County officer or employee. (signature) Date: STATE OF COUNTY OF PERSONAllY APPEARED BEFORE ME, the undersigned authority, who, after first being sworn by me, affixed his/her signature (name of individual signing) in the space provided above on this day of , 20---,--. NOTARY PUBLIC My commission expires: OMB - MCP FORM #4 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." MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract # Contract with: Catholic Charities Effective Date: 10/01102 Expiration Date: 9/30/03 Contract Purpose/Description: provides funding for services such as housing assistance, housing- related emergency services, soUP kitchen services, distribution of used and donated furniture, and disaster recovery services. Contract Manager: David P. Owens (Name) 4482 (Ext. ) OMB/Grants (Department) for BOCC meeting on 10/16/02 Agenda Deadline: 10/02/02 CONTRACT COSTS Total Dollar Value of Contract: $19,348.00 Budgeted? Yesrgj No 0 Account Codes: Grant: $0.00 County Match: $ Current Year Portion: $19,348.00 001-03216-530340-_ - - ---- - - - ---- - - - ---- ADDITIONAL COSTS Estimated Ongoing Costs: $_/yr For: (Not included in dollar value above) (eg. maintenance, utilities, ianitorial, salaries, etc.) CONTRACT REVIEW Risk Management ~ -~I-oJtesO NoCY O.M.B./PurChasing~1.;i)I[}L.- YesD NoGY": ~ County Attorney ~ / /.5"/ " 2,.... Y esO No~ Date Out Changes Date In Needed Division Director /~ _1..-~1.--- YesO No /~ -L. --'-- ?-J\ -o~ CZS/?-DJo p~2- Comments: OMB Form Revised 9/11/95 MCP #2 AGREEMENT This Agreement is made and entered into this day of , 2002, between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter referred to as "Board" or "County," and Catholic Charities, hereinafter referred to as "PROVIDER." WHEREAS, the PROVIDER isa not-for-profit corporation established for the provision of housing assistance, housing-related emergency services, soup kitchen services, distribution of used and donated furniture, and disaster recovery services that benefit residents of Monroe County, and WHEREAS, it is a legitimate publiC purpose to provide housing assistance, housing-related emergency services, soup kitchen services, distribution of used and donated furniture, and disaster recovery services that benefit residents 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 housing assistance, housing-related emergency services, soup kitchen services, distribution of used and donated furniture, and disaster recovery services that benefit residents of Monroe County, Florida, shall pay to the PROVIDER the sum of NINETEEN THOUSAND, THREE HUNDRED, FORTY-EIGHT, AND 00/100 DOLLARS ($19,348.00) for fiscal year 2002-2003. 2. TERM. This Agreement shall commence on October 1, 2002, and terminate September 30, 2003, 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 housing assistance, hOUSing-related emergency services, soup kitchen services, distribution of used and donated furniture, and disaster recovery services that benefit residents 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 SOl(c)(3) status; (b) a list of the organization's Board of Directors of which there must be five or more; (c) evidence of annual election of Officers and Directors; Cd) 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. As provided by applicable law, the PROVIDER shall not discriminate against any person on the basis of 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. As provided by applicable law, 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 Gato Building 1100 Simonton Street Key West, Fl33040 and Monroe County Attorney PO Box 1026 Key West, Fl 33041 For PROVIDER Anita Brackett, Executive Director Catholic Charities 2700 Flagler Avenue Key West, Fl 33045 305-292-9790 305-872-4076 305-292-5257 FAX 16. CONSENT TO JURISDICTION. This agreement shall be construed by and governed under the laws of the State of Florida and venue for any action arising under this agreement shall be in Monroe County, Florida. 17. NON-WAIVER. Any waiver of any breach of covenants herein contained to be kept and performed by the PROVIDER shall not be deemed or considered as a continuing waiver and shall not operate to bar or prevent the Board from declaring a forfeiture for any succeeding breach, either of the same conditions or covenants or otherwise. 18. AVAILABILITY OF FUNDS. If funds cannot be obtained or cannot be continued at a level sufficient to allow for continued reimbursement of expenditures for services specified herein, this agreement may be terminated immediately at the option of the Board by written notice of termination delivered to the PROVIDER. The Board shall not be obligated to pay for any services or goods provided by the PROVIDER after the PROVIDER has received written notice of termination, unless otherwise required by law. 19. PURCHASE OF PROPERTY. All property, whether real or personal, purchased with funds provided under this agreement, shall become the property of Monroe County and shall be accounted for pursuant to statutory requirements. 20. TERMINATION. Either party may terminate this agreement upon thirty (30) days written notice. 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 PROVIDER (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 appreciated to facilitate the audit trail. Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example, taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is considered a reimbursable travel expense at the destination. Airport parking during a business trip is not. A detailed list of charges is required on the lodging invoice. Balance due must be zero. Room must be registered and paid for by traveler. The County will only reimburse the actual room and related bed tax. Room service, movies, and personal telephone calls are not allowable expenses. Meal reimbursement is: breakfast at $3.00, lunch at $6.00, and dinner at $12.00. Meal guidelines state that travel must begin prior to 6 a.m. for breakfast reimbursement, before noon and end after 2 p.m. for lunch reimbursement, and before 6 p.m. and end after 8 p.m. for dinner reimbursement. Mileage reimbursement is calculated at .29 cents per mile for personal auto mileage while on County business. An odometer reading must be included on the state travel voucher for vicinity travel. Mileage is not allowed from a residence or office to a point of departure. For example, driving form one's home to the airport for a business trip is not a reimbursable expense. Non-allowable Expenses The following expenses are not allowable for reimbursement: capital outlay expenditures (unless specifically included in the contract), contributions, depreciation expenses (unless specifically included in the contract), entertainment expenses, fundraising, non-sufficient check charges, penalties and fines. ATTACHMENT B ORGANIZATION LETTERHEAD Monroe County Board of County Commissioners Finance Department 500 Whitehead Street Key West, FL 33040 Date The following is a summary of the expenses for ( Organization name) for the time period of to Check # Payee Reason Amount 101 Company A Rent $ X,XXX.XX 102 Company B Utilities XXX.XX 104 Employee A P/R ending 05/14/01 XXX.XX 105 Employee B P/R ending OS/28/01 XXX .XX (A) Total $ X.XXX.XX (B) Total prior payments $ X,XXX.XX (C) Total requested and paid (A + B) $ X,XXX.XX (D) Total contract amount $ X,XXX.XX Balance of contract (D-C) $ X.XXX.XX I certify that the above checks have been submitted to the vendors as noted and that the expenses are accurate and in agreement with the records of this organization. Furthermore, these expenses are in compliance with this organizations_ contract with the Monroe County Board of County Commissioners and will not be submitted for reimbursement to any other funding source. Executive Director Attachments (supporting documentation) Sworn to and subscribed before me this _ day of 2002 by who is personally known to me. Notary Public Notary Stamp ATTACHMENT C DESCRIPTION OF SERVICES TO BE PROVIDED Services such as, but not necessarily limited to, housing assistance, housing-related emergency services, soup kitchen services, distribution of used and donated furniture, and disaster recovery services. SWORN STATEMENT UNDER ORDINANCE NO. 10-1990 MONROE COUNTY, FLORIDA ETHICS CLAUSE warrants that he/it has not employed, retained or otherwise had act on his/its behalf any former County officer or employee in violation of Section 2 of Ordinance No. 10-1990 or any County officer or employee in violation of Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the County may, in its discretion, terminate this contract without liability and may also, in its discretion, deduct from the contract or purchase price, or otherwise recover, the full amount of any fee, commission, percentage, gift, or consideration paid to the former County officer or employee. (signature) Date: STATE OF COUNTY OF PERSONALLY APPEARED BEFORE ME, the undersigned authority, who, after first being sworn by me, affixed his/her signature (name of individual signing) in the space provided above on this day of , 20---,-. NOTARY PUBLIC My commission expires: OMB - MCP FORM #4 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." MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract # Contract with: Domestic Abuse Shelter Effective Date: 10/01/02 Expiration Date: 9/30/03 Contract Purpose/Description: provides funding to perform services such as shelter, counseling and other appropriate services to battered spouses. Contract Manager: David P. Owens (Name) OMB/Grants (Department) 4482 (Ext.) for BOCC meeting on 10/16/02 Agenda Deadline: 10/02/02 CONTRACT COSTS Total Dollar Value of Contract: $29,022.00 Current Year Portion: $29,022.00 Budgeted? Yes~ No 0 Account Codes: 001-03201-530340-_ Grant: $0.00 _-_-_-_ County Match: $ _-_-_-_ - - - ---- Estimated Ongoing Costs: $ (Not included in dollar value above) ADDITIONAL COSTS /yr For: (el!. maintenance, utilities, ianitorial, salaries, etc.) CONTRACT REVIEW Changes Date In Needed ~ReVl r Division Director /,:,_). _.::>........ YesD N~~- ,- - -- Risk Management <(' &\ ,i:iY YesO No0 ,- - -- , , " , ,. :' , O,M.B/Purchasing "liufaz.- Y esO No~ ~ County Attorney ~ 115/ " 2.- YesD NoW . Comments: Date Out I.., - )'-.:l2-- '?' (~\ -oj- '8jrZh/D2 c- ~0v OMB Form Revised 9/11/95 MCP #2 AGREEMENT This Agreement is made and entered into this day of , 2002, between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter referred to as "Board" or "County," and The Domestic Abuse Shelter, Inc., hereinafter referred to as "PROVIDER." WHEREAS, the PROVIDER is a not-for-profit corporation established for the provision of comprehensive services for individuals and families experiencing domestic and sexual abuse, and WHEREAS, it is a legitimate public purpose to provide facilities and services for the provision of comprehensive services for individuals and families experiencing domestic and sexual abuse, now, therefore, IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed as follows: 1. AMOUNT OF AGREEMENT. The Board, in consideration of the PROVIDER substantially and satisfactorily performing and carrying out the duties of the Board as to providing facilities and services for comprehensive services for individuals and families living in Monroe County, Florida experiencing domestic and sexual abuse, shall pay to the PROVIDER the sum of TWENTY-NINE- THOUSAND, TWENTY-TWO AND 00/100 DOLLARS ($29,022.00) for fiscal year 2002-2003. 2. TERM. This Agreement shall commence on October 1, 2002, and terminate September 30, 2003, unless earlier terminated pursuant to other provisions herein. 3. PAYMENT. Payment will be paid periodically, but no more frequently than monthly as hereinafter set forth. Reimbursement requests will be submitted to the Board via the Clerk's Finance Office. The COUNTY shall only reimburse, subject to the funded amounts below, those reimbursable expenses which are reviewed and approved as complying with Florida Statutes 112.061 and Attachment A - Expense Reimbursement Requirements. Evidence of payment by the PROVIDER shall be in the form of a letter, summarizing the expenses, with supporting documentation attached. The letter should contain a certification statement. An example of a reimbursement request cover letter is included as Attachment B. The organization's final invoice must be received within sixty days after the termination date of this contract shown in Article 2 above. After the Clerk of the Board examines and approves the request for reimbursement, the Board shall reimburse the PROVIDER. However, the total of said reimbursement expense payments in the aggregate sum shall not exceed the total amount shown in Article 1, above, during the term of this agreement. 4. SCOPE OF SERVICES. The PROVIDER, for the consideration named, covenants and agrees with the Board to substantially and satisfactorily perform and carry out the duties of the Board in providing comprehensive services for individuals and families experiencing domestic and sexual abuse to persons and families living in Monroe County, Florida. PROVIDER shall provide services described in Attachment C, attached hereto and incorporated herein. S. RECORDS. The PROVIDER shall maintain appropriate records to insure a proper accounting of all funds and expenditures, and shall provide a clear financial audit trail to allow for full accountability of funds received from said Board. Access to these records shall be provided during weekdays, 8 A.M. to 5 P.M., upon request of the Board, the State of Florida, or authorized agents and representatives of the Board or State. The PROVIDER shall be responsible for repayment of any and all audit exceptions which are identified by the Auditor General of the State of Florida, the Clerk of Court for Monroe County, an independent auditor, or their agents and representatives. In the event of an audit exception, the current fiscal year contract amount or subsequent fiscal year contract amounts shall be offset by the amount of the audit exception. In the event this agreement is not renewed or continued in subsequent years through new or amended contracts, the PROVIDER shall be billed by the Board for the amount of the audit exception and the PROVIDER shall promptly repay any audit exception. 6. INDEMNIFICATION AND HOLD HARMLESS. The PROVIDER covenants and agrees to indemnify and hold harmless Monroe County Board of County Commissioners from any and all claims for bodily injury (including death), personal injury, and property damage (including property owned by Monroe County) and any other losses, damages, and expenses (including attorney's fees) which arise out of, in connection with, or by reason of services provided by the PROVIDER occasioned by the negligence, errors, or other wrongful act or omission of the PROVIDER'S employees, agents, or volunteers. 7. INDEPENDENT CONTRACTOR. At all times and for all purposes hereunder, the PROVIDER is an independent contractor and not an employee of the Board. No statement contained in this agreement shall be construed so as to find the PROVIDER or any of its employees, contractors, servants or agents to be employees of the Board. 8. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement, the PROVIDER shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating the provision of such services, including those now in effect and hereinafter adopted. Any violation of said statutes, ordinances, rules and regulations shall constitute a material breach of this agreement and shall entitle the Board to terminate this contract immediately upon delivery of written notice of termination to the PROVIDER. 9. COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the COUNTY: (a) evidence of the organization's SOl(c)(3) status; (b) a list of the organization's Board of Directors of which there must be five or more; (c) evidence of annual election of Officers and Directors; (d) an annual audited financial report; (e) a copy the organization's Corporate Bylaws, which must address the organization's mission, board and membership composition, election of officers, and so on; (f) a copy of the organization's Corporate Policies and Procedures Manual which must include hiring policies for all staff, drug and alcohol free workplace provisions, equal employment opportunity provisions, and so on; (g) cooperation with County monitoring visits; (h) semi-annual performance reports. These reports should include performance measurements which will demonstrate the level of accomplishment of goals for which funding has been provided. (i) other reasonable reports and information related to compliance with applicable laws, contract provisions and the scope of services that the County may from time to time request. 10. PROFESSIONAL RESPONSIBILITY AND LICENSING. The PROVIDER shall assure that all professionals have current and appropriate professional licenses and professional liability insurance coverage. Funding by the Board is contingent upon retention of appropriate local, state and/or federal certification and/or licensure of the PROVIDER'S program and staff. 11. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services and/or reimbursement of services shall be accomplished by an amendment, which must be approved in writing by the COUNTY. 12. NO ASSIGNMENT. The PROVIDER shall not assign this agreement except in writing and with the prior written approval of the Board, which approval shall be subject to such conditions and provisions as the Board may deem necessary. This agreement shall be incorporated by reference into any assignment and any assignee shall comply with all of the provisions herein. Unless expressly provided for therein, such approval shall in no manner or event be deemed to impose any obligation upon the Board in addition to the total agreed upon reimbursement amount for the services of the PROVIDER. . . 13. NON-DISCRIMINATION. The PROVIDER shall not discriminate against any person on the basis race, creed, color, national origin, sex or sexual orientation, age, physical handicap, or any other characteristic or aspect which is not job-related in its recruiting, hiring, promoting, terminating or any other area affecting employment under this agreement. At all times, the PROVIDER shall comply with all applicable laws and regulations with regard to employing the most qualified person(s) for positions under this agreement. The PROVIDER shall not discriminate against any person on the basis of race, creed, color, national origin, sex or sexual orientation, age, physical handicap, financial status or any characteristic or aspect in its providing of services. 14. AUTHORIZED SIGNATURES. The signatory for the PROVIDER below, certifies and warrants that: (a) The PROVIDER'S name in this agreement is the full name as designated in its corporate charter, if a corporation, or the full name under which the PROVIDER is authorized to do business in the State of Florida. (b) He or she is empowered to act and contract for the PROVIDER; and (c) This agreement has been approved by the Board of Directors of the PROVIDER if the PROVIDER is a corporation. 15. NOTICE. Any notice required or permitted under this agreement shall be in writing and hand-delivered or mailed, postage pre-paid, by certified mail, return receipt requested, to the other party as follows: For Board: David P. Owens, Grants Administrator Gato Building 1100 Simonton Street Key West, Fl33040 and Monroe County Attorney PO Box 1026 Key West, Fl 33041 For PROVIDER Venita Garvin, Executive Director Domestic Abuse Shelter, Inc. POBox 522696 78 Coco Plum Drive Marathon, Fl 33052 16. CONSENT TO JURISDICTION. This agreement shall be construed by and governed under the laws of the State of Florida and venue for any action arising under this agreement shall be in Monroe County, Florida. 17. NON-WAIVER. Any waiver of any breach of covenants herein contained to be kept and performed by the PROVIDER shall not be deemed or considered as a continuing waiver and shall not operate to bar or prevent the Board from declaring a forfeiture for any succeeding breach, either of the same conditions or covenants or otherwise. 18. AVAILABILITY OF FUNDS. If funds cannot be obtained or cannot be continued at a level sufficient to allow for continued reimbursement of expenditures for services specified herein, this agreement may be terminated immediately at the option of the Board by written notice of termination delivered to the PROVIDER. The Board shall not be obligated to pay for any services or goods provided by the PROVIDER after the PROVIDER has received written notice of termination, unless otherwise required by law. 19. PURCHASE OF PROPERTY. All property, whether real or personal, purchased with funds provided under this agreement, shall become the property of Monroe County and shall be accounted for pursuant to statutory requirements. 20. ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the parties hereto with respect to the subject matter hereof and supersedes any and all prior agreements with respect to such subject matter between the PROVIDER and the Board. IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed as of the day and year first written above. (SEAL) ATTEST: DANNY L. KOlHAGE, CLERK BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA By By Deputy Clerk Mayor/Chairman PROVIDER (Federal ID No. ) Witness By Witness President BY Z NN~ ~}~ON ,",.n:-W.J-- - ATTACHMENT A EXPENSE REIMBURSEMENT REQUIREMENTS This document is intended to provide basic guidelines to Human Service Organizations, county travelers, and contractual parties who have reimbursable expenses associated with Monroe County business. These guidelines, as they relate to travel, are from Florida Statute 112.061. A cover letter summarizing the major line items on the reimbursable expense request needs to also contain a notarized certified statement such as: "I certify that the attached expenses are accurate and in agreement with the records of this organization. Furthermore, these expenses are in compliance with this organization's contract with the Monroe County Board of County Commissioners," Invoices should be billed to the contracting agency. Third party payments will not be considered for reimbursement. Remember, the expense should be paid prior to requesting a reimbursement. Only current charges will be considered, no previous balances. Reimbursement requests will be monitored in accordance with the level of detail in the contract. This document should not be considered all-inclusive. The Clerk's Finance Department reserves the right to review reimbursement requests on an individual basis. Any questions regarding these guidelines should be directed to 305-292-3534. Data Processing, PC Time, etc. The vendor invoice is required for reimbursement. Inter-company allocations are not considered reimbursable expenditures unless appropriate payroll journals for the charging department are attached and certified. Payroll A certified statement verifying the accuracy and authenticity of the payroll expense is needed. If a Payroll Journal is provided, it should include: dates, employee name, salary or hourly rate, total hours worked, withholding information and payroll taxes, check number and check amount. If a Payroll Journal is not provided, the following information must be provided: check amount, check number, date, payee, support for applicable payroll taxes. Postage, Overnight Deliveries, Courier, etc. A log of all postage expenses as they relate to the County contract is required for reimbursement. For overnight or express deliveries, the vendor invoice must be included. Rents, Leases, etc. A copy of the rental or lease agreement is required. Deposits and advance payments are not allowable expenses. Reproductions, Copies, etc. A log of copy expenses as they relate to the County contract is required for reimbursement. The log must define the date, number of copies made, source document, purpose, and recipient. A reasonable fee for copy expenses will be allowable. For vendor services, the vendor invoice and a sample of the finished product are required. Supplies, Services, etc. For supplies or services ordered, a vendor invoice is required. Telefax, Fax, etc. A fax log is required. The log must define the sender, the intended recipient, the date, the number called, and the reason for sending the fax. Telephone Expenses A user log of pertinent information must be remitted including: the party called, the caller, the telephone number, the date, and the purpose of the call. Travel Expenses Travel expenses must be submitted on a State of Florida Voucher for Reimbursement of Travel Expenses. Travel must be submitted in accordance with Florida Statute 112.061. Credit card statements are not acceptable documentation for reimbursement. If attending a conference or meeting a copy of the agenda is needed. Airfare reimbursement requires the original passenger receipt portion of the airline ticket. A travel itinerary is appreciated to facilitate the audit trail. Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example, taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is considered a reimbursable travel expense at the destination. Airport parking during a business trip is not. A detailed list of charges is required on the lodging invoice. Balance due must be zero. Room must be registered and paid for by traveler. The County will only reimburse the actual room and related bed tax. Room service, movies, and personal telephone calls are not allowable expenses. Meal reimbursement is: breakfast at $3.00, lunch at $6.00, and dinner at $12.00. Meal guidelines state that travel must begin prior to 6 a.m. for breakfast reimbursement, before noon and end after 2 p.m. for lunch reimbursement, and before 6 p.m. and end after 8 p.m. for dinner reimbursement. Mileage reimbursement is calculated at .29 cents per mile for personal auto mileage while on County business. An odometer reading must be included on the state travel voucher for vicinity travel. Mileage is not allowed from a residence or office to a point of departure. For example, driving form one's home to the airport for a business trip is not a reimbursable expense. Non-allowable Expenses The following expenses are not allowable for reimbursement: capital outlay expenditures (unless specifically included in the contract), contributions, depreciation expenses (unless speCifically included in the contract), entertainment expenses, fundraising, non-sufficient check charges, penalties and fines. ATTACHMENT B ORGANIZATION LETTERHEAD Monroe County Board of County Commissioners Finance Department 500 Whitehead Street Key West, FL 33040 Date The following is a summary of the expenses for ( Organization name) for the time period of to Check # Payee Reason Amount 101 Company A Rent $ X,XXX.XX 102 Company B Utilities XXX.XX 104 Employee A P/R ending 05/14/01 XXX.XX 105 Employee B P/R ending OS/28/01 XXX .XX (A) Total $ X.XXX.XX (B) Total prior payments $ X,XXX.XX (C) Total requested and paid (A + B) $ X,XXX.XX (D) Total contract amount $ X,XXX.XX Balance of contract (D-C) $ X.XXX.XX I certify that the above checks have been submitted to the vendors as noted and that the expenses are accurate and in agreement with the records of this organization. Furthermore, these expenses are in compliance with this organizations_ contract with the Monroe County Board of County Commissioners and will not be submitted for reimbursement to any other funding source. Executive Director Attachments (supporting documentation) Sworn to and subscribed before me this _ day of 2002 by who is personally known to me. Notary Public Notary Stamp ATTACHMENT C Provision of comprehensive services for individuals and families experiencing domestic and sexual abuse. Reduction of the incidence and minimization of the impact of domestic and sexual abuse in Monroe county by directing the appropriate, effective programs and services at victims and abusers. SWORN STATEMENT UNDER ORDINANCE NO. 10-1990 MONROE COUNTY. FLORIDA ETHICS CLAUSE warrants that he/it has not employed, retained or otherwise had act on his/its behalf any former County officer or employee in violation of Section 2 of Ordinance No. 10-1990 or any County officer or employee in violation of Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the County may, in its discretion, terminate this contract without liability and may also, in its discretion, deduct from the contract or purchase price, or otherwise recover, the full amount of any fee, commission, percentage, gift, or consideration paid to the former County officer or employee. (signature) Date: STATE OF COUNTY OF PERSONAllY APPEARED BEFORE ME, the undersigned authority, who, after first being sworn by me, affixed his/her signature (name of individual signing) in the space provided above on this day of , 20---,--, NOTARY PUBLIC My commission expires: OMB - MCP FORM #4 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." MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract # Contract with: Florida Keys Children's Effective Date: 10/01/02 Shelter Expiration Date: 9/30/03 Contract Purpose/Description: provides funding to perform services such as shelter, and early intervention and prevention programs for youths and their families. Contract Manager: David P. Owens (N ame) 4482 (Ext.) OMB/Grants (Department) for BOCC meeting on 10/16/02 Agenda Deadline; 10/02/02 CONTRACT COSTS Total Dollar Value of Contract: $35,020.00 Budgeted? Yesl:8J No D Account Codes: Grant: $0.00 County Match: $ Current Year Portion: $35,020.00 001-03002-530340-_ - - - ---- - - - ---- - - - ---- ADDITIONAL COSTS Estimated Ongoing Costs: $_/yr For: (Not included in dollar value above) (eg. maintenance, utilities, ianitorial, salaries, etc.) CONTRACT REVIEW Changes Date In Needed Division Director Ie _)..._.:>'- YesD NoB-: Risk Management t5 'd-.f-o Ci--- YesD No~ O.M.B./Purchasing ~lJZ.-. Y esD No~ County Attorney E' /15'102- YesD Noc;r/' Date Out /-,> ._:).-0<- ~01 -d.,)- 8~Dlu ~0~ Comments: OMB Form Revised 9/11/95 MCP #2 AGREEMENT This Agreement is made and entered into this day of , 2002, between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter referred to as "Board" or "County," and Florida Keys Children's Shelter, Inc., hereinafter referred to as "PROVIDER." WHEREAS, the PROVIDER is a not-for-profit corporation established for the provision of shelter and counseling to youth and families, and WHEREAS, it is a legitimate public purpose to provide facilities and services for the provision of shelter and counseling to youth and families, now, therefore, IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed as follows: 1. AMOUNT OF AGREEMENT. The Board, in consideration of the PROVIDER substantially and satisfactorily performing and carrying out the duties of the Board as to providing facilities and services for shelter and counseling to youth and families living in Monroe County, Florida, shall pay to the PROVIDER the sum of THIRTY-FIVE-THOUSAND, TWENTY, AND 00/100 DOLLARS ($35,020.00) for fiscal year 2002-2003. 2. TERM. This Agreement shall commence on October 1, 2002, and terminate September 30, 2003, unless earlier terminated pursuant to other provisions herein. 3. PAYMENT. Payment will be paid periodically, but no more frequently than monthly as hereinafter set forth. Reimbursement requests will be submitted to the Board via the Clerk's Finance Office. The COUNTY shall only reimburse, subject to the funded amounts below, those reimbursable expenses which are reviewed and approved as complying with Florida Statutes 112.061 and Attachment A - Expense Reimbursement Requirements. Evidence of payment by the PROVIDER shall be in the form of a letter, summarizing the expenses, with supporting documentation attached. The letter should contain a certification statement. An example of a reimbursement request cover letter is included as Attachment B. The organization's final invoice must be received within sixty days after the termination date of this contract shown in Article 2 above. After the Clerk of the Board examines and approves the request for reimbursement, the Board shall reimburse the PROVIDER. However, the total of said reimbursement expense payments in the aggregate sum shall not exceed the total amount shown in Article 1, above, during the term of this agreement. 4. SCOPE OF SERVICES. The PROVIDER, for the consideration named, covenants and agrees with the Board to substantially and satisfactorily perform and carry out the duties of the Board in providing shelter and counseling to youth and families living in Monroe County, Florida. PROVIDER shall provide services described in Attachment C, attached hereto and incorporated herein. S. RECORDS. The PROVIDER shall maintain appropriate records to insure a proper accounting of all funds and expenditures, and shall provide a clear financial audit trail to allow for full accountability of funds received from said Board. Access to these records shall be provided during weekdays, 8 A.M. to 5 P.M., upon request of the Board, the State of Florida, or authorized agents and representatives of the Board or State. The PROVIDER shall be responsible for repayment of any and all audit exceptions which are identified by the Auditor General of the State of Florida, the Clerk of Court for Monroe County, an independent auditor, or their agents and representatives. In the event of an audit exception, the current fiscal year contract amount or subsequent fiscal year contract amounts shall be offset by the amount of the audit exception. In the event this agreement is not renewed or continued in subsequent years through new or amended contracts, the PROVIDER shall be billed by the Board for the amount of the audit exception and the PROVIDER shall promptly repay any audit exception. 6. INDEMNIFICATION AND HOLD HARMLESS. The PROVIDER covenants and agrees to indemnify and hold harmless Monroe County Board of County Commissioners from any and all claims for bodily injury (including death), personal injury, and property damage (including property owned by Monroe County) and any other losses, damages, and expenses (including attorney's fees) which arise out of, in connection with, or by reason of services provided by the PROVIDER occasioned by the negligence, errors, or other wrongful act or omission of the PROVIDER'S employees, agents, or volunteers. 7. INDEPENDENT CONTRACTOR. At all times and for all purposes hereunder, the PROVIDER is an independent contractor and not an employee of the Board. No statement contained in this agreement shall be construed so as to find the PROVIDER or any of its employees, contractors, servants or agents to be employees of the Board. 8. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement, the PROVIDER shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating the provision of such services, including those now in effect and hereinafter adopted. Any violation of said statutes, ordinances, rules and regulations shall constitute a material breach of this agreement and shall entitle the Board to terminate this contract immediately upon delivery of written notice of termination to the PROVIDER. 9. COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the COUNTY: (a) evidence of the organization's SOl(c)(3) status; (b) a list of the organization's Board of Directors of which there must be five or more; (c) evidence of annual election of Officers and Directors; (d) an annual audited financial report; (e) a copy the organization's Corporate Bylaws, which must address the organization's mission, board and membership composition, election of officers, and so on; (f) a copy of the organization's Corporate Policies and Procedures Manual which must include hiring policies for all staff, drug and alcohol free workplace provisions, equal employment opportunity provisions, and so on; (g) cooperation with County monitoring visits; (h) semi-annual performance reports. These reports should include performance measurements which will demonstrate the level of accomplishment of goals for which funding has been provided. (i) other reasonable reports and information related to compliance with applicable laws, contract provisions and the scope of services that the County may from time to time request. 10. PROFESSIONAL RESPONSIBILITY AND LICENSING. The PROVIDER shall assure that all professionals have current and appropriate professional licenses and professional liability insurance coverage. Funding by the Board is contingent upon retention of appropriate local, state and/or federal certification and/or licensure of the PROVIDER'S program and staff. 11. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services and/or reimbursement of services shall be accomplished by an amendment, which must be approved in writing by the COUNTY. 12. NO ASSIGNMENT. The PROVIDER shall not assign this agreement except in writing and with the prior written approval of the Board, which approval shall be subject to such conditions and provisions as the Board may deem necessary. This agreement shall be incorporated by reference into any assignment and any assignee shall comply with all of the provisions herein. Unless expressly provided for therein, such approval shall in no manner or event be deemed to impose any obligation upon the Board in addition to the total agreed upon reimbursement amount for the services of the PROVIDER. 13. NON-DISCRIMINATION. The PROVIDER shall not discriminate against any person on the basis race, creed, color, national origin, sex or sexual orientation, age, physical handicap, or any other characteristic or aspect which is not job-related in its recruiting, hiring, promoting, terminating or any other area affecting employment under this agreement. At all times, the PROVIDER shall comply with all applicable laws and regulations with regard to employing the most qualified person(s) for positions under this agreement. The PROVIDER shall not discriminate against any person on the basis of race, creed, color, national origin, sex or sexual orientation, age, physical handicap, financial status or any characteristic or aspect in its providing of services. 14. AUTHORIZED SIGNATURES. The signatory for the PROVIDER below, certifies and warrants that: (a) The PROVIDER'S name in this agreement is the full name as designated in its corporate charter, if a corporation, or the full name under which the PROVIDER is authorized to do business in the State of Florida. (b) He or she is empowered to act and contract for the PROVIDER; and (c) This agreement has been approved by the Board of Directors of the PROVIDER if the PROVIDER is a corporation. 15. NOTICE. Any notice required or permitted under this agreement shall be in writing and hand-delivered or mailed, postage pre-paid, by certified mail, return receipt requested, to the other party as follows: For Board: David P. Owens, Grants Administrator Gato Building 1100 Simonton Street Key West, Fl33040 For PROVIDER Kathleen Tuell, Executive Director Florida Keys Children's Shelter, Inc. 73 High Point Road Tavernier, Fl 33070 305-852-4246 305-852-6902 FAX and Monroe County Attorney PO Box 1026 Key West, Fl 33041 16. CONSENT TO JURISDICTION. This agreement shall be construed by and governed under the laws of the State of Florida and venue for any action arising under this agreement shall be in Monroe County, Florida. 17. NON-WAIVER. Any waiver of any breach of covenants herein contained to be kept and performed by the PROVIDER shall not be deemed or considered as a continuing waiver and shall not operate to bar or prevent the Board from declaring a forfeiture for any succeeding breach, either of the same conditions or covenants or otherwise. 18. AVAILABILITY OF FUNDS. If funds cannot be obtained or cannot be continued at a level sufficient to allow for continued reimbursement of expenditures for services specified herein, this agreement may be terminated immediately at the option of the Board by written notice of termination delivered to the PROVIDER. The Board shall not be obligated to pay for any services or goods provided by the PROVIDER after the PROVIDER has received written notice of termination, unless otherwise required by law. 19. PURCHASE OF PROPERTY. All property, whether real or personal, purchased with funds provided under this agreement, shall become the property of Monroe County and shall be accounted for pursuant to statutory requirements. 20. ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the parties hereto with respect to the subject matter hereof and supersedes any and all prior agreements with respect to such subject matter between the PROVIDER and the Board. IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed as of the day and year first written above. (SEAL) ATTEST: DANNY L. KOLHAGE, CLERK BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA By By Deputy Clerk Mayor/Chairman PROVIDER (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 appreciated to facilitate the audit trail. Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example, taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is considered a reimbursable travel expense at the destination. Airport parking during a business trip is not. A detailed list of charges is required on the lodging invoice. Balance due must be zero. Room must be registered and paid for by traveler. The County will only reimburse the actual room and related bed tax. Room service, movies, and personal telephone calls are not allowable expenses. Meal reimbursement is: breakfast at $3.00, lunch at $6.00, and dinner at $12.00. Meal guidelines state that travel must begin prior to 6 a.m. for breakfast reimbursement, before noon and end after 2 p.m. for lunch reimbursement, and before 6 p.m. and end after 8 p.m. for dinner reimbursement. Mileage reimbursement is calculated at .29 cents per mile for personal auto mileage while on County business. An odometer reading must be included on the state travel voucher for vicinity travel. Mileage is not allowed from a residence or office to a point of departure. For example, driving form one's home to the airport for a business trip is not a reimbursable expense. Non-allowable Expenses The following expenses are not allowable for reimbursement: capital outlay expenditures (unless specifically included in the contract), contributions, depreciation expenses (unless specifically included in the contract), entertainment expenses, fund raising, non-sufficient check charges, penalties and fines. ATTACHMENT B ORGANIZATION 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 2002 by who is personally known to me. Notary Public Notary Stamp DESCRIPTION OF SERVICES TO BE PROVIDED Shelter for youth in need aged ten through seventeen. Community-based counseling program at schools throughout the Keys. ATTACHMENT C SWORN STATEMENT UNDER ORDINANCE NO. 10-1990 MONROE COUNTY. FLORIDA ETHICS CLAUSE warrants that he/it has not employed, retained or otherwise had act on his/its behalf any former County officer or employee in violation of Section 2 of Ordinance No. 10-1990 or any County officer or employee in violation of Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the County may, in its discretion, terminate this contract without liability and may also, in its discretion, deduct from the contract or purchase price, or otherwise recover, the full amount of any fee, commission, percentage, gift, or consideration paid to the former County officer or employee. (signature) Date: STATE OF COUNTY OF PERSONALLY APPEARED BEFORE ME, the undersigned authority, who, after first being sworn by me, affixed his/her signature (name of individual signing) in the space provided above on this day of , 20---,--. NOTARY PUBLIC My commission expires: OMB - MCP FORM #4 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." MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract # Contract with: Florida Keys Outreach Effective Date: 1 % 1/02 Coalition Expiration Date:9/30/03 Contract Purpose/Description: provides funding to perform services such as shelter, and other services for homeless persons in Momoe County. Contract Manager: David P. Owens (Name) 4482 (Ext. ) OMB/Grants (Department) for BOCC meeting on 10/16/02 Agenda Deadline: 10/02/02 CONTRACT COSTS Total Dollar Value of Contract: $19,928.00 Budgeted? Y es~ No D Account Codes: Grant: $0.00 County Match: $ Current Year Portion: $19,928.00 001-03206-530340-_ - - - ---- - - - ---- - - ---- ADDITIONAL COSTS Estimated Ongoing Costs: $_/yr For: (Not included in dollar value above) (eg. maintenance, utilities, ianitorial, salaries, etc.) CONTRACT REVIEW Division Director Date Out !-:.-L- 0"1.- Risk Management 8'.o,.J -Oo-YesD NoG}- O.M.B.IPurchasinglll-D!OZ__YesD No~ ~ County Attorney f'/Is:lo2-YesDNo~ ~ gc).) -Dd- oj~D ~~2- Comments: OMB Form Revised 9/11/95 MCP #2 AGREEMENT This Agreement is made and entered into this day of , 2002, between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter referred to as "Board" or "County," and Florida Keys Outreach Coalition, Inc., hereinafter referred to as "PROVIDER." WHEREAS, the PROVIDER is a not-for-profit corporation established for the provision of shelter to homeless individuals and families, and WHEREAS, it is a legitimate public purpose to provide facilities and services to provide shelter to homeless individuals and families, now, therefore, IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed as follows: 1. AMOUNT OF AGREEMENT. The Board, in consideration of the PROVIDER substantially and satisfactorily performing and carrying out the duties of the Board as to providing facilities and services for homeless individuals and families living in Monroe County, Florida, shall pay to the PROVIDER the sum of NINETEEN-THOUSAND. NINE-HUNDRED. TWENTY-EIGHT. AND 00/100 DOLLARS ($19.928.00) for fiscal year 2002-2003. 2. TERM. This Agreement shall commence on October 1, 2002, and terminate September 30, 2003, unless earlier terminated pursuant to other provisions herein. 3. PAYMENT. Payment will be paid periodically, but no more frequently than monthly as hereinafter set forth. Reimbursement requests will be submitted to the Board via the Clerk's Finance Office. The COUNTY shall only reimburse, subject to the funded amounts below, those reimbursable expenses which are reviewed and approved as complying with Florida Statutes 112.061 and Attachment A - Expense Reimbursement Requirements. Evidence of payment by the PROVIDER shall be in the form of a letter, summarizing the expenses, with supporting documentation attached. The letter should contain a certification statement. An example of a reimbursement request cover letter is included as Attachment B. The organization's final invoice must be received within sixty days after the termination date of this contract shown in Article 2 above. After the Clerk of the Board examines and approves the request for reimbursement, the Board shall reimburse the PROVIDER. However, the total of said reimbursement expense payments in the aggregate sum shall not exceed the total amount shown in Article 1, above, during the term of this agreement. 4. SCOPE OF SERVICES. The PROVIDER, for the consideration named, covenants and agrees with the Board to substantially and satisfactorily perform and carry out the duties of the Board in providing shelter to homeless individuals and families living in Monroe County, Florida. PROVIDER shall provide services described in Attachment C, attached hereto and incorporated herein. 5. RECORDS. The PROVIDER shall maintain appropriate records to insure a proper accounting of all funds and expenditures, and shall provide a clear financial audit trail to allow for full accountability of funds received from said Board. Access to these records shall be provided during weekdays, 8 A.M. to 5 P.M., upon request of the Board, the State of Florida, or authorized agents and representatives of the Board or State. The PROVIDER shall be responsible for repayment of any and all audit exceptions which are identified by the Auditor General of the State of Florida, the Clerk of Court for Monroe County, an independent auditor, or their agents and representatives. In the event of an audit exception, the current fiscal year contract amount or subsequent fiscal year contract amounts shall be offset by the amount of the audit exception. In the event this agreement is not renewed or continued in subsequent years through new or amended contracts, the PROVIDER shall be billed by the Board for the amount of the audit exception and the PROVIDER shall promptly repay any audit exception. 6. INDEMNIFICATION AND HOLD HARMLESS. The PROVIDER covenants and agrees to indemnify and hold harmless Monroe County Board of County Commissioners from any and all claims for bodily injury (including death), personal injury, and property damage (including property owned by Monroe County) and any other losses, damages, and expenses (including attorney's fees) which arise out of, in connection with, or by reason of services provided by the PROVIDER occasioned by the negligence, errors, or other wrongful act or omission of the PROVIDER'S employees, agents, or volunteers. 7. INDEPENDENT CONTRACTOR. At all times and for all purposes hereunder, the PROVIDER is an independent contractor and not an employee of the Board. No statement contained in this agreement shall be construed so as to find the PROVIDER or any of its employees, contractors, servants or agents to be employees of the Board. 8. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement, the PROVIDER shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating the provision of such services, including those now in effect and hereinafter adopted. Any violation of said statutes, ordinances, rules and regulations shall constitute a material breach of this agreement and shall entitle the Board to terminate this contract immediately upon delivery of written notice of termination to the PROVIDER. 9. COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the COUNTY: (a) evidence of the organization's 501(c)(3) status; (b) a list of the organization's Board of Directors of which there must be five or more; (c) evidence of annual election of Officers and Directors; (d) an annual audited financial report; (e) a copy the organization's Corporate Bylaws, which must address the organization's mission, board and membership composition, election of officers, and so on; (f) a copy of the organization's Corporate Policies and Procedures Manual which must include hiring policies for all staff, drug and alcohol free workplace provisions, equal employment opportunity provisions, and so on; (g) cooperation with County monitoring visits; (h) semi-annual performance reports. These reports should include performance measurements which will demonstrate the level of accomplishment of goals for which funding has been provided. (i) other reasonable reports and information related to compliance with applicable laws, contract provisions and the scope of services that the County may from time to time request. 10. PROFESSIONAL RESPONSIBILITY AND LICENSING. The PROVIDER shall assure that all professionals have current and appropriate professional licenses and professional 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 Gato Building 1100 Simonton Street Key West, FL 33040 and Monroe County Attorney PO Box 1026 Key West, FL 33041 For PROVIDER Rev. Stephen E. Braddock, Executive Director Florida Keys Outreach Coalition, Inc. POBox 4767 (1615-A Truesdell Court) Key West, FL 33040 305-293-0641 305-293-8276 FAX 16. CONSENT TO JURISDICTION. This agreement shall be construed by and governed under the laws of the State of Florida and venue for any action arising under this agreement shall be in Monroe County, Florida. 17. NON-WAIVER. Any waiver of any breach of covenants herein contained to be kept and performed by the PROVIDER shall not be deemed or considered as a continuing waiver and shall not operate to bar or prevent the Board from declaring a forfeiture for any succeeding breach, either of the same conditions or covenants or otherwise. 18. AVAILABILITY OF FUNDS. If funds cannot be obtained or cannot be continued at a level sufficient to allow for continued reimbursement of expenditures for services specified herein, this agreement may be terminated immediately at the option of the Board by written notice of termination delivered to the PROVIDER. The Board shall not be obligated to pay for any services or goods provided by the PROVIDER after the PROVIDER has received written notice of termination, unless otherwise required by law. 19. PURCHASE OF PROPERTY. All property, whether real or personal, purchased with funds provided under this agreement, shall become the property of Monroe County and shall be accounted for pursuant to statutory requirements. 20. ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the parties hereto with respect to the subject matter hereof and supersedes any and all prior agreements with respect to such subject matter between the PROVIDER and the Board. IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed as of the day and year first written above. (SEAL) ATTEST: DANNY L. KOLHAGE, CLERK BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA By By Deputy Clerk Mayor/Chairman PROVIDER (Federal ID No. ) Witness By Witness President 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 appUcable payroll taxes. Postage, Overnight Deliveries, Courier, etc. A log of all postage expenses as they relate to the County contract is required for reimbursement. For overnight or express deliveries, the vendor invoice must be included. Rents, Leases, etc. A copy of the rental or lease agreement is required. Deposits and advance payments are not allowable expenses. Reproductions, Copies, etc. A log of copy expenses as they relate to the County contract is required for reimbursement. The log must define the date, number of copies made, source document, purpose, and recipient. A reasonable fee for copy expenses will be allowable. For vendor services, the vendor invoice and a sample of the finished product are required. Supplies, Services, etc. For supplies or services ordered, a vendor invoice is required. Telefax, Fax, etc. A fax log is required. The log must define the sender, the intended recipient, the date, the number called, and the reason for sending the fax. Telephone Expenses A user log of pertinent information must be remitted including: the party called, the caller, the telephone number, the date, and the purpose of the call. Travel Expenses Travel expenses must be submitted on a State of Florida Voucher for Reimbursement of Travel Expenses. Travel must be submitted in accordance with Florida Statute 112.061. Credit card statements are not acceptable documentation for reimbursement. If attending a conference or meeting a copy of the agenda is needed. Airfare reimbursement requires the original passenger receipt portion of the airline ticket. A travel itinerary is appreciated to facilitate the audit trail. Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example, taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is considered a reimbursable travel expense at the destination. Airport parking during a business trip is not. A detailed list of charges is required on the lodging invoice. Balance due must be zero. Room must be registered and paid for by traveler. The County will only reimburse the actual room and related bed tax. Room service, movies, and personal telephone calls are not allowable expenses. Meal reimbursement is: breakfast at $3.00, lunch at $6.00, and dinner at $12.00. Meal guidelines state that travel must begin prior to 6 a.m. for breakfast reimbursement, before noon and end after 2 p.m. for lunch reimbursement, and before 6 p.m. and end after 8 p.m. for dinner reimbursement. Mileage reimbursement is calculated at .29 cents per mile for personal auto mileage while on County business. An odometer reading must be included on the state travel voucher for vicinity travel. Mileage is not allowed from a residence or office to a point of departure. For example, driving form one's home to the airport for a business trip is not a reimbursable expense. Non-allowable Expenses The following expenses are not allowable for reimbursement: capital outlay expenditures (unless specifically included in the contract), contributions, depreciation expenses (unless specifically included in the contract), entertainment expenses, fundraising, non-sufficient check charges, penalties and fines. ATTACHMENT B ORGANIZATION LETTERHEAD Monroe County Board of County Commissioners Finance Department 500 Whitehead Street Key West, FL 33040 Date The following is a summary of the expenses for ( Organization name) for the time period of to Check # Payee Reason Amount 101 Company A Rent $ X,XXX.XX 102 Company B Utilities XXX.XX 104 Employee A P/R ending 05/14/01 XXX. XX 105 Employee B P/R ending OS/28/01 XXX.XX (A) Total $ X.XXX.XX (B) Total prior payments $ X,XXX.XX (C) Total requested and paid (A + B) $ X,XXX.XX (D) Total contract amount $ X,XXX.XX Balance of contract (D-C) $ X.XXX.XX I certify that the above checks have been submitted to the vendors as noted and that the expenses are accurate and in agreement with the records of this organization. Furthermore, these expenses are in compliance with this organizations_ contract with the Monroe County Board of County Commissioners and will not be submitted for reimbursement to any other funding source. Executive Director Attachments (supporting documentation) Sworn to and subscribed before me this _ day of 2002 by who is personally known to me. Notary Public Notary Stamp ATTACHMENT C DESCRIPTION OF SERVICES TO BE PROVIDED Shelter and assistance for homeless individuals and families in Monroe County. SWORN STATEMENT UNDER ORDINANCE NO. 10-1990 MONROE COUNTY. FLORIDA ETHICS CLAUSE warrants that he/it has not employed, retained or otherwise had act on his/its behalf any former County officer or employee in violation of Section 2 of Ordinance No. 10-1990 or any County officer or employee in violation of Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the County may, in its discretion, terminate this contract without liability and may also, in its discretion, deduct from the contract or purchase price, or otherwise recover, the full amount of any fee, commission, percentage, gift, or consideration paid to the former County officer or employee. (signature) Date: STATE OF COUNTY OF PERSONALLY APPEARED BEFORE ME, the undersigned authority, who, after first being sworn by me, affixed his/her signature (name of individual signing) in the space provided above on this day of ,20~. NOTARY PUBLIC My commission expires: OMB - MCP FORM #4 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. II MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract # Contract with: Guidance Clinic of the Middle Effective Date:1 0/01/02 Kevs Expiration Date:9/30/03 Contract Purpose/Description: provide fundinq for various mental health and transportation- disadvantaqed services in Monroe County. Contract Manager: David P. Owens (Name) 4482 (Ext.) OMB/Grants (Department) for BOCC meetinq on 10/16/02 Aoenda Deadline: 10/02/02 Estimated Ongoing Costs: $_/yr (Not included in dollar value above) CONTRACT COSTS Total Dollar Value of Contract: $754.549.00 Current Year Portion: $754.549.00 Budgeted? Yes[8] No D Account Codes: 001-01501-530340-_-525.615.00 Grant: $0.00 102-01507-530340-_-94,307.00 County Match: $ 102-04542-530340-_-45.104.00 101-68607 -530340-_-89,523.00 ADDITIONAL COSTS For: (eo. maintenance, utilities, ianitorial, salaries, etc,) CONTRACT REVIEW Date In Changes Neede~ YesD Not:] Date Out Division Director Risk Management 14) ...7... el- Ie. 3'-c:~ YesD Nol:]--" YesD No[JJ/' ~ I{; III () z,. YesD No~ I.:> ...,-CL- JD-;3-Ud... /0/8/02- /~0~ O.M.B./Purchasing County Attorney Comments: OMB Form Revised 9/11/95 MCP #2 AGREEMENT This Agreement is made and entered into this day of , 2002, 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 2002-2003, 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 SEVEN HUNDRED FIFTY-FOUR THOUSAND, FIVE-HUNDRED, FORTY-NINE, AND NO/100 DOLLARS ($754,549.00), during the fiscal year 2002-2003, payable as follows: a) Pay to the Provider the sum of FORTY-FIVE THOUSAND, ONE-HUNDRED, FOUR, AND NO/100 DOLLARS ($45,104.00) for Community Transportation Coordinator services. b) Pay to the Provider the sum of FIVE-HUNDRED TWENTY-FIVE THOUSAND, SIX- HUNDRED FIFTEEN, AND NO/100 DOLLARS ($525,615.00) for Baker Act Inpatient, Residential Detox, and Mental Health/Substance Outpatient counseling services and community mental health and substance abuse services. c) Pay to the Provider the sum of EIGHTY-NINE THOUSAND, FIVE-HUNDRED TWENTY- THREE, AND NO/100 DOLLARS ($89,523.00) for residential treatment services, including detoxification, long-term substance abuse treatment, and long-term psychiatric treatment services. d) Pay to the provider the sum of NINETY-FOUR THOUSAND, THREE HUNDRED, SEVEN, AND NOj100 DOLLARS ($94,307.00) for Baker Act transportation. 2. TERM. This Agreement shall commence on October 1, 2002, and terminate September 30, 2003, 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 hereto 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 subcontractor 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. S. RECORDS. The Provider shall maintain appropriate records to insure a proper accounting of all funds and expenditures, and shall provide a clear financial audit trail to allow for full accountability of funds received from said Board. Access to these records shall be provided during weekdays, 8 a.m. to 5 p.m., upon request of the Board, the State of Florida, or authorized agents and representatives of the Board or State. The Provider shall be responsible for repayment of any and all audit exceptions which are identified by the Auditor General of the State of Florida, the Clerk of Court for Monroe County, an independent auditor, or their agents and representatives. In the event of an audit exception, the current fiscal year contract amount or subsequent fiscal year contract amounts shall be offset by the amount of the audit exception. In the event this agreement is not renewed or continued in subsequent years through new or amended contracts, the Provider shall be billed by the Board for the amount of the audit exception and the Provider shall promptly repay any audit exception. 6. INDEMNIFICATION AND HOLD HARMLESS. The Provider covenants and agrees to indemnify and hold harmless Monroe County Board of County Commissioners from any and all claims for bodily injury (including death), personal injury, and property damage (including property owned by Monroe County) and any other losses, damages, and expenses (including attorney's fees) which arise out of, in connection with, or by reason of services provided by the Provider occasioned by the negligence, errors, or other wrongful act or omission of the Provider's employees, agents or volunteers. 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 "S01(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 1100 Simonton Street 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 Marathon, 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 Deputy Clerk By 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 meeting a copy of the agenda is needed. Airfare reimbursement requires the original passenger receipt portion of the airline ticket. A travel itinerary is appreciated to facilitate the audit trail. Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example, taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is considered a reimbursable travel expense at the destination. Airport parking during a business trip is not. A detailed list of charges is required on the lodging invoice. Balance due must be zero. Room must be registered and paid for by traveler. The County will only reimburse the actual room and related bed tax. Room service, movies, and personal telephone calls are not allowable expenses. Meal reimbursement is: breakfast at $3.00, lunch at $6.00, and dinner at $12.00. Meal guidelines state that travel must begin prior to 6 a.m. for breakfast reimbursement, before noon and end after 2 p.m. for lunch reimbursement, and before 6 p.m. and end after 8 p.m. for dinner reimbursement. Mileage reimbursement is calculated at .29 cents per mile for personal auto mileage while on County business. An odometer reading must be included on the state travel voucher for vicinity travel. Mileage is not allowed from a residence or office to a point of departure. For example, driving form one's home to the airport for a business trip is not a reimbursable expense. Non-allowable Expenses The following expenses are not allowable for reimbursement: capital outlay expenditures (unless specifically included in the contract), contributions, depreciation expenses (unless specifically included in the contract), entertainment expenses, fundraising, non-sufficient check charges, penalties and fines. ATTACHMENT B ORGANIZATION LETTERHEAD Monroe County Board of County Commissioners Finance Department 500 Whitehead Street Key West, FL 33040 Date The following is a summary of the expenses for ( Organization name) for the time period of to Check # Payee Reason Amount 101 Company A Rent $ X,XXX.XX 102 Company B Utilities XXX.XX 104 Employee A P/R ending 05/14/01 XXX.XX 105 Employee B P/R ending OS/28/01 XXX.XX (A) Total $ X.XXX.XX (B) Total prior payments $ X,XXX.XX (C) Total requested and paid (A + B) $ X,XXX.XX (D) Total contract amount $ X,XXX.XX Balance of contract (D-C) $ X.XXX.XX I certify that the above checks have been submitted to the vendors as noted and that the expenses are accurate and in agreement with the records of this organization. Furthermore, these expenses are in compliance with this organizations_ contract with the Monroe County Board of County Commissioners and will not be submitted for reimbursement to any other funding source. Executive Director Attachments (supporting documentation) Sworn to and subscribed before me this _ day of 2002 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. 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.1 0-1990 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. (sig nature) 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 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." 09/30/2002 10:39 FAX 13052896158 GUIDANCE CLINIC HIDDLE K ~002 ~c.-hrt\~ U (S~\I~ f'C\~~.s) GUIDANCE CUNIC OF THE MIDDLE KEYS, INC. 3000 41ST STREET, OCEAN MARATHON, Fl 33050 (v) 3051289-6150 I (f) 3051289-6158 deb.barsell@gcmk.otg Septel nber 18, 2002 Darrer Guttman Jessr(, <1 Corporation 800 1~ ,th Street Key \1'1 est. Fl 33040 RE: LI TIER OF AGREEMENT Dear I 4r. Guttman: The Guidance Clinic of the Middle Keys. Inc. (GCMK), hereby enters into an agreement with J !ssrica Corporation to provide coordination and transportation seNices for Baker A~4 lrchman Act (BAIMA) clients throughout Monroe County and tolfrom Miami-Dade Coun1 .f as required. The effective term of this agreement is October 1. 2002- Septe nber 30, 2003. GeMI . will supply Jessrica with two Chevrolet Caprices meeting Jessrica maintenance speci1 cations; one to be stationed in Key West at a Jessrica location and one to be statiol 'ed in Marathon at GCMK headquarters. A BNMA backup vehicle (Ford Crown Victor a) will be stationed at GCMK at Safeport located at 301 White Street in Key West. Jessrica will have access to this backup vehicle in the event that either of the two C ,prices is out of service. GeMI : will pay for the fuel and maintenance of the three vehicles used for BAlMA trans~ ortation. Jessrica will coordinate the maintenance for the Caprice located in Key West. Invoices for routine maintenance (labor and parts) on the Caprice will be forwa: ded to GCMK Transportation Coordinator for payment. Jessrica will not charge an B.,,(, ra fee for coordinating the maintenance of the vehicle. Jessrica must obtain prior appro lal from the GCMK Transportation Coordinator to initiate major vehicle repairs. GeMI : wiJl coordinate the maintenance for the Caprice located in Marathon and the Crowl Victoria located in Key West. GeM I : will maintain insurance on the two Caprices and one backup Crown Victoria assigl ed to BAIMA transportation service. Jessrica will be named as an "additional insure :I" for these three cars. Jessrica will report and document accidents involving GCMI : vehicles and incidents involving clients to the proper authorities and immediately therec fter contact GCMK. All Je: .srica drivers operating GCMK vehicles will hold a Class D Florida Driver's licem e and be approved for GCMK insurance coverage. Upon execution of this 1 ~c'iiiiDiii.. Partially funded by the Florida Depanment of Children & Farnmes. District 11 e" FA#l\IUIS 09/30/2002 10:39 FAX 13052896158 GUIDANCE CLINIC MIDDLE K ~003 A-+f; 1). agreer lent, Jessrica will fax to GCMK Transportation Coordinator a current list of drivers - including a copy of the driver's license and social security number for each driver. for approval to operate GCMK vehicles. Prior to adding a driver, Jessrica will fax to I ~CMK Transportation Coordinator or designee a copy of the driver's license and social ;ecurity number of the person. GCMK will initiate procedures to add the driver to GCMI< vehicle insurance. Jessrica cannot use the driver until it has received written notiflCl :tion that the driver has been added to the GCMK insurance coverage. Additic nally, Jessrica will fax a copy of picture identification and social security number for eaf h escort to GCMK Transportation Coordinator or designee. Jessrlca cannot use the es ;ort until it has received written ,notification that the escort has been approved by GCM~. GCM~ will supply Jessrica with a cell phone. Jessrica will follow the transportation protoc >/ and complete the documentation provided as Attachment 1-3 herein. The fc Ilowing fee structure is established for the period of the agreement 1\,1; Iximum # R:( undtri s* 40 Jessrica Pa ent $130 $130 $130 $130 $130 $250 $250 $350 Client Picku Point Client Dro ff Point Key West Key West Key West Marathon Marathon Key West Marathon Marathon Marathon Ke Lar: 0 Marathon Miami-Dade County Ke La 0 Miami-Dade Coun Ke West Miami-Dade Coun GCMK Preauthorization Required for All Trips Below Appro 'aJ for below fees will be granted only when the Marathon BNMA vehicle is engaged with anc 'her BNMA tri that would reclude another icku within a reasonable eriod of time. M lximum Car Client Pickup Jessrica # Rc -undtri s. Location Point Client Dro ff Point Pa ment 3 Key West Marathon & North Key Largo $225 5 Key West Marathon & North Miami-Dade Count $350 *To b" renegotiated in April 2003 if necessary. 300 25 Timel~ ' payment for services rendered is ensured by adherence 10 the following invoic ng procedures: · Jessrica will submit two statements/invoices per month; one covering the trips made from the first through the fifteenth and one covering trips made from the sixteenth through the end of the month. Jessrica will send statementslinvoices to GCMK within 5 business days after the end of the billing period. · Jessrica will indude required documentation with each statement/invoice. · Jessrica statementsJinvoices for BAlMA trips will be submitted to the attention of GCMK Stabilization Unit Director. 2 ~CHii.;;;iN Partially funded by the Florida Department of Children & Families. District 11 ~ It F~llIU 09/30/2002 10:40 FAX 13052896158 GUIDANCE CLINIC HIDDLE K ~004 A-H-. D . I ,CMK Stabilization Director will review statementlinvoice, mediate any I Jiscrepancies with Jessrica, and forward approved Invoice to GCMK Finance >apartment. . 3CMK will mail payment to Jessrica within 7 working days (Finance Department) Jpon receipt of statementlinvoice by the Stabilization Unit Director. This 21~ reement will begin on October 1, 2002.and will tenninate on Septer lber 30. 2003. The agreement can be cancelled by either party with 60 days written notice. GCMI< and Jessrica enter into this agreement including Attachments 1-3 by affixing signatL res below: 111L~ I ; . De6~. Barsell. M t CAP Assoc lte Director, GCMK &- Darren Guttman Jessrica Corporation Attach Tlents: 1. GCMK Transportation Protocol 2. GCMK Transportation Record and Payment Authorization Sheet 3. Statement 3 ~__ 1M........... eM.LoPRIN Parti.lly funded by the Florida DePlJrtment of Children & FamUie$. District 11 . FA#I\IUES 09/30/2002 10:40 FAX 13052896158 GUIDANCE CLINIC HIDDLE K @005 A-++.i) AlTACHIII. ENT 1 GL IDANCE CLINIC OF THE MIDDLE KEYS TRANSPORTATION PROTOCOL: T -IE TRANSPORTATION OF BAKER ACT AND MARCHMAN ACT CLIENTS A. Client ~elated Rules: 1. An :lien1s will be transported with a driver and an escort (who may also be a driver.) 2. All frivers and escorts must be approved by the Transportation Department of the GC \t1K prior to accepting a driving assignment. 3. CUt nt transportation within Monroe County may be conducted with a driver and an est ort. 4. C'lit .nt transportation outside of Monroe County must be made with 2 drivers. 5. CIi. .nt must be observed for any unusual behaviors including hurting setf/others or sue den medical conditions. Report/respond to conditions immediately. Nurse on Duty. Do not go after the dient. 6. At.. he time of pick up for a Baker Act or Marchman Act client. a driver must obtain the Oril inal Baker Act or Marchman Act paper work from the Pick Up facility. If the original pal >er work is not available the driver must immediately report this information to the GC MK Nurse on Duty for further direction. 7. A f ~male client requires a female escort or a female driver. 8. A J arent is not allowed to travel in the Baker Act vehicle with a Baker Act or Marchman Ac minor. Parents may follow in another car. 9. Or. y one client may be transported at a time in the Baker Act vehicle. . 10.Cli mts are not to smoke in the car. 11. CIi mts are not to be placed in handcuffs or any type of restraints for any reason by a drt 'er or escort. 12.A (lienfs movement is not to be impeded with any physical restraint unless directed by a r urse/MDllaw enforcement officer. 13.lf ~ client is violent during transport and poses a treat to safety, stop the vehicle and call 91 i, than notify the Nurse on Duty of the situation. 14.A client shall not be left alone in the vehicle for any reason. 15. ell mt is encouraged to use restroom facilities prior to departure. If the trip is generated fro n Key West and a stop is required, the GCMK may be used for that purpose. 16.A t Iient may use aluminum/metal cans. Bottle caps must be removed prior to client use. Cli :mts may not have any metal utensils or other hard products such as pencils'or pens. 17.A I .Iient may not shop during a stop. All efforts should be made to avoid stops. If a stop is equired. it should be short and without delay. , 18.lf f client must use a pUblic facility, the client must be escorted to the restroom and the dri ter must remain outside the restroom door until the client leaves the restroom. The dri fer will remain in conversation with client while the client is in the restroom. B. COOI/'( ination of Transportation Rules: 1. TI :Jnsportation arrangements for Baker Act and Marchman Act clients are under the di "ection of the Unit Nurse on Duty/GCMK per contractual arrangements with Jessrica C >rp. No other agency is authorized to contact Jessrica directly for transportation. rev. 09/1, ./02 Created: n 9/18/2002 12:39 PMTrsnsportation Rules 1 09/30/2002 10:40 FAX 13052896158 GUIDANCE CLINIC HIDDLE K ~006 t}H-. D 2. All trips will be made within the approved fee structure. 3. All trips will be made using the closest vehicle and the shortest distance unless pl1 ~authorization is obtained from the Unit Nurse on Duty at the GCMK. 4. Cl ants may be picked up at only approved locations. The GCMK Nurse on Duty will co nmunicate the piCk up location. Approved locations will include: Hospitals Detention Facility Mental Health Clinics Anchor Away Safeport With a GCMK staff member 5. At Depoo: Call security with phone located on the first floor. 6. PIt GCMK: Use the "Call" button on the intercom box next to the elevator. 7. Ai GCMK, staff members will place the client in the vehicle for departure and will assist tl1 ~ client from the vehicle at time of arrival. 8. Tl e facility responsible for the departing client for a trip longer than 2 hours shall pr )vide a brown bag snack. AU minors shall be supplied with a snack for any trip over 1 tiC ur. 9. If J driver determines a client is too dangerous to transport, the GCMK Nurse on Duty m Jst be notified. The Nurse shall make arrangements for alternative transportation. 1 D. If ~ client absconds at time of or during transport. immediately report the infonnation to th ~ GCMK Nurse on Duty. Do not go after the client. 11. "J ~il Hold" clients from the Monroe County Detention Facility shall be picked up from tJ- 3 Saltyport area only. To access the Sallyport area, the driver must drive the car \II thin 1 foot of the Sallyport entrance. If the door does not open, the escort must use It. ~ speaker mounted on the wall next to the Sallyport entrance to request entrance. o ,ce inside, Detention Facility staff will bring the client to the car. When the client is il'1 ;ide the car and the doors are locked, the Sallyport area exit doors will open. 12. T Ie driver/escort must determine from the Pick Up facility if the client has been SI !arched and encourage staff to conduct a search prior to transport. If the client is not $I :arched prior to transport. the driver must communicate this information to the Duty S aft Member prior to opening the client door at the Designation point. 13. C 'iver/escort must respond to the piCk up point within 1 hour and 15 minutes. C. Reirr Jursement related rules 1. } ,II cancelled and otherwise diverted trips will be reported on the Transportation F :ecord and Payment Authorization Sheet. 2. [l3i1y inspection checklist will be maintained for alt Baker Act vehicles and sen~ r lonthly to the GCMK Transportation Coordinator. 3. . 'ransportation Record and Payment Authorization Sheets and a Statement of services r ~ndered will be faxed to the Stabilization Unit Director on the first and sixteenth of ~ 8ch month. 4. I: the driver arrives without the original Baker or Marchman Act paperwork, Jessrica , Jill obtain the paper work without charge to the GCMK. ,.ev. OS/' 9102 Created :>n 9/18,12002 12:39 PMTi2rlSportation Rules 2 _____09/30/2002 10:41 FAX 13052896158 GUIDANCE CLINIC HIDDLE K ~007 4#, D A TrACt IMENT 2 GUIDANCE CLINIC OF THE MIDDLE KEYS 3000 41sT ST. Ocean Marathon, FL 33050 Voice 305-289-6150 . Fax 305-289-6157 TRANSPORTATION RECORD AND PAYMENT AUTHORIZATION SHEET TranslP lrtation Type: o Baker Act o Marchman Act Date: Client Name: Time of Pick Up: TIme van returned to Duty: Time Called: Time to = Drop Off: VehicJI ~: 0 KW Caprice o Mar Caprice o Crown Vie Place, )f Pick Up: (Where did you pick up the Client: Facility Name/City) Authol ized Staff Signature at Pick Up Facility: Time: l ID ti ti es r 3 on: (Where did you take the Client: Facility Name/City) Autho ;zed Staff Signature at Designation Facility: Time: (Staff member accepting client) Drivel Name: Esecl k Name: Begin ning Miles: Pick Up Miles: Drop )ff Miles: Ending Miles: FOR I ;CMK USE ONLY: Arnot.. nt to be paid: Stabi'ization Unit Director Signature: 09/30/2002 1~~AX 13052896158 GUIDANCE CLINIC HIDDLE K .. , ~008 4t+. 0 ATTAGliMENT 3 Statement Date: JessriCll Corp. 800 Cl3 henne St. Key WI; st, Florida 33040 Stabiliz !tion Unit Director Guidar :e Clinic of the Middle Keys 3000 4 1st St. Ocean Marath )nJ Fl33050 Re: 8a ter Act and Marchman Act transportation The fo lowing is a break down for trips from to Da h Name Pick Up Cost Vehicle Designation 1 2 3 - \L TOTJ Jess ica Corp Representative Signature GCMK CFO Signature MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract # Contract with: Guidance Clinic of the Upper Effective Date:1 0/01/02 Kevs Expiration Date:09/30/03 Contract Purpose/Description: provides fundinq to perform mental health services such as counselinq in Monroe County. Contract Manager: David P. Owens (Name) 4482 (Ext.) OMB/Grants (Department) for BOCC meetinq on 10/16/02 Aqenda Deadline: 10/02/02 CONTRACT COSTS Total Dollar Value of Contract: $92.961.00 Current Year Portion: $92.961.00 Budgeted? YeslZ] No D Account Codes: 001-01502-530340-_ 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 Division Director I~-L-..l,....---- YesD NQ Risk Management ~~c\[Dd--YesD Nocy O.M.B./Purchasing 3J?v/?Z-- YesD Noc:r' County Attorney g I/.s 10 '2- YesD NO~ , Date Out /o,-~.-~L- ~~l-0~ 01 ZiJ) gj0jo2- Comments: OMB Form Revised 9/11/95 MCP #2 AGREEMENT This Agreement is made and entered into this day of , 2002, 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 2002-2003, 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 NINETY-TWO THOUSAND, NINE-HUNDRED, SIXTY- ONE, AND NO/100 DOLLARS ($92,961.00) for fiscal year 2002-2003. 2. TERM. This Agreement shall commence on October 1, 2002, and terminate September 30, 2003, 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. S. RECORDS. The Provider shall maintain appropriate records to insure a proper accounting of all funds and expenditures, and shall provide a clear financial audit trail to allow for full accountability of funds received from said Board. Access to these records shall be provided during weekdays, 8 a.m. to 5 p.m., upon request of the Board, the State of Florida, or authorized agents and representatives of the Board or State. The Provider shall be responsible for repayment of any and all audit exceptions which are identified by the Auditor General of the State of Florida, the Clerk of Court for Monroe County, an independent auditor, or their agents and representatives. In the event of an audit exception, the current fiscal year contract amount or subsequent fiscal year contract amounts shall be offset by the amount of the audit exception. In the event this agreement is not renewed or continued in subsequent years through new or amended contracts, the Provider shall be billed by the Board for the amount of the audit exception and the Provider shall promptly repay any audit exception. 6. INDEMNIFICATION AND HOLD HARMLESS. The Provider covenants and agrees to indemnify and hold harmless Monroe County Board of County Commissioners from any and all claims for bodily injury (including death), personal injury, and property damage (including property owned by Monroe County) and any other losses, damages, and expenses (including attorney's fees) which arise out of, in connection with, or by reason of services provided by the Provider occasioned by the negligence, errors, or other wrongful act or omission of the Provider's employees, agents or volunteers. 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 Gato Building 1100 Simonton Street 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 By Deputy Clerk Mayor/Chairman GUIDANCE CLINIC OF THE UPPER KEYS, INC. (Federal ID No. ) Witness By Director Witness 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 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 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 LETTERH EAD Monroe County Board of County Commissioners Finance Department 500 Whitehead Street Key West, FL 33040 Date The following is a summary of the expenses for ( Organization name) for the time period of to Check # Payee Reason Amount 101 Company A Rent $ X,XXX.XX 102 Company B Utilities XXX .XX 104 Employee A P/R ending 05/14/01 XXX.XX 105 Employee B P/R ending OS/28/01 XXX.XX (A) Total $ X.XXX.XX (B) Total prior payments $ X,XXX.XX (C) Total requested and paid (A + B) $ X,XXX.XX (D) Total contract amount $ X,XXX.XX Balance of contract (D-C) $ X.XXX.XX I certify thqt 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 2002 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. 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. (sig nature) 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 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." MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract # Contract with: Helpline Effective Date: 1 % 1/02 Expiration Date: 09/30/03 Contract Purpose/Description: provides funding for crisis intervention and refelTal services Contract Manager: David P. Owens (Name) for BOCC meeting on 10/16/02 4482 (Ext. ) OMB/Grants (Department) Agenda Deadline: 10/02/02 CONTRACT COSTS Total Dollar Value of Contract: $12.400.00 Budgeted? Yes[;8J No 0 Account Codes: Grant: $0.00 County Match: $ Current Year Portion: $12,400.00 001-03200-530340-_ - ---- - - - ---- - - - ---- ADDITIONAL COSTS Estimated Ongoing Costs: $_/yr. For: eN ot included in dollar value above) e e.g. maintenance, utilities, i anitorial, salaries, etc.) CONTRACT REVIEW Changes Date In Needed Division Director /0 -l.. - e. L-- Y esO No~ Risk Management ~~1-6 (}-- YesO NoGr' O.M.B./Purchasing ~lrz,.~ [)l..'l esO Nog--- County Attorney 2? II S /" 2- Y esO N oif Comments: OMB Form Revised 9/11/95 MCP #2 Date Out I~->--"'L-- 8pjo F/bft- AGREEMENT This Agreement is made and entered into this day of , 2002, between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter referred to as "Board" or "County," and Helpline, Inc., hereinafter referred to as "PROVIDER." WHEREAS, the PROVIDER is a not-for-profit corporation established for the provision of crisis intervention and referral services, and WHEREAS, it is a legitimate public purpose to provide facilities and services for crisis intervention and referral, now, therefore, IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed as follows: 1. AMOUNT OF AGREEMENT. The Board, in consideration of the PROVIDER substantially and satisfactorily performing and carrying out the duties of the Board as to providing facilities and services for crisis intervention and referral for persons living in Monroe County, Florida, shall pay to the PROVIDER the sum of TWELVE THOUSAND, FOUR HUNDRED, AND 00/100 DOLLARS ($12,400.00) for fiscal year 2002-2003. 2. TERM. This Agreement shall commence on October 1, 2002, and terminate September 30, 2003, unless earlier terminated pursuant to other provisions herein. 3. PAYMENT. Payment will be paid periodically, but no more frequently than monthly as hereinafter set forth. Reimbursement requests will be submitted to the Board via the Clerk's Finance Office. The COUNTY shall only reimburse, subject to the funded amounts below, those reimbursable expenses which are reviewed and approved as complying with Florida Statutes 112.061 and Attachment A - Expense Reimbursement Requirements. Evidence of payment by the PROVIDER shall be in the form of a letter, summarizing the expenses, with supporting documentation attached. The letter should contain a certification statement. An example of a reimbursement request cover letter is included as Attachment B. The organization's final invoice must be received within sixty days after the termination date of this contract shown in Article 2 above. After the Clerk of the Board examines and approves the request for reimbursement, the Board shall reimburse the PROVIDER. However, the total of said reimbursement expense payments in the aggregate sum shall not exceed the total amount shown in Article 1, above, during the term of this agreement. 4. SCOPE OF SERVICES. The PROVIDER, for the consideration named, covenants and agrees with the Board to substantially and satisfactorily perform and carry out the duties of the Board in providing crisis intervention and referral services to persons living in Monroe County, Florida. PROVIDER shall provide services described in Attachment C, attached hereto and incorporated herein. S. RECORDS. The PROVIDER shall maintain appropriate records to insure a proper accounting of all funds and expenditures, and shall provide a clear financial audit trail to allow for full accountability of funds received from said Board. Access to these records shall be provided during weekdays, 8 A.M. to 5 P.M., upon request of the Board, the State of Florida, or authorized agents and representatives of the Board or State. The PROVIDER shall be responsible for repayment of any and all audit exceptions which are identified by the Auditor General of the State of Florida, the Clerk of Court for Monroe County, an independent auditor, or their agents and representatives. In the event of an audit exception, the current fiscal year contract amount or subsequent fiscal year contract amounts shall be offset by the amount of the audit exception. In the event this agreement is not renewed or continued in subsequent years through new or amended contracts, the PROVIDER shall be billed by the Board for the amount of the audit exception and the PROVIDER shall promptly repay any audit exception. 6. INDEMNIFICATION AND HOLD HARMLESS. The PROVIDER covenants and agrees to indemnify and hold harmless Monroe County Board of County Commissioners from any and all claims for bodily injury (including death), personal injury, and property damage (including property owned by Monroe County) and any other losses, damages, and expenses (including attorney's fees) which arise out of, in connection with, or by reason of services provided by the PROVIDER occasioned by the negligence, errors, or other wrongful act or omission of the PROVIDER'S employees, agents, or volunteers. 7. INDEPENDENT CONTRACTOR. At all times and for all purposes hereunder, the PROVIDER is an independent contractor and not an employee of the Board. No statement contained in this agreement shall be construed so as to find the PROVIDER or any of its employees, contractors, servants or agents to be employees of the Board. 8. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement, the PROVIDER shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating the provision of such services, including those now in effect and hereinafter adopted. Any violation of said statutes, ordinances, rules and regulations shall constitute a material breach of this agreement and shall entitle the Board to terminate this contract immediately upon delivery of written notice of termination to the PROVIDER. 9. COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the COUNTY: (a) evidence of the organization's 501(c)(3) status; (b) a list of the organization's Board of Directors of which there must be five or more; (c) evidence of annual election of Officers and Directors; (d) an annual audited financial report; (e) a copy the organization's Corporate Bylaws, which must address the organization's mission, board and membership composition, election of officers, and so on; (f) a copy of the organization's Corporate Policies and Procedures Manual which must include hiring policies for all staff, drug and alcohol free workplace provisions, equal employment opportunity provisions, and so on; (g) cooperation with County monitoring visits; (h) semi-annual performance reports. These reports should include performance measurements which will demonstrate the level of accomplishment of goals for which funding has been provided. (i) other 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 Gato Building 1100 Simonton Street Key West, FL 33040 For PROVIDER Lou Hernandez, Executive Director Helpline, Inc. POBox 2186 1923-1 Spalding Court Key West, FL 33040 305-292-8445 305-292-8447 FAX and Monroe County Attorney PO Box 1026 Key West, FL 33041 16. CONSENT TO JURISDICTION. This agreement shall be construed by and governed under the laws of the State of Florida and venue for any action arising under this agreement shall be in Monroe County, Florida. 17. NON-WAIVER. Any waiver of any breach of covenants herein contained to be kept and performed by the PROVIDER shall not be deemed or considered as a continuing waiver and shall not operate to bar or prevent the Board from declaring a forfeiture for any succeeding breach, either of the same conditions or covenants or otherwise. 18. AVAILABILITY OF FUNDS. If funds cannot be obtained or cannot be continued at a level sufficient to allow for continued reimbursement of expenditures for services specified herein, this agreement may be terminated immediately at the option of the Board by written notice of termination delivered to the PROVIDER. The Board shall not be obligated to pay for any services or goods provided by the PROVIDER after the PROVIDER has received written notice of termination, unless otherwise required by law. 19. PURCHASE OF PROPERTY. All property, whether real or personal, purchased with funds provided under this agreement, shall become the property of Monroe County and shall be accounted for pursuant to statutory requirements. 20. ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the parties hereto with respect to the subject matter hereof and supersedes any and all prior agreements with respect to such subject matter between the PROVIDER and the Board. IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed as of the day and year first written above. (SEAL) ATTEST: DANNYL. KOLHAGE,CLERK BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA By Deputy Clerk By Mayor/Chairman Witness PROVIDER (Federal ID No. ) Witness 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. II Invoices should be billed to the contracting agency. Third party payments will not be considered for reimbursement. Remember, the expense should be paid prior to requesting a reimbursement. Only current charges will be considered, no previous balances. Reimbursement requests will be monitored in accordance with the level of detail in the contract. This document should not be considered all-inclusive. The Clerk's Finance Department reserves the right to review reimbursement requests on an individual basis. Any questions regarding these guidelines should be directed to 305-292-3534. Data Processing, PC Time, etc. The vendor invoice is required for reimbursement. Inter-company allocations are not considered reimbursable expenditures unless appropriate payroll journals for the charging department are attached and certified. Payroll A certified statement verifying the accuracy and authenticity of the payroll expense is needed. If a Payroll Journal is provided, it should include: dates, employee name, salary or hourly rate, total hours worked, withholding information and payroll taxes, check number and check amount. If a Payroll Journal is not provided, the following information must be provided: check amount, check number, date, payee, support for applicable payroll taxes. Postage, Overnight Deliveries, Courier, etc. A log of all postage expenses as they relate to the County contract is required for reimbursement. For overnight or express deliveries, the vendor invoice must be included. Rents, Leases, etc. A copy of the rental or lease agreement is required. Deposits and advance payments are not allowable expenses. Reproductions, Copies, etc. A log of copy expenses as they relate to the County contract is required for reimbursement. The log must define the date, number of copies made, source document, purpose, and recipient. A reasonable fee for copy expenses will be allowable. For vendor services, the vendor invoice and a sample of the finished product are required. Supplies, Services, etc. For supplies or services ordered, a vendor invoice is required. Telefax, Fax, etc. A fax log is required. The log must define the sender, the intended recipient, the date, the number called, and the reason for sending the fax. Telephone Expenses A user log of pertinent information must be remitted including: the party called, the caller, the telephone number, the date, and the purpose of the call. Travel Expenses Travel expenses must be submitted on a State of Florida Voucher for Reimbursement of Travel Expenses. Travel must be submitted in accordance with Florida Statute 112.061. Credit card statements are not acceptable documentation for reimbursement. If attending a conference or meeting a copy of the agenda is needed. Airfare reimbursement requires the original passenger receipt portion of the airline ticket. A travel itinerary is appreciated to facilitate the audit trail. Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example, taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is considered a reimbursable travel expense at the destination. Airport parking during a business trip is not. A detailed list of charges is required on the lodging invoice. Balance due must be zero. Room must be registered and paid for by traveler. The County will only reimburse the actual room and related bed tax. Room service, movies, and personal telephone calls are not allowable expenses. Meal reimbursement is: breakfast at $3.00, lunch at $6.00, and dinner at $12.00. Meal guidelines state that travel must begin prior to 6 a.m. for breakfast reimbursement, before noon and end after 2 p.m. for lunch reimbursement, and before 6 p.m. and end after 8 p.m. for dinner reimbursement. Mileage reimbursement is calculated at .29 cents per mile for personal auto mileage while on County business. An odometer reading must be included on the state travel voucher for vicinity travel. Mileage is not allowed from a residence or office to a point of departure. For example, driving form one's home to the airport for a business trip is not a reimbursable expense. Non-allowable Expenses The following expenses are not allowable for reimbursement: capital outlay expenditures (unless specifically included in the contract), contributions, depreciation expenses (unless specifically included in the contract), entertainment expenses, fundraising, non-sufficient check charges, penalties and fines. ATTACHMENT B ORGANIZATION LETTERHEAD Monroe County Board of County Commissioners Finance Department 500 Whitehead Street Key West, FL 33040 Date The following is a summary of the expenses for ( Organization name) for the time period of to Check # Payee Reason Amount 101 Company A Rent $ X,XXX.XX 102 Company B Utilities XXX.XX 104 Employee A P/R ending 05/14/01 XXX.XX 105 Employee B P/R ending OS/28/01 XXX. XX (A) Total $ X.XXX.XX (B) Total prior payments $ X,XXX.XX (C) Total requested and paid (A + B) $ X,XXX.XX (D) Total contract amount $ X,XXX.XX Balance of contract (D-C) $ X.XXX.XX I certify that the above checks have been submitted to the vendors as noted and that the expenses are accurate and in agreement with the records of this organization. Furthermore, these expenses are in compliance with this organizations_ contract with the Monroe County Board of County Commissioners and will not be submitted for reimbursement to any other funding source. Executive Director Attachments (supporting documentation) Sworn to and subscribed before me this _ day of 2002 by who is personally known to me. Notary Public Notary Stamp DESCRIPTION OF SERVICES TO BE PROVIDED ATTACHMENT C Telephone hotline services for crisis intervention and referral. Telephone link for Alcoholics Anonymous and Narcotics Anonymous. Periodic reassurance calls to disabled, elderly and homebound individuals. 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 fi~st being sworn by me, affixed his/her signature (name of individual signing) in the space provided above on this day of , 20---,--. NOTARY PUBLIC My commission expires: OMB - MCP FORM #4 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." MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract # Contract with: Hospice of the Florida Keys Effective Date: 10/01/02 Expiration Date:9/30/03 Contract Purpose/Description: provides funding for medical psychological. physical. and social needs of terminally ill persons and their families in Monroe County Contract Manager: David P. Owens (Name) 4482 (Ext.) OMB/Grants (Department) for BOCC meeting on 10/16/02 Agenda Deadline: 10/02/02 Total Dollar Value of Contract: $40.000.00 Budgeted? Yes[g] No 0 Account Codes: Grant: $0.00 County Match: $ CONTRACT COSTS Current Year Portion: $40.000.00 001-03202-530340-_ - - - ---- - - - ---- ADDITIONAL COSTS Estimated Ongoing Costs: $_/yr For: (Not included in dollar value above) (eg. maintenance, utilities, ianitorial, salaries, etc.) - - - ---- CONTRACT REVIEW Changes ~ Date In Needed. ~e e _ DivisionDireclor "0->-01- YeSDNoG--_~..x i _ 'J Risk Managemenl<2'o.l-oJ.- YesD NOCJ . ~~ OM.B./Purchasing D\w{x-YesD NoEr ~ k County Attorney 8/' s: I 0 '2.... YesD NoQ/ Date Out r...:;; -~-oL SSc\l -{) d- ~[)llrL _ ~G~~ Comments: OMB Form Revised 9/11/95 MCP #2 AGREEMENT This Agreement is made and entered into this day of , 2002, between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter referred to as "Board" or "County," and Hospice of the Florida Keys, Inc., hereinafter referred to as "PROVIDER." WHEREAS, the PROVIDER is a not-for-profit corporation established for the provision of home health care, and WHEREAS, it is a legitimate public purpose to provide facilities and services for home health care, now, therefore, IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed as follows: 1. AMOUNT OF AGREEMENT. The Board, in consideration of the PROVIDER substantially and satisfactorily performing and carrying out the duties of the Board as to providing facilities and services for home health care for persons living in Monroe County, Florida, shall pay to the PROVIDER the sum of FORTY THOUSAND AND 00/100 DOLLARS ($40,000.00) for fiscal year 2002-2003. 2. TERM. This Agreement shall commence on October 1, 2002, and terminate September 30, 2003, 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 home health care to persons living in Monroe County, Florida. PROVIDER shall provide services described in Attachment C, attached hereto and incorporated herein. S. RECORDS. The PROVIDER shall maintain appropriate records to insure a proper accounting of all funds and expenditures, and shall provide a clear financial audit trail to allow for full accountability of funds received from said Board. Access to these records shall be provided during weekdays, 8 A.M. to 5 P.M., upon request of the Board, the State of Florida, or authorized agents and representatives of the Board or State. The PROVIDER shall be responsible for repayment of any and all audit exceptions which are identified by the Auditor General of the State of Florida, the Clerk of Court for Monroe County, an independent auditor, or their agents and representatives. In the event of an audit exception, the current fiscal year contract amount or subsequent fiscal year contract amounts shall be offset by the amount of the audit exception. In the event this agreement is not renewed or continued in subsequent years through new or amended contracts, the PROVIDER shall be billed by the Board for the amount of the audit exception and the PROVIDER shall promptly repay any audit exception. 6. INDEMNIFICATION AND HOLD HARMLESS. The PROVIDER covenants and agrees to indemnify and hold harmless Monroe County Board of County Commissioners from any and all claims for bodily injury (including death), personal injury, and property damage (including property owned by Monroe County) and any other losses, damages, and expenses (including attorney's fees) which arise out of, in connection with, or by reason of services provided by the PROVIDER occasioned by the negligence, errors, or other wrongful act or omission of the PROVIDER'S employees, agents, or volunteers. 7. INDEPENDENT CONTRACTOR. At all times and for all purposes hereunder, the PROVIDER is an independent contractor and not an employee of the Board. No statement contained in this agreement shall be construed so as to find the PROVIDER or any of its employees, contractors, servants or agents to be employees of the Board. 8. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement, the PROVIDER shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating the provision of such services, including those now in effect and hereinafter adopted. Any violation of said statutes, ordinances, rules and regulations shall constitute a material breach of this agreement and shall entitle the Board to terminate this contract immediately upon delivery of written notice of termination to the PROVIDER. 9. COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the COUNTY: (a) evidence of the organization's SOl(c)(3) status; (b) a list of the organization's Board of Directors of which there must be five or more; (c) evidence of annual election of Officers and Directors; (d) an annual audited financial report; (e) a copy the organization's Corporate Bylaws, which must address the organization's mission, board and membership composition, election of officers, and so on; (f) a copy of the organization's Corporate Policies and Procedures Manual which must include hiring policies for all staff, drug and alcohol free workplace provisions, equal employment opportunity provisions, and so on; (g) cooperation with County monitoring visits; (h) semi-annual performance reports. These reports should include performance measurements which will demonstrate the level of accomplishment of goals for which funding has been provided. (i) other reasonable reports and information related to compliance with applicable laws, contract provisions and the scope of services that the County may from time to time request. 10. PROFESSIONAL RESPONSIBILITY AND LICENSING. The PROVIDER shall assure that all professionals have current and appropriate professional licenses and professional liability insurance coverage. Funding by the Board is contingent upon retention of appropriate local, state and/or federal certification and/or licensure of the PROVIDER'S program and staff. 11. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services and/or reimbursement of services shall be accomplished by an amendment, which must be approved in writing by the COUNTY. 12. NO ASSIGNMENT. The PROVIDER shall not assign this agreement except in writing and with the prior written approval of the Board, which approval shall be subject to such conditions and provisions as the Board may deem necessary. This agreement shall be incorporated by reference into any assignment and any assignee shall comply with all of the provisions herein. Unless expressly provided for therein, such approval shall in no manner or event be deemed to impose any obligation upon the Board in addition to the total agreed upon reimbursement amount for the services of the PROVIDER. 13. NON-DISCRIMINATION. The PROVIDER shall not discriminate against any person on the basis race, creed, color, national origin, sex or sexual orientation, age, physical handicap, or any other characteristic or aspect which is not job-related in its recruiting, hiring, promoting, terminating or any other area affecting employment under this agreement. At all times, the PROVIDER shall comply with all applicable laws and regulations with regard to employing the most qualified person(s) for positions under this agreement. The PROVIDER shall not discriminate against any person on the basis of race, creed, color, national origin, sex or sexual orientation, age, physical handicap, financial status or any characteristic or aspect in its providing of services. 14. AUTHORIZED SIGNATURES. The signatory for the PROVIDER below, certifies and warrants that: (a) The PROVIDER'S name in this agreement is the full name as designated in its corporate charter, if a corporation, or the full name under which the PROVIDER is authorized to do business in the State of Florida. (b) He or she is empowered to act and contract for the PROVIDER; and (c) This agreement has been approved by the Board of Directors of the PROVIDER if the PROVIDER is a corporation. 15. NOTICE. Any notice required or permitted under this agreement shall be in writing and hand-delivered or mailed, postage pre-paid, by certified mail, return receipt requested, to the other party as follows: For Board: David P. Owens, Grants Administrator Gato Building 1100 Simonton Street Key West, FL 33040 For PROVIDER Liz Kern, Executive Director Hospice of the Florida Keys, Inc. 1319 William St. Key West, FL 33040 305-294-8812 305-294-9348 FAX and Monroe County Attorney PO Box 1026 Key West, FL 33041 16. CONSENT TO JURISDICTION. This agreement shall be construed by and governed under the laws of the State of Florida and venue for any action arising under this agreement shall be in Monroe County, Florida. 17. NON-WAIVER. Any waiver of any breach of covenants herein contained to be kept and performed by the PROVIDER shall not be deemed or considered as a continuing waiver and shall not operate to bar or prevent the Board from declaring a forfeiture for any succeeding breach, either of the same conditions or covenants or otherwise. 18. AVAILABILITY OF FUNDS. If funds cannot be obtained or cannot be continued at a level sufficient to allow for continued reimbursement of expenditures for services specified herein, this agreement may be terminated immediately at the option of the Board by written notice of termination delivered to the PROVIDER. The Board shall not be obligated to pay for any services or goods provided by the PROVIDER after the PROVIDER has received written notice of termination, unless otherwise required by law. 19. PURCHASE OF PROPERTY. All property, whether real or personal, purchased with funds provided under this agreement, shall become the property of Monroe County and shall be accounted for pursuant to statutory requirements. 20. ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the parties hereto with respect to the subject matter hereof and supersedes any and all prior agreements with respect to such subject matter between the PROVIDER and the Board. IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed as of the day and year first written above. (SEAL) ATTEST: DANNY L. KOLHAGE, CLERK BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA By Deputy Clerk By Mayor/Chairman Witness PROVIDER (Federal ID No. ) Witness By President BY " NNJ,7j~HlmJ '" T~ o...._1p-o/-Q 2- ATTACHMENT A EXPENSE REIMBURSEMENT REQUIREMENTS This document is intended to provide basic guidelines to Human Service Organizations, county travelers, and contractual parties who have reimbursable expenses associated with Monroe County business. These guidelines, as they relate to travel, are from Florida Statute 112.061. A cover letter summarizing the major line items on the reimbursable expense request needs to also contain a notarized certified statement such as: "I certify that the attached expenses are accurate and in agreement with the records of this organization. Furthermore, these expenses are in compliance with this organization's contract with the Monroe County Board of County Commissioners.// Invoices should be billed to the contracting agency. Third party payments will not be considered for reimbursement. Remember, the expense should be paid prior to requesting a reimbursement. Only current charges will be considered, no previous balances. Reimbursement requests will be monitored in accordance with the level of detail in the contract. This document should not be considered all-inclusive. The Clerk's Finance Department reserves the right to review reimbursement requests on an individual basis. Any questions regarding these guidelines should be directed to 305-292-3534. Data Processing, PC Time, etc. The vendor invoice is required for reimbursement. Inter-company allocations are not considered reimbursable expenditures unless appropriate payroll journals for the charging department are attached and certified. Payroll A certified statement verifying the accuracy and authenticity of the payroll expense is needed. If a Payroll Journal is provided, it should include: dates, employee name, salary or hourly rate, total hours worked, withholding information and payroll taxes, check number and check amount. If a Payroll Journal is not provided, the following information must be provided: check amount, check number, date, payee, support for applicable payroll taxes. Postage, Overnight Deliveries,Courier, etc. A log of all postage expenses as they relate to the County contract is required for reimbursement. For overnight or express deliveries, the vendor invoice must be included. Rents, Leases, etc. A copy of the rental or lease agreement is required. Deposits and advance payments are not allowable expenses. Reproductions, Copies, etc. A log of copy expenses as they relate to the County contract is required for reimbursement. The log must define the date, number of copies made, source document, purpose, and recipient. A reasonable fee for copy expenses will be allowable. For vendor services, the vendor invoice and a sample of the finished product are required. Supplies, Services, etc. For supplies or services ordered, a vendor invoice is required. Telefax, Fax, etc. A fax log is required. The log must define the sender, the intended recipient, the date, the number called, and the reason for sending the fax. Telephone Expenses A user log of pertinent information must be remitted including: the party called, the caller, the telephone number, the date, and the purpose of the call. Travel Expenses Travel expenses must be submitted on a State of Florida Voucher for Reimbursement of Travel Expenses. Travel must be submitted in accordance with Florida Statute 112.061. Credit card statements are not acceptable documentation for reimbursement. If attending a conference or meeting a copy of the agenda is needed. Airfare reimbursement requires the original passenger receipt portion of the airline ticket. A travel itinerary is appreciated to facilitate the audit trail. Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example, taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is considered a reimbursable travel expense at the destination. Airport parking during a business trip is not. A detailed list of charges is required on the lodging invoice. Balance due must be zero. Room must be registered and paid for by traveler. The County will only reimburse the actual room and related bed tax. Room service, movies, and personal telephone calls are not allowable expenses. Meal reimbursement is: breakfast at $3.00, lunch at $6.00, and dinner at $12.00. Meal gUidelines state that travel must begin prior to 6 a.m. for breakfast reimbursement, before noon and end after 2 p.m. for lunch reimbursement, and before 6 p.m. and end after 8 p.m. for dinner reimbursement. Mileage reimbursement is calculated at .29 cents per mile for personal auto mileage while on County business. An odometer reading must be included on the state travel voucher for vicinity travel. Mileage is not allowed from a residence or office to a point of departure. For example, driving form one's home to the airport for a business trip is not a reimbursable expense. Non-allowable Expenses The following expenses are not allowable for reimbursement: capital outlay expenditures (unless specifically included in the contract), contributions, depreciation expenses (unless specifically included in the contract), entertainment expenses, fundraising, non-sufficient check charges, penalties and fines. ATTACHMENT B ORGANIZATION LETTERH EAD Monroe County Board of County Commissioners Finance Department 500 Whitehead Street Key West, FL 33040 Date The following is a summary of the expenses for ( Organization name) for the time period of to Check # Payee Reason Amount 101 Company A Rent $ X,XXX.XX 102 Company B Utilities XXX. XX 104 Employee A P/R ending 05/14/01 XXX.XX 105 Employee B P/R ending OS/28/01 XXX.XX (A) Total $ X.XXX.XX (B) Total prior payments $ X,XXX.XX (C) Total requested and paid (A + B) $ X,XXX.XX (D) Total contract amount $ X,XXX.XX Balance of contract (D-C) $ X.XXX.XX I certify that the above checks have been submitted to the vendors as noted and that the expenses are accurate and in agreement with the records of this organization. Furthermore, these expenses are in compliance with this organizations_ contract with the Monroe County Board of County Commissioners and will not be submitted for reimbursement to any other funding source. Executive Director Attachments (supporting documentation) Sworn to and subscribed before me this _ day of 2002 by who is personally known to me. Notary Public Notary Stamp DESCRIPTION OF SERVICES TO BE PROVIDED ATTACHMENT C Comprehensive direct services to patients and their families experiencing a Iife- threatening illness (generally those with a prognosis of six months of less). Services include, but are not limited to, pain and symptom management, medical consultation, skilled nursing, personal care, counseling, spiritual advising, rehabilitation therapies, nutrition consultation, medical social work and bereavement programs. Most services are provided at the client's residence. SWORN STATEMENT UNDER ORDINANCE NO. 10-1990 MONROE COUNTY. FLORIDA ETHICS CLAUSE warrants that he/it has not employed, retained or otherwise had act on his/its behalf any former County officer or employee in violation of Section 2 of Ordinance No. 10-1990 or any County officer or employee in violation of Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the County may, in its discretion, terminate this contract without liability and may also, in its discretion, deduct from the contract or purchase price, or otherwise recover, the full amount of any fee, commission, percentage, gift, or consideration paid to the former County officer or employee. (signature) Date: STATE OF COUNTY OF PERSONALLY APPEARED BEFORE ME, the undersigned authority, who, after first being sworn by me, affixed his/her signature (name of individual signing) in the space provided above on this day of ,20~. NOTARY PUBLIC My commission expires: OMB - MCP FORM #4 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." MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract # Contract with: Literacy Volunteers of Effective Date: 10/01102 America - Monroe County, Inc. Expiration Date: 9/30/03 Contract Purpose/Description: provides funding for literacy training of citizens of Monroe County Contract Manager: David P. Owens (Name) 4482 (Ext. ) OMB/Grants (Department) for BOCC meeting on 10/16/02 Agenda Deadline: 1 O/O? /02 CONTRACT COSTS Total Dollar Value of Contract: $6,200.00 Current Year Portion: $6,200.00 Budgeted? Yes~ No 0 Account Codes: 001-03205-530340-_ Grant: $0.00 _-_ _-_ County Match: $ _-__-_ - - - ---- ADDITIONAL COSTS Estimated Ongoing Costs: $~yr For: (Not included in dollar value above) (eg. maintenance, utilities, janitorial, salaries, etc.) CONTRACT REVIEW Changes Date In Needed Division Director /o_~-0L YesD No~ Risk Management S'O-I-O).. Y esD No~ ( ,~~ O.M.B./Purchasing 'ZtvlOlxesO NoEr" ~ Connty Attorney g./IS /0 2.. YesO Noc;a/ ~ ~ Date Out /;:; -.2 - .o.L. C? C)I-o~ '6/.7.4j~ ~6;;~ Comments: OMB Form Revised 9/11/95 MCP #2 AGREEMENT This Agreement is made and entered into this day of , 2002, between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter referred to as "Board" or "County," and Literacy Volunteers of America - Monroe County, Inc., hereinafter referred to as "PROVIDER." WHEREAS, the PROVIDER is a not-for-profit corporation established for the provision of literacy training, and WHEREAS, it is a legitimate public purpose to provide facilities and services for literacy training, now, therefore, IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed as follows: 1. AMOUNT OF AGREEMENT. The Board, in consideration of the PROVIDER substantially and satisfactorily performing and carrying out the duties of the Board as to providing facilities and services for literacy training for persons living in Monroe County, Florida, shall pay to the PROVIDER the sum of SIX-THOUSAND, TWO HUNDRED, AND 00/100 DOLLARS ($6,200.00) for fiscal year 2002-2003. 2. TERM. This Agreement shall commence on October 1, 2002, and terminate September 30, 2003, 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 literacy training to persons living in Monroe County, Florida. PROVIDER shall provide services described in Attachment C, attached hereto and incorporated herein. S. RECORDS. The PROVIDER shall maintain appropriate records to insure a proper accounting of all funds and expenditures, and shall provide a clear financial audit trail to allow for full accountability of funds received from said Board. Access to these records shall be provided during weekdays, 8 A.M. to 5 P.M., upon request of the Board, the State of Florida, or authorized agents and representatives of the Board or State. The PROVIDER shall be responsible for repayment of any and all audit exceptions which are identified by the Auditor General of the State of Florida, the Clerk of Court for Monroe County, an independent auditor, or their agents and representatives. In the event of an audit exception, the current fiscal year contract amount or subsequent fiscal year contract amounts shall be offset by the amount of the audit exception. In the event this agreement is not renewed or continued in subsequent years through new or amended contracts, the PROVIDER shall be billed by the Board for the amount of the audit exception and the PROVIDER shall promptly repay any audit exception. 6. INDEMNIFICATION AND HOLD HARMLESS. The PROVIDER covenants and agrees to indemnify and hold harmless Monroe County Board of County Commissioners from any and all claims for bodily injury (including death), personal injury, and property damage (including property owned by Monroe County) and any other losses, damages, and expenses (including attorney's fees) which arise out of, in connection with, or by reason of services provided by the PROVIDER occasioned by the negligence, errors, or other wrongful act or omission of the PROVIDER'S employees, agents, or volunteers. 7. INDEPENDENT CONTRACTOR. At all times and for all purposes hereunder, the PROVIDER is an independent contractor and not an employee of the Board. No statement contained in this agreement shall be construed so as to find the PROVIDER or any of its employees, contractors, servants or agents to be employees of the Board. 8. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement, the PROVIDER shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating the provision of such services, including those now in effect and hereinafter adopted. Any violation of said statutes, ordinances, rules and regulations shall constitute a material breach of this agreement and shall entitle the Board to terminate this contract immediately upon delivery of written notice of termination to the PROVIDER. 9. COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the COUNTY: (a) evidence of the organization's 501(c)(3) status; (b) a list of the organization's Board of Directors of which there must be five or more; (c) evidence of annual election of Officers and Directors; (d) an annual audited financial report; (e) a copy the organization's Corporate Bylaws, which must address the organization's mission, board and membership composition, election of officers, and so on; (f) a copy of the organization's Corporate Policies and Procedures Manual which must include hiring policies for all staff, drug and alcohol free workplace provisions, equal employment opportunity provisions, and so on; (g) cooperation with County monitoring visits; (h) semi-annual performance reports. These reports should include performance measurements which will demonstrate the level of accomplishment of goals for which funding has been provided. (i) other 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 Gato Building 1100 Simonton Street Key West, FL 33040 and Monroe County Attorney PO Box 1026 Key West, FL 33041 For PROVIDER Literacy Volunteers of America - Monroe County, Inc. Mary Casanova, Executive Director 812 Southard St, #3 Key West, FL 33040 305-294-4352 305-296-1337 FAX 16. CONSENT TO JURISDICTION. This agreement shall be construed by and governed under the laws of the State of Florida and venue for any action arising under this agreement shall be in Monroe County, Florida. 17. NON-WAIVER. Any waiver of any breach of covenants herein contained to be kept and performed by the PROVIDER shall not be deemed or considered as a continuing waiver and shall not operate to bar or prevent the Board from declaring a forfeiture for any succeeding breach, either of the same conditions or covenants or otherwise. 18. AVAILABILITY OF FUNDS. If funds cannot be obtained or cannot be continued at a level sufficient to allow for continued reimbursement of expenditures for services specified herein, this agreement may be terminated immediately at the option of the Board by written notice of termination delivered to the PROVIDER. The Board shall not be obligated to pay for any services or goods provided by the PROVIDER after the PROVIDER has received written notice of termination, unless otherwise required by law. 19. PURCHASE OF PROPERTY. All property, whether real or personal, purchased with funds provided under this agreement, shall become the property of Monroe County and shall be accounted for pursuant to statutory requirements. 20. ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the parties hereto with respect to the subject matter hereof and supersedes any and all prior agreements with respect to such subject matter between the PROVIDER and the Board. IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed as of the day and year first written above. (SEAL) ATTEST: DANNY L. KOLHAGE, CLERK BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA By By Deputy Clerk Mayor/Chairman Witness PROVIDER (Federal ID No. ) Witness By President ay )ZANN~ 7:. H;;;~ . 01IGfJ~~. -'-. '- r"'\ --\T~ ATTACHMENT A EXPENSE REIMBURSEMENT REQUIREMENTS This document is intended to provide basic guidelines to Human Service Organizations, county travelers, and contractual parties who have reimbursable expenses associated with Monroe County business. These guidelines, as they relate to travel, are from Florida Statute 112.061. A cover letter summarizing the major line items on the reimbursable expense request needs to also contain a notarized certified statement such as: "I certify that the attached expenses are accurate and in agreement with the records of this organization. Furthermore, these expenses are in compliance with this organization's contract with the Monroe County Board of County Commissioners.// Invoices should be billed to the contracting agency. Third party payments will not be considered for reimbursement. Remember, the expense should be paid prior to requesting a reimbursement. Only current charges will be considered, no previous balances. Reimbursement requests will be monitored in accordance with the level of detail in the contract. This document should not be considered all-inclusive. The Clerk's Finance Department reserves the right to review reimbursement requests on an individual basis. Any questions regarding these guidelines should be directed to 305-292-3534. Data Processing, PC Time, etc. The vendor invoice is required for reimbursement. Inter-company allocations are not considered reimbursable expenditures unless appropriate payroll journals for the charging department are attached and certified. Payroll A certified statement verifying the accuracy and authenticity of the payroll expense is needed. If a Payroll Journal is provided, it should include: dates, employee name, salary or hourly rate, total hours worked, withholding information and payroll taxes, check number and check amount. If a Payroll Journal is not provided, the following information must be provided: check amount, check number, date, payee, support for applicable payroll taxes. Postage, Overnight Deliveries,Courier, etc. A log of all postage expenses as they relate to the County contract is required for reimbursement. For overnight or express deliveries, the vendor invoice must be included. Rents, Leases, etc. A copy of the rental or lease agreement is required. Deposits and advance payments are not allowable expenses. Reproductions, Copies, etc. A log of copy expenses as they relate to the County contract is required for reimbursement. The log must define the date, number of copies made, source document, purpose, and recipient. A reasonable fee for copy expenses will be allowable. For vendor services, the vendor invoice and a sample of the finished product are required. Supplies, Services, etc. For supplies or services ordered, a vendor invoice is required. Telefax, Fax, etc. A fax log is required. The log must define the sender, the intended recipient, the date, the number called, and the reason for sending the fax. Telephone Expenses A user log of pertinent information must be remitted including: the party called, the caller, the telephone number, the date, and the purpose of the call. Travel Expenses Travel expenses must be submitted on a State of Florida Voucher for Reimbursement of Travel Expenses. Travel must be submitted in accordance with Florida Statute 112.061. Credit card statements are not acceptable documentation for reimbursement. If attending a conference or meeting a copy of the agenda is needed. Airfare reimbursement requires the original passenger receipt portion of the airline ticket. A travel itinerary is appreciated to facilitate the audit trail. Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example, taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is considered a reimbursable travel expense at the destination. Airport parking during a business trip is not. A detailed list of charges is required on the lodging invoice. Balance due must be zero. Room must be registered and paid for by traveler. The County will only reimburse the actual room and related bed tax. Room service, movies, and personal telephone calls are not allowable expenses. Meal reimbursement is: breakfast at $3.00, lunch at $6.00, and dinner at $12.00. Meal guidelines state that travel must begin prior to 6 a.m. for breakfast reimbursement, before noon and end after 2 p.m. for lunch reimbursement, and before 6 p.m. and end after 8 p.m. for dinner reimbursement. Mileage reimbursement is calculated at .29 cents per mile for personal auto mileage while on County business. An odometer reading must be included on the state travel voucher for vicinity travel. Mileage is not allowed from a residence or office to a point of departure. For example, driving form one's home to the airport for a business trip is not a reimbursable expense. Non-allowable Expenses The following expenses are not allowable for reimbursement: capital outlay expenditures (unless specifically included in the contract), contributions, depreciation expenses (unless specifically included in the contract), entertainment expenses, fundraising, non-sufficient check charges, penalties and fines. ATTACHMENT B ORGANIZATION LETTERHEAD Monroe County Board of County Commissioners Finance Department 500 Whitehead Street Key West, FL 33040 Date The following is a summary of the expenses for ( Organization name) for the time period of to Check # Payee Reason Amount 101 Company A Rent $ X,XXX.XX 102 Company B Utilities XXX.XX 104 Employee A P/R ending 05/14/01 XXX.XX 105 Employee B P/R ending OS/28/01 XXX.XX (A) Total $ X.XXX.XX (B) Total prior payments $ X,XXX.XX (C) Total requested and paid (A + B) $ X,XXX.XX (D) Total contract amount $ X,XXX.XX Balance of contract (D-C) $ X.XXX.XX I certify that the above checks have been submitted to the vendors as noted and that the expenses are accurate and in agreement with the records of this organization. Furthermore, these expenses are in compliance with this organizations_ contract with the Monroe County Board of County Commissioners and will not be submitted for reimbursement to any other funding source. Executive Director Attachments (supporting documentation) Sworn to and subscribed before me this _ day of 2002 by who is personally known to me. Notary Public Notary Stamp ATTACHMENT C DESCRIPTION OF SERVICES TO BE PROVIDED Tutoring in basic reading, writing, and conversational English to adults. English as a Second Language program, which teaches conversational English and reading and writing to adults who have no English or limited English proficiency. SWORN STATEMENT UNDER ORDINANCE NO. 10-1990 MONROE COUNTY. FLORIDA ETHICS CLAUSE warrants that he/it has not employed, retained or otherwise had act on his/its behalf any former County officer or employee in violation of Section 2 of Ordinance No. 10-1990 or any County officer or employee in violation of Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the County may, in its discretion, terminate this contract without liability and may also, in its discretion, deduct from the contract or purchase price, or otherwise recover, the full amount of any fee, commission, percentage, gift, or consideration paid to the former County officer or employee. (signature) Date: STATE OF COUNTY OF PERSONALLY APPEARED BEFORE ME, the undersigned authority, who, after first being sworn by me, affixed his/her signature (name of individual signing) in the space provided above on this day of , 20--,--. NOTARY PUBLIC My commission expires: OMB - MCP FORM #4 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." MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract # Contract with: Monroe Association for Effective Date: 10/01102 Retarded Citizens. Inc. Expiration Date: 9/30/03 Contract Purpose/Description: provides funding for services for retarded citizens of Monroe County Contract Manager: David P. Owens (Name) 4482 (Ext. ) OMB/Grants (Department) for BOCC meeting on 10/16102 Agenda Deadline: 10/02/02 CONTRACT COSTS Total Dollar Value of Contract: $48.370.00 Budgeted? Yes~ No 0 Account Codes: Grant: $0.00 County Match: $ Current Year Portion: $48.370.00 001-01505-530340-_ - - - ---- - - - ---- - - - ---- ADDITIONAL COSTS Estimated Ongoing Costs: $_/yr For: (Not included in dollar value above) (el!. maintenance, utilities, ianitorial, salaries, etc.) CONTRACT REVIEW Date In Division Director /" _~ -Ol...- Date Out /...:._")--u,--- Risk Management q -ol-DJ- YesO Ng O.M.B./Purchasing '3\ ]i)\~ esO NoQ.....--- ~ County Attorney S< / / S / () 2... Y esO No~ , -"\ ( ,- Vdt-U~ zj2UJO ;PG~ Comments: OMB Form Revised 9/11/95 MCP #2 AGREEMENT This Agreement is made and entered into this day of , 2002, between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter referred to as "Board" or "County," and Monroe Association for Retarded Citizens, Inc., hereinafter referred to as "PROVIDER." WHEREAS, the PROVIDER is a not-for-profit corporation established for the provision of adult day training, and WHEREAS, it is a legitimate public purpose to provide facilities and services for adult day training, now, therefore, IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed as follows: 1. AMOUNT OF AGREEMENT. The Board, in consideration of the PROVIDER substantially and satisfactorily performing and carrying out the duties of the Board as to providing facilities and services for adult day training for retarded citizens living in Monroe County, Florida, shall pay to the PROVIDER the sum of FORTY-EIGHT THOUSAND, THREE-HUNDRED, SEVENTY, AND 00/100 DOLLARS ($48,370.00) for fiscal year 2002-2003. 2. TERM. This Agreement shall commence on October 1, 2002, and terminate September 30, 2003, 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 adult day training to retarded citizens living in Monroe County, Florida. PROVIDER shall provide services described in Attachment C, attached hereto and incorporated herein. S. RECORDS. The PROVIDER shall maintain appropriate records to insure a proper accounting of all funds and expenditures, and shall provide a clear financial audit trail to allow for full accountability of funds received from said Board. Access to these records shall be provided during weekdays, 8 A.M. to 5 P.M., upon request of the Board, the State of Florida, or authorized agents and representatives of the Board or State. The PROVIDER shall be responsible for repayment of any and all audit exceptions which are identified by the Auditor General of the State of Florida, the Clerk of Court for Monroe County, an independent auditor, or their agents and representatives. In the event of an audit exception, the current fiscal year contract amount or subsequent fiscal year contract amounts shall be offset by the amount of the audit exception. In the event this agr,eement is not renewed or continued in subsequent years through new or amended contracts, the PROVIDER shall be billed by the Board for the amount of the audit exception and the PROVIDER shall promptly repay any audit exception. 6. INDEMNIFICATION AND HOLD HARMLESS. The PROVIDER covenants and agrees to indemnify and hold harmless Monroe County Board of County Commissioners from any and all claims for bodily injury (including death), personal injury, and property damage (including property owned by Monroe County) and any other losses, damages, and expenses (including attorney's fees) which arise out of, in connection with, or by reason of services provided by the PROVIDER occasioned by the negligence, errors, or other wrongful act or omission of the PROVIDER'S employees, agents, or volunteers. 7. INDEPENDENT CONTRACTOR. At all times and for all purposes hereunder, the PROVIDER is an independent contractor and not an employee of the Board. No statement contained in this agreement shall be construed so as to find the PROVIDER or any of its employees, contractors, servants or agents to be employees of the Board. 8. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement, the PROVIDER shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating the provision of such services, including those now in effect and hereinafter adopted. Any violation of said statutes, ordinances, rules and regulations shall constitute a material breach of this agreement and shall entitle the Board to terminate this contract immediately upon delivery of written notice of termination to the PROVIDER. 9. COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the COUNTY: (a) evidence of the organization's 501(c)(3) status; (b) a list of the organization's Board of Directors of which there must be five or more; (c) evidence of annual election of Officers and Directors; (d) an annual audited financial report; (e) a copy the organization's Corporate Bylaws, which must address the organization's mission, board and membership composition, election of officers, and so on; (f) a copy of the organization's Corporate Policies and Procedures Manual which must include hiring policies for all staff, drug and alcohol free workplace provisions, equal employment opportunity provisions, and so on; (g) cooperation with County monitoring visits; (h) semi-annual performance reports. These reports should include performance measurements which will demonstrate the level of accomplishment of goals for which funding has been provided. (i) other reasonable reports and information related to compliance with applicable laws, contract provisions and the scope of services that the County may from time to time request. 10. PROFESSIONAL RESPONSIBILITY AND LICENSING. The PROVIDER shall assure that all professionals have current and appropriate professional licenses and professional liability insurance coverage. Funding by the Board is contingent upon retention of appropriate local, state and/or federal certification and/or licensure of the PROVIDER'S program and staff. 11. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services and/or reimbursement of services shall be accomplished by an amendment, which must be approved in writing by the COUNTY. 12. NO ASSIGNMENT. The PROVIDER shall not assign this agreement except in writing and with the prior written approval of the Board, which approval shall be subject to such conditions and provisions as the Board may deem necessary. This agreement shall be incorporated by reference into any assignment and any assignee shall comply with all of the provisions herein. Unless expressly provided for therein, such approval shall in no manner or event be deemed to impose any obligation upon the Board in addition to the total agreed upon reimbursement amount for the services of the PROVIDER. 13. NON-DISCRIMINATION. The PROVIDER shall not discriminate against any person on the basis race, creed, color, national origin, sex or sexual orientation, age, physical handicap, or any other characteristic or aspect which is not job-related in its recruiting, hiring, promoting, terminating or any other area affecting employment under this agreement. At all times, the PROVIDER shall comply with all applicable laws and regulations with regard to employing the most qualified person(s) for positions under this agreement. The PROVIDER shall not discriminate against any person on the basis of race, creed, color, national origin, sex or sexual orientation, age, physical handicap, financial status or any characteristic or aspect in its providing of services. 14. AUTHORIZED SIGNATURES. The signatory for the PROVIDER below, certifies and warrants that: (a) The PROVIDER'S name in this agreement is the full name as designated in its corporate charter, if a corporation, or the full name under which the PROVIDER is authorized to do business in the State of Florida. (b) He or she is empowered to act and contract for the PROVIDER; and (c) This agreement has been approved by the Board of Directors of the PROVIDER if the PROVIDER is a corporation. 15. NOTICE. Any notice required or permitted under this agreement shall be in writing and hand-delivered or mailed, postage pre-paid, by certified mail, return receipt requested, to the other party as follows: For Board: David P. Owens, Grants Administrator Gato Building 1100 Simonton Street Key West, FL 33040 and Monroe County Attorney PO Box 1026 Key West, FL 33041 For PROVIDER Monroe Association for Retarded Citizens, Inc. Diana Flenard-Moore, Executive Director 812 Southard St., #3 Key West, FL 33040 305-294-9526 305-292-0078 FAX 16. CONSENT TO JURISDICTION. This agreement shall be construed by and governed under the laws of the State of Florida and venue for any action arising under this agreement shall be in Monroe County, Florida. 17. NON-WAIVER. Any waiver of any breach of covenants herein contained to be kept and performed by the PROVIDER shall not be deemed or considered as a continuing waiver and shall not operate to bar or prevent the Board from declaring a forfeiture for any succeeding breach, either of the same conditions or covenants or otherwise. 18. AVAILABILITY OF FUNDS. If funds cannot be obtained or cannot be continued at a level sufficient to allow for continued reimbursement of expenditures for services specified herein, this agreement may be terminated immediately at the option of the Board by written notice of termination delivered to the PROVIDER. The Board shall not be obligated to pay for any services or goods provided by the PROVIDER after the PROVIDER has received written notice of termination, unless otherwise required by law. 19. PURCHASE OF PROPERTY. All property, whether real or personal, purchased with funds provided under this agreement, shall become the property of Monroe County and shall be accounted for pursuant to statutory requirements. 20. ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the parties hereto with respect to the subject matter hereof and supersedes any and all prior agreements with respect to such subject matter between the PROVIDER and the Board. IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed as of the day and year first written above. (SEAL) ATTEST: DANNY L. KOLHAGE, CLERK BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA By By Deputy Clerk Mayor/Chairman PROVIDER (Federal ID No. ) Witness By Witness President nl'TF ATTACHMENT A EXPENSE REIMBURSEMENT REQUIREMENTS This document is intended to provide basic guidelines to Human Service Organizations, county travelers, and contractual parties who have reimbursable expenses associated with Monroe County business. These guidelines, as they relate to travel, are from Florida Statute 112.061. A cover letter summarizing the major line items on the reimbursable expense request needs to also contain a notarized certified statement such as: "I certify that the attached expenses are accurate and in agreement with the records of this organization. Furthermore, these expenses are in compliance with this organization's contract with the Monroe County Board of County Commissioners." Invoices should be billed to the contracting agency. Third party payments will not be considered for reimbursement. Remember, the expense should be paid prior to requesting a reimbursement. Only current charges will be considered, no previous balances. Reimbursement requests will be monitored in accordance with the level of detail in the contract. This document should not be considered all-inclusive. The Clerk's Finance Department reserves the right to review reimbursement requests on an individual basis. Any questions regarding these guidelines should be directed to 305-292-3534. Data Processing, PC Time, etc. The vendor invoice is required for reimbursement. Inter-company allocations are not considered reimbursable expenditures unless appropriate payroll journals for the charging department are attached and certified. Payroll A certified statement verifying the accuracy and authenticity of the payroll expense is needed. If a Payroll Journal is provided, it should include: dates, employee name, salary or hourly rate, total hours worked, withholding information and payroll taxes, check number and check amount. If a Payroll Journal is not provided, the following information must be provided: check amount, check number, date, payee, support for applicable payroll taxes. Postage, Overnight Deliveries, Courier, etc. A log of all postage expenses as they relate to the County contract is required for reimbursement. For overnight or express deliveries, the vendor invoice must be included. Rents, Leases, etc. A copy of the rental or lease agreement is required. Deposits and advance payments are not allowable expenses. Reproductions, Copies, etc. A log of copy expenses as they relate to the County contract is required for reimbursement. The log must define the date, number of copies made, source document, purpose, and recipient. A reasonable fee for copy expenses will be allowable. For vendor services, the vendor invoice and a sample of the finished product are required. Supplies, Services, etc. For supplies or services ordered, a vendor invoice is required. Telefax, Fax, etc. A fax log is required. The log must define the sender, the intended recipient, the date, the number called, and the reason for sending the fax. Telephone Expenses A user log of pertinent information must be remitted including: the party called, the caller, the telephone number, the date, and the purpose of the call. Travel Expenses Travel expenses must be submitted on a State of Florida Voucher for Reimbursement of Travel Expenses. Travel must be submitted in accordance with Florida Statute 112.061. Credit card statements are not acceptable documentation for reimbursement. If attending a conference or meeting a copy of the agenda is needed. Airfare reimbursement requires the original passenger receipt portion of the airline ticket. A travel itinerary is appreciated to facilitate the audit trail. Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example, taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is considered a reimbursable travel expense at the destination. Airport parking during a business trip is not. A detailed list of charges is required on the lodging invoice. Balance due must be zero. Room must be registered and paid for by traveler. The County will only reimburse the actual room and related bed tax. Room service, movies, and personal telephone calls are not allowable expenses. Meal reimbursement is: breakfast at $3.00, lunch at $6.00, and dinner at $12.00. Meal guidelines state that travel must begin prior to 6 a.m. for breakfast reimbursement, before noon and end after 2 p.m. for lunch reimbursement, and before 6 p.m. and end after 8 p.m. for dinner reimbursement. Mileage reimbursement is calculated at .29 cents per mile for personal auto mileage while on County business. An odometer reading must be included on the state travel voucher for vicinity travel. Mileage is not allowed from a residence or office to a point of departure. For example, driving form one's home to the airport for a business trip is not a reimbursable expense. Non-allowable Expenses The following expenses are not allowable for reimbursement: capital outlay expenditures (unless specifically included in the contract), contributions, depreciation expenses (unless specifically included in the contract), entertainment expenses, fund raising, non-sufficient check charges, penalties and fines. ATTACHMENT B ORGANIZATION 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 2002 by who is personally known to me. Notary Public Notary Stamp ATTACHMENT C DESCRIPTION OF SERVICES TO BE PROVIDED Adult Day Training Program, which includes: mobile work crews, arts and crafts, work at retail plant store, and functional academic training. SWORN STATEMENT UNDER ORDINANCE NO. 10-1990 MONROE COUNTY. FLORIDA ETHICS CLAUSE warrants that he/it has not employed, retained or otherwise had act on his/its behalf any former County officer or employee in violation of Section 2 of Ordinance No. 10-1990 or any County officer or employee in violation of Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the County may, in its discretion, terminate this contract without liability and may also, in its discretion, deduct from the contract or purchase price, or otherwise recover, the full amount of any fee, commission, percentage, gift, or consideration paid to the former County officer or employee. (signature) Date: STATE OF COUNTY OF PERSONALLY APPEARED BEFORE ME, the undersigned authority, who, after first being sworn by me, affixed his/her signature (name of individual signing) in the space provided above on this day of ,20_. NOTARY PUBLIC My commission expires: OMB - MCP FORM #4 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." MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract # Contract with: PACE Center for Girls Effective Date: 10/01102 Expiration Date: 9/30/03 Contract PurposelDescription: provides funding for educational services for at-risk adolescent girls and young women of Monroe County Contract Manager: David P. Owens (Name) 4482 (Ext. ) OMB/Grants (Department) for BOCC meeting on 10/16/02 Agenda Deadline: 10/02/02 CONTRACT COSTS Total Dollar Value of Contract: $22,250.00 Current Year Portion: $22,250.00 Budgeted? Yes~ No D Account Codes: 001-03004-530340-_ Grant: $0.00 _-_-_-_ County Match: $ _-_-_-_ - ---- ADDITIONAL COSTS Estimated Ongoing Costs: $_/yr For: (Not included in dollar value above) (eg. maintenance, utilities, janitorial, salaries, etc.) CONTRACT REVIEW Date Out Division Director / ..;;. - )...-<:>,-- ~~}.I-'{).}- 6\ 'lV\ rf0'1- Comments: OMB Form Revised 9/11/95 MCP #2 AGREEMENT This Agreement is made and entered into this day of , 2002, between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter referred to as "Board" or "County," and PACE Center for Girls of Monroe, Inc., hereinafter referred to as "PROVIDER.// WHEREAS, the PROVIDER is a not-for-profit corporation established for the provision of education counseling, training, and advocacy, and WHEREAS, it is a legitimate public purpose to provide facilities and services for education counseling, training, and advocacy, now, therefore, IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed as follows: 1. AMOUNT OF AGREEMENT. The Board, in consideration of the PROVIDER substantially and satisfactorily performing and carrying out the duties of the Board as to providing facilities and services for education counseling, training, and advocacy for girls and young women living in Monroe County, Florida, shall pay to the PROVIDER the sum of TWENTY-TWO THOUSAND, TWO HUNDRED, FIFTY, AND 00/100 DOLLARS ($22,250.00) for fiscal year 2002-2003. 2. TERM This Agreement shall commence on October 1, 2002, and terminate September 30, 2003, 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 education counseling, training, and advocacy to girls and young women living in Monroe County, Florida. PROVIDER shall provide services described in Attachment C, attached hereto and incorporated herein. 5. RECORDS The PROVIDER shall maintain appropriate records to insure a proper accounting of all funds and expenditures, and shall provide a clear financial audit trail to allow for full accountability of funds received from said Board. Access to these records shall be provided during weekdays, 8 a.m. to 5 p.m., upon request of the Board, the State of Florida, or authorized agents and representatives of the Board or State. The PROVIDER shall be responsible for repayment of any and all audit exceptions which are identified by the Auditor General of the State of Florida, the Clerk of Court for Monroe County, an independent auditor, or their agents and representatives. In the event of an audit exception, the current fiscal year contract amount or subsequent fiscal year contract amounts shall be offset by the amount of the audit exception. In the event this agreement is not renewed or continued in subsequent years through new or amended contracts, the PROVIDER shall be billed by the Board for the amount of the audit exception and the PROVIDER shall promptly repay any audit exception. 6. INDEMNIFICATION AND HOLD HARMLESS. The PROVIDER covenants and agrees to indemnify and hold harmless Monroe County Board of County Commissioners from any and all claims for bodily injury (including death), personal injury, and property damage (including property owned by Monroe County) and any other losses, damages, and expenses (including attorney's fees) which arise out of, in connection with, or by reason of services provided by the PROVIDER occasioned by the negligence, errors, or other wrongful act or omission of the PROVIDER's employees, agents, or volunteers. 7. INDEPENDENT CONTRACTOR At all times and for all purposes hereunder, the PROVIDER is an independent contractor and not an employee of the Board. No statement contained in this agreement shall be construed so as to find the PROVIDER or any of its employees, contractors, servants or agents to be employees of the Board. 8. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement, the PROVIDER shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating the provision of such services, including those now in effect and hereinafter adopted. Any violation of said statutes, ordinances, rules and regulations shall constitute a material breach of this agreement and shall entitle the Board to terminate this contract immediately upon delivery of written notice of termination to the PROVIDER. 9. COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the COUNTY: (a) evidence of the organization's 501(c)(3) status; (b) a list of the organization's Board of Directors of which there must be five or more; (c) evidence of annual election of Officers and Directors; (d) an annual audited financial report ; (e) a copy the organization's Corporate Bylaws, which must address the organization's mission, board and membership composition, election of officers, and so on; (f) a copy of the organization's Corporate Policies and Procedures Manual which must include hiring policies for all staff, drug and alcohol free workplace provisions, equal employment opportunity provisions, and so on; (g) cooperation with County monitoring visits; (h) semi-annual performance reports. These reports should include performance measurements which will demonstrate the level of accomplishment of goals for which funding has been provided. (i) other reasonable reports and information related to compliance with applicable laws, contract provisions and the scope of services that the County may from time to time request. 10. PROFESSIONAL RESPONSIBILITY AND LICENSING. The PROVIDER shall assure that all professionals have current and appropriate professional licenses and professional liability insurance coverage. Funding by the Board is contingent upon retention of appropriate local, state and/or federal certification and/or licensure of the PROVIDER's program and staff. 11. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services and/or reimbursement of services shall be accomplished by an amendment, which must be approved in writing by the COUNTY. 12. NO ASSIGNMENT The PROVIDER shall not assign this agreement except in writing and with the prior written approval of the Board, which approval shall be subject to such conditions and provisions as the Board may deem necessary. This agreement shall be incorporated by reference into any assignment and any assignee shall comply with all of the provisions herein. Unless expressly provided for therein, such approval shall in no manner or event be deemed to impose any obligation upon the Board in addition to the total agreed upon reimbursement amount for the services of the PROVIDER. 13. NON-DISCRIMINATION The PROVIDER shall not discriminate against any person on the basis race, creed, color, national origin, sex or sexual orientation, age, physical handicap, or any other characteristic or aspect which is not job-related in its recruiting, hiring, promoting, terminating or any other area affecting employment under this agreement. At all times, the PROVIDER shall comply with all applicable laws and regulations with regard to employing the most qualified person(s) for positions under this agreement. The PROVIDER shall not discriminate against any person on the basis of race, creed, color, national origin, sex or sexual orientation, age, physical handicap, financial status or any characteristic or aspect in its providing of services. 14. AUTHORIZED SIGNATURES. The signatory for the PROVIDER below, certifies and warrants that: (a) The PROVIDER's name in this agreement is the full name as designated in its corporate charter, if a corporation, or the full name under which the PROVIDER is authorized to do business in the State of Florida. (b) He or she is empowered to act and contract for the PROVIDER; and (c) This agreement has been approved by the Board of Directors of the PROVIDER if the PROVIDER is a corporation. 15. NOTICE. Any notice required or permitted under this agreement shall be in writing and hand-delivered or mailed, postage pre-paid, by certified mail, return receipt requested, to the other party as follows: For Board: David P. Owens, Grants Administrator Gato Building 1100 Simonton Street Key West, FL 33040 and Monroe County Attorney PO Box 1026 Key West, FL 33041 For PROVIDER Julie Smith, Executive Director PACE Center for Girls of Monroe County, Inc. 3130 Flagler Ave Key West, FL 33040 305-293-1892 305-293-1895 FAX 16. CONSENT TO JURISDICTION. This agreement shall be construed by and governed under the laws of the State of Florida and venue for any action arising under this agreement shall be in Monroe County, Florida. 17. NON-WAIVER. Any waiver of any breach of covenants herein contained to be kept and performed by the PROVIDER shall not be deemed or considered as a continuing waiver and shall not operate to bar or prevent the Board from declaring a forfeiture for any succeeding 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: DANNYL. KOLHAGE,CLERK BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA By By Deputy Clerk Mayor/Chairman Witness PROVIDER (Federal ID No. ) Witness 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 meeting a copy of the agenda is needed. Airfare reimbursement requires the original passenger receipt portion of the airline ticket. A travel itinerary is appreciated to facilitate the audit trail. Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example, taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is considered a reimbursable travel expense at the destination. Airport parking during a business trip is not. A detailed list of charges is required on the lodging invoice. Balance due must be zero. Room must be registered and paid for by traveler. The County will only reimburse the actual room and related bed tax. Room service, movies, and personal telephone calls are not allowable expenses. Meal reimbursement is: breakfast at $3.00, lunch at $6.00, and dinner at $12.00. Meal guidelines state that travel must begin prior to 6 a.m. for breakfast reimbursement, before noon and end after 2 p.m. for lunch reimbursement, and before 6 p.m. and end after 8 p.m. for dinner reimbursement. Mileage reimbursement is calculated at .29 cents per mile for personal auto mileage while on County business. An odometer reading must be included on the state travel voucher for vicinity travel. Mileage is not allowed from a residence or office to a point of departure. For example, driving form one's home to the airport for a business trip is not a reimbursable expense. Non-allowable Expenses The following expenses are not allowable for reimbursement: capital outlay expenditures (unless specifically included in the contract), contributions, depreciation expenses (unless specifically included in the contract), entertainment expenses, fundraising, non-sufficient check charges, penalties and fines. ATTACHMENT B ORGANIZATION LETTERHEAD Monroe County Board of County Commissioners Finance Department 500 Whitehead Street Key West, FL 33040 Date The following is a summary of the expenses for ( Organization name) for the time period of to Check # Payee Reason Amount 101 Company A Rent $ X,XXX.XX 102 Company B Utilities XXX. XX 104 Employee A P/R ending 05/14/01 XXX.XX 105 Employee B P/R ending OS/28/01 XXX.XX (A) Total $ X.XXX.XX (B) Total prior payments $ X,XXX.XX (C) Total requested and paid (A + B) $ X,XXX.XX (D) Total contract amount $ X,XXX.XX Balance of contract (D-C) $ X.XXX.XX I certify that the above checks have been submitted to the vendors as noted and that the expenses are accurate and in agreement with the records of this organization. Furthermore, these expenses are in compliance with this organizations_ contract with the Monroe County Board of County Commissioners and will not be submitted for reimbursement to any other funding source. Executive Director Attachments (supporting documentation) Sworn to and subscribed before me this _ day of 2002 by who is personally known to me. Notary Public Notary Stamp ATTACHMENT C DESCRIPTION OF SERVICES TO BE PROVIDED Education counseling, training, and advocacy for at-risk girls and young women in Monroe County. SWORN STATEMENT UNDER ORDINANCE NO. 10-1990 MONROE COUNTY. FLORIDA ETHICS CLAUSE warrants that he/it has not employed, retained or otherwise had act on his/its behalf any former County officer or employee in violation of Section 2 of Ordinance No. 10-1990 or any County officer or employee in violation of Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the County may, in its discretion, terminate this contract without liability and may also, in its discretion, deduct from the contract or purchase price, or otherwise recover, the full amount of any fee, commission, percentage, gift, or consideration paid to the former County officer or employee. (signature) Date: STATE OF COUNTY OF PERSONALLY APPEARED BEFORE ME, the undersigned authority, who, after first being sworn by me, affixed his/her signature (name of individual signing) in the space provided above on this day of ,20~. NOTARY PUBLIC My commission expires: OMB - MCP FORM #4 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,lI MONROE COUNTY BOARD OF COUNTY COMMISSIONERS Contract with: Red Ribbon Kids Foundation CONTRACT SUMMARY Contract # Effective Date: 10/01102 Expiration Date: 9/30/03 Contract Purpose/Description: provides funding for services to benefit children of Monroe County who are infected with, or affected by, AIDS. Contract Manager: David P. Owens (Name) 4482 (Ext. ) OMB/Grants (Department) for BOCC meeting on 10/16/02 Agenda Deadline: 10/02/02 CONTRACT COSTS Total Dollar Value of Contract: $3,100.00 Budgeted? Y es~ No 0 Account Codes: Grant: $0.00 County Match: $ Current Year Portion: $3,100.00 001-03217-530340-_ - ---- - ---- - - ---- ADDITIONAL COSTS Estimated Ongoing Costs: $_/yr For: (Not included in dollar value above) (eg. maintenance, utilities, janitorial, salaries, etc.) CONTRACT REVIEW Changes ~ Needed .. ~ ei er . Division Director /~_)-Ol..- YesD N~ ~ . .~. 0 II 'V'I) C:;(i -I; Risk Management It'~6-Do- Yes NOk....d. \ \ ~ ~CL ( I ~D- O.M.B./Purchasing q )'-i)o~esD NO~~~ County Attorney gJ;;2I/0LYesDNO~~ Date Out Date In I~.- ~-.:,L. Of -~'-Cd- C1 /~JDZ.~ f /YcR Comments: OMB Form Revised 9/11/95 MCP #2 AGREEMENT This Agreement is made and entered into this day of , 2002, between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter referred to as "Board" or "County/, and Red Ribbon Kids Foundation, Inc., hereinafter referred to as "PROVIDER." WHEREAS, the PROVIDER is a not-for-profit corporation established for the provIsion of services that benefit children infected with, or affected by, AIDS in Monroe County, and WHEREAS, it is a legitimate public purpose to provide services for that benefit children infected with, or affected by, AIDS in Monroe County, now, therefore, IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed as follows: 1, AMOUNT OF AGREEMENT, The Board, in consideration of the PROVIDER substantially and satisfactorily performing and carrying out the duties of the Board as to providing facilities and services for the provision of services that benefit children infected with, or affected by, AIDS in Monroe County, Florida, shall pay to the PROVIDER the sum of THREE THOUSAND, ONE HUNDRED, AND 00/100 DOLLARS ($3,100.00) for fiscal year 2002-2003. 2. TERM. This Agreement shall commence on October 1, 2002, and terminate September 30, 2003, 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. Only those types of expenses appearing on Attachment A will be reimbursed. Direct aid to clients, such as cash or check payments, gifts, vouchers, goods, and the like, will not be reimbursed. 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 services that benefit children infected with, or affected by, AIDS in Monroe County, Florida. PROVIDER shall provide services described in Attachment C, attached hereto and incorporated herein. 5, RECORDS. The PROVIDER shall maintain appropriate records to insure a proper accounting of all funds and expenditures, and shall provide a clear financial audit trail to allow for full accountability of funds received from said Board. Access to these records shall be provided during weekdays, 8 A.M. to 5 P.M., upon request of the Board, the State of Florida, or authorized agents and representatives of the Board or State. The PROVIDER shall be responsible for repayment of any and all audit exceptions which are identified by the Auditor General of the State of Florida, the Clerk of Court for Monroe County, an independent auditor, or their agents and representatives. In the event of an audit exception, the current fiscal year contract amount or subsequent fiscal year contract amounts shall be offset by the amount of the audit exception. In the event this agreement is not renewed or continued in subsequent years through new or amended contracts, the PROVIDER shall be billed by the Board for the amount of the audit exception and the PROVIDER shall promptly repay any audit exception. 6. INDEMNIFICATION AND HOLD HARMLESS. The PROVIDER covenants and agrees to indemnify and hold harmless Monroe County Board of County Commissioners from any and all claims for bodily injury (including death), personal injury, and property damage (including property owned by Monroe County) and any other losses, damages, and expenses (including attorney's fees) which arise out of, in connection with, or by reason of services provided by the PROVIDER occasioned by the negligence, errors, or other wrongful act or omission of the PROVIDER'S employees, agents, or volunteers. 7, INDEPENDENT CONTRACTOR. At all times and for all purposes hereunder, the PROVIDER is an independent contractor and not an employee of the Board. No statement contained in this agreement shall be construed so as to find the PROVIDER or any of its employees, contractors, servants or agents to be employees of the Board. 8. COMPLIANCE WITH LAW, In providing all services pursuant to this agreement, the PROVIDER shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating the provision of such services, including those now in effect and hereinafter adopted. Any violation of said statutes, ordinances, rules and regulations shall constitute a material breach of this agreement and shall entitle the Board to terminate this contract immediately upon delivery of written notice of termination to the PROVIDER. 9. COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the COUNTY: (a) evidence of the organization's SOl(c)(3) status; (b) a list of the organization's Board of Directors of which there must be five or more; (c) evidence of annual election of Officers and Directors; (d) an annual audited financial report; (e) a copy the organization's Corporate Bylaws, which must address the organization's mission, board and membership composition, election of officers, and so on; (f) a copy of the organization's Corporate Policies and Procedures Manual which must include hiring policies for all staff, drug and alcohol free workplace provisions, equal employment opportunity provisions, and so on; (g) cooperation with County monitoring visits; (h) semi-annual performance reports. These reports should include performance measurements which will demonstrate the level of accomplishment of goals for which funding has been provided. (i) other reasonable reports and information related to compliance with applicable laws, contract provisions and the scope of services that the County may from time to time request. 10, PROFESSIONAL RESPONSIBILITY AND LICENSING. The PROVIDER shall assure that all professionals have current and appropriate professional licenses and professional liability insurance coverage. Funding by the Board is contingent upon retention of appropriate local, state and/or federal certification and/or licensure of the PROVIDER'S program and staff. 11. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services and/or reimbursement of services shall be accomplished by an amendment, which must be approved in writing by the COUNTY. 12. NO ASSIGNMENT. The PROVIDER shall not assign this agreement except in writing and with the prior written approval of the Board, which approval shall be subject to such conditions and provisions as the Board may deem necessary. This agreement shall be incorporated by reference into any assignment and any assignee shall comply with all of the prOVISions herein. Unless expressly provided for therein, such approval shall in no manner or event be deemed to impose any obligation upon the Board in addition to the total agreed upon reimbursement amount for the services of the PROVIDER. 13. NON-DISCRIMINATION. The PROVIDER shall not discriminate against any person on the basis of 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 Gato Building 1100 Simonton Street Key West, FL 33040 and Monroe County Attorney PO Box 1026 Key West, FL 33041 For PROVIDER Richard Dennison, Executive Director Red Ribbon Kids Foundation, Inc. PO Box 1032 Key West, FL 33040-1032 305-296-0640 16. CONSENT TO JURISDICTION. This agreement shall be construed by and governed under the laws of the State of Florida and venue for any action arising under this agreement shall be in Monroe County, Florida. 17. NON-WAIVER, Any waiver of any breach of covenants herein contained to be kept and performed by the PROVIDER shall not be deemed or considered as a continuing waiver and shall not operate to bar or prevent the Board from declaring a forfeiture for any succeeding breach, either of the same conditions or covenants or otherwise. 18, AVAILABILITY OF FUNDS. If funds cannot be obtained or cannot be continued at a level sufficient to allow for continued reimbursement of expenditures for services specified herein, this agreement may be terminated immediately at the option of the Board by written notice of termination delivered to the PROVIDER. The Board shall not be obligated to pay for any services or goods provided by the PROVIDER after the PROVIDER has received written notice of termination, unless otherwise required by law. 19, PURCHASE OF PROPERTY. All property, whether real or personal, purchased with funds provided under this agreement, shall become the property of Monroe County and shall be accounted for pursuant to statutory requirements. 20, ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the parties hereto with respect to the subject matter hereof and supersedes any and all prior agreements with respect to such subject matter between the PROVIDER and the Board. IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed as of the day and year first written above. (SEAL) ATTEST: DANNY L. KOLHAGE, CLERK BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA By By Deputy Clerk Mayor/Chairman PROVIDER (Federal ID No. ) Witness By Witness President 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. 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. Expenses related to lobbying, fundraising, and the like will not be reimbursed. 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 Advance approval in writing is required for out-of-county travel. Travel expenses must be submitted on a State of Florida Voucher for Reimbursement of Travel Expenses. Travel must be submitted in accordance with Florida Statute 112.061. Credit card statements are not acceptable documentation for reimbursement. If attending a conference or meeting a copy of the agenda is needed. Airfare reimbursement requires the original passenger receipt portion of the airline ticket. A travel itinerary is appreciated to facilitate the audit trail. Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example, taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is considered a reimbursable travel expense at the destination. Airport parking during a business trip is not. A detailed list of charges is required on the lodging invoice. Balance due must be zero. Room must be registered and paid for by traveler. The County will only reimburse the actual room and related bed tax. Room service, movies, and personal telephone calls are not allowable expenses. Meal reimbursement is: breakfast at $3.00, lunch at $6.00, and dinner at $12.00. Meal guidelines state that travel must begin prior to 6 a.m. for breakfast reimbursement, before noon and end after 2 p.m. for lunch reimbursement, and before 6 p.m. and end after 8 p.m. for dinner rei m bu rsement. Mileage reimbursement is calculated at .29 cents per mile for personal auto mileage while on County business. An odometer reading must be included on the state travel voucher for vicinity travel. Mileage is not allowed from a residence or office to a point of departure. For example, driving form one's home to the airport for a business trip is not a reimbursable expense. Non-allowable Expenses The following expenses are not allowable for reimbursement: capital outlay expenditures (unless specifically included in the contract), contributions, depreciation expenses (unless specifically included in the contract), entertainment expenses, fundraising, non-sufficient check charges, penalties and fines. ATTACHMENT B ORGANIZATION LETIERHEAD 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 2002 by who is personally known to me. Notary Public Notary Stamp ATTACHMENT C DESCRIPTION OF SERVICES TO BE PROVIDED Provision of necessities such as educational equipment, clothing and holiday gifts, and direct financial aid for low income children who are infected with HIV or who have a member of their immediate family infected with HIV. SWORN STATEMENT UNDER ORDINANCE NO. 10-1990 MONROE COUNTY, FLORIDA ETHICS CLAUSE warrants that he/it has not employed, retained or otherwise had act on hiS/its behalf any former County officer or employee in violation of Section 2 of Ordinance No. 10-1990 or any County officer or employee in violation of Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the County may, in its discretion, terminate this contract without liability and may also, in its discretion, deduct from the contract or purchase price, or otherwise recover, the full amount of any fee, commission, percentage, gift, or consideration paid to the former County officer or employee. (signature) Date: STATE OF COUNTY OF PERSONALLY APPEARED BEFORE ME, the undersigned authority, who, after first being sworn by me, affixed his/her signature (name of individual signing) in the space provided above on this day of ,20_. NOTARY PUBLIC My commission expires: OMB - MCP FORM #4 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. II MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract with: Rural Health Network Effective Date: 10/1/02 Expiration Date: 9/30/03 Contract Purpose/Description: Approval of contract with Rural Health Network to provide administration and promotional activities related to the Florida KidCare program in Monroe County. Contract Manager: David P. Owens (Name) 4482 (Ext.) OMB/Grants Mgt. (Department) for BOCC meeting on 10/16/02 Agenda Deadline: 10/2/02 CONTRACT COSTS Total Dollar Value of Contract: $20,000.00 Current Year Portion: $20,000.00 Budgeted? Yes X No Account Codes: 001-03211-530340 Grant: $0.00 County Match: $0.00 Estimated Ongoing Costs: $0.00 (Not included in dollar value above) ADDITIONAL COSTS For: (eg. Maintenance, utilities, ianitorial, salaries, etc.) CONTRACT REVIEW Changes Date In Needed ./ ;:;>R-e:Je[~r Division Director /t>_).._.~''-- YesDN~ ~~~~~-_ Risk Management g-~1td.-4'.;L YesD Noc:} 01) .::)Q-<LC'C......(]:;r /\ O.M.B.lPurchaSingtt/tlfl~ esD Noc:r-- ~ County Attorney 8/2010"2- YesDNoO/ __ '_ , Date Out 1=, ")-...__ <;S- <.3, ~-{;,;L ~~~~ fj; /l-/o 2..- Comments: OMB Form Revised 9/11/95 MCP #2 AGREEMENT Rural Health Network of Monroe County, Florida, Inc. This Agreement is made and entered into this day of , 2002, between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter referred to as "Board" or "County," and RURAL HEALTH NETWORK OF MONROE COUNTY, FLORIDA, INC., hereinafter referred to as "Provider." WHEREAS, the Provider is a not-for-profit corporation established for the provision of health-related services to the disadvantaged citizens of Monroe County, and WHEREAS, it is a legitimate public purpose to provide outreach and promotional activities for the Florida Kid Care Program 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 outreach and promotional activities related to the Florida Kid Care Program in Monroe County, Florida, shall pay to the Provider the sum of TWENTY-THOUSAND AND NO/100 DOLLARS ($20,000.00) for fiscal year 2002- 2003. 2. TERM. This Agreement shall commence on October 1, 2002, and terminate September 30, 2003, 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. 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 paragraph one 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 outreach and promotional activities related to the Florida Kid Care Program 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 S 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 demonstrate and sustain compliance with: (a) SOl( c)(3) Registration; (b) Board of Directors of five or more; (c) Annual election of Officers and Directors; (d) Annual provision of annual report to County; (e) Corporate Bylaws; (f) Corporate Policies and Procedures Manual; (g) Hiring policies for all staff; (h) Cooperate with County monitoring visits; and (i) Semi-annual performance reports to be presented to County. 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: David P. Owens, Grants Administrator Gato Building 1100 Simonton Street Key West, FL 33040 and Monroe County Attorney PO Box 1026 Key West, FL 33041 For Provider Mark L. Szurek Executive Director Rural Health Network of Monroe County Post Office Box 4966 Key West, FL 33041-4966 16. CONSENT TO JURISDICTION. This agreement shall be construed by and governed under the laws of the State of Florida and venue for any action arising under this agreement shall be in Monroe County, Florida. 17. NON-WAIVER. Any waiver of any breach of covenants herein contained to be kept and performed by the Provider shall not be deemed or considered as a continuing waiver and shall not operate to bar or prevent the Board from declaring a forfeiture for any succeeding breach, either of the same conditions or covenants or otherwise. 18. AVAILABILITY OF FUNDS. If funds cannot be obtained or cannot be continued at a level sufficient to allow for continued reimbursement of expenditures for services specified herein, this agreement may be terminated immediately at the option of the Board by written notice of termination delivered to the Provider. The Board shall not be obligated to pay for any services or goods provided by the Provider after the Provider has received written notice of termination, unless otherwise required by law. 19. PURCHASE OF PROPERTY. All property, whether real or personal, purchased with funds provided under this agreement, shall become the property of Monroe County and shall be accounted for pursuant to statutory requirements. 20. ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the parties hereto with respect to the subject matter hereof and supersedes any and all prior agreements with respect to such subject matter between the Provider and the Board. IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed as of the day and year first written above. (SEAL) ATTEST: DANNY L. KOLHAGE, CLERK BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA By By Deputy Clerk Mayor/Chairman RURAL HEALTH NETWORK OF MONROE COUNTY, FLORIDA, 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 appreciated to facilitate the audit trail. Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example, taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is considered a reimbursable travel expense at the destination. Airport parking during a business trip is not. A detailed list of charges is required on the lodging invoice. Balance due must be zero. Room must be registered and paid for by traveler. The County will only reimburse the actual room and related bed tax. Room service, movies, and personal telephone calls are not allowable expenses. Meal reimbursement is: breakfast at $3.00, lunch at $6.00, and dinner at $12.00. Meal guidelines state that travel must begin prior to 6 a.m. for breakfast reimbursement, before noon and end after 2 p.m. for lunch reimbursement, and before 6 p.m. and end after 8 p.m. for dinner reimbursement. Mileage reimbursement is calculated at .29 cents per mile for personal auto mileage while on County business. An odometer reading must be included on the state travel voucher for vicinity travel. Mileage is not allowed from a residence or office to a point of departure. For example, driving form one's home to the airport for a business trip is not a reimbursable expense. Non-allowable Expenses The following expenses are not allowable for reimbursement: capital outlay expenditures (unless specifically included in the contract), contributions, depreciation expenses (unless specifically included in the contract), entertainment expenses, fundraising, non-sufficient check charges, penalties and fines. ATTACHMENT B ORGANIZATION LETTERHEAD Monroe County Board of County Commissioners Finance Department 500 Whitehead Street Key West, FL 33040 Date The following is a summary of the expenses for ( Organization name) for the time period of to Check # Payee Reason Amount 101 Company A Rent $ X,XXX.XX 102 Company B Utilities XXX.XX 104 Employee A P/R ending 05/14/01 XXX.XX 105 Employee B P/R ending OS/28/01 XXX.XX (A) Total $ X.XXX.XX (B) Total prior payments $ X,XXX.XX (C) Total requested and paid (A + B) $ X,XXX.XX (D) Total contract amount $ X,XXX.XX Balance of contract (D-C) $ X.XXX.XX I certify that the above checks have been submitted to the vendors as noted and that the expenses are accurate and in agreement with the records of this organization, Furthermore, these expenses are in compliance with this organizations_ contract with the Monroe County Board of County Commissioners and will not be submitted for reimbursement to any other funding source. Executive Director Attachments (supporting documentation) Sworn to and subscribed before me this _ day of 2002 by who is personally known to me. Notary Public Notary Stamp SWORN STATEMENT UNDER ORDINANCE NO. 10-1990 MONROE COUNTY. FLORIDA ETHICS CLAUSE warrants that he/it has not employed, retained or otherwise had act on his/its behalf any former County officer or employee in violation of Section 2 of Ordinance No. 10-1990 or any County officer or employee in violation of Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the County may, in its discretion, terminate this contract without liability and may also, in its discretion, deduct from the contract or purchase price, or otherwise recover, the full amount of any fee, commission, percentage, gift, or consideration paid to the former County officer or employee. (signature) Date: STATE OF COUNTY OF PERSONALLY APPEARED BEFORE ME, the undersigned authority, who, after first being sworn by me, affixed his/her signature (name of individual signing) in the space provided above on this day of ,19_, NOTARY PUBLIC My commission expires: OMB - MCP FORM #4 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 I ist. II MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract # Contract with: Salvation Army Effective Date: 10/01102 Expiration Date: 9/30/03 Contract Purpose/Description: provides funding for emergency management and disaster recovery services, including shelter operation. Contract Manager: David P. Owens (Name) for BOCC meeting on 10/16/02 4482 (Ext. ) OMB/Grants (Department) Agenda Deadline: 10/02/02 CONTRACT COSTS Total Dollar Value of Contract: $25,000.00 Budgeted? Yes~ No 0 Account Codes: Grant: $0.00 County Match: $ Current Year Portion: $25,000.00 001-03210-530340-_ - - - ---- - - - ---- - - - ---- ADDITIONAL COSTS Estimated Ongoing Costs: $_/yr For: (Not included in dollar value above) (eg. maintenance, utilities, janitorial, salaries, etc.) CONTRACT REVIEW Changes Date In Needed Division Director /"'-").-0>- YesD N~ Risk Management <t'od -OCt--- YesD NoGY O.M.B./Purchasing 0\ W\Ol--Y esD N~ County Attorney if / /S/ () 2... Y esD NO~ Comments: OMB Form Revised 9/11/95 MCP #2 Date Out /..:, -)..-OL ~'d-! -dJ- ~) 7/~2- AGREEMENT This Agreement is made and entered into this day of , 2002, between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter referred to as "Board" or "County," and Salvation Army, hereinafter referred to as "PROVIDER." WHEREAS, the PROVIDER is a not-for-profit corporation established for the provision of disaster recovery and emergency management services that benefit residents of Monroe County, and WHEREAS, it is a legitimate public purpose to provide disaster recovery and emergency management services that benefit residents 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 disaster recovery and emergency management services that benefit residents of Monroe County, Florida, shall pay to the PROVIDER the sum of TWENTY-FIVE THOUSAND AND 00/100 DOLLARS ($25,000.00) for fiscal year 2002-2003. 2, TERM. This Agreement shall commence on October 1, 2002, and terminate September 30, 2003, 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 disaster recovery and emergency management services that benefit residents 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 SOl(c)(3) status; (b) a list of the organization's Board of Directors of which there must be five or more; (c) evidence of annual election of Officers and Directors; (d) an annual audited financial report; (e) a copy the organization's Corporate Bylaws, which must address the organization/s mission, board and membership composition, election of officers, and so on; (f) a copy of the organization/s Corporate Policies and Procedures Manual which must include hiring policies for all staff, drug and alcohol free workplace provisions, equal employment opportunity provisions, and so on; (g) cooperation with County monitoring visits; (h) semi-annual performance reports. These reports should include performance measurements which will demonstrate the level of accomplishment of goals for which funding has been provided. (i) other reasonable reports and information related to compliance with applicable laws, contract provisions and the scope of services that the County may from time to time request. 10, PROFESSIONAL RESPONSIBILITY AND LICENSING. The PROVIDER shall assure that all professionals have current and appropriate professional licenses and professional liability insurance coverage. Funding by the Board is contingent upon retention of appropriate local, state and/or federal certification and/or licensure of the PROVIDER'S program and staff. 11. MODIFICATIONS AND AMENDMENTS, Any and all modifications of the services and/or reimbursement of services shall be accomplished by an amendment, which must be approved in writing by the COUNTY. 12, NO ASSIGNMENT, The PROVIDER shall not assign this agreement except in writing and with the prior written approval of the Board, which approval shall be subject to such conditions and provisions as the Board may deem necessary. This agreement shall be incorporated by reference into any assignment and any assignee shall comply with all of the provisions herein. Unless expressly provided for therein, such approval shall in no manner or event be deemed to impose any obligation upon the Board in addition to the total agreed upon reimbursement amount for the services of the PROVIDER. 13, NON-DISCRIMINATION. The PROVIDER shall not discriminate against any person on the basis of 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 Gato Building 1100 Simonton Street Key West, FL 33040 and Monroe County Attorney PO Box 1026 Key West, FL 33041 For PROVIDER Captain David Worthy Salvation Army 1920 Flagler Avenue P.O. Box 2878 Key West, FL 33045 305-296-0640 16. CONSENT TO JURISDICTION. This agreement shall be construed by and governed under the laws of the State of Florida and venue for any action arising under this agreement shall be in Monroe County, Florida. 17. NON-WAIVER. Any waiver of any breach of covenants herein contained to be kept and performed by the PROVIDER shall not be deemed or considered as a continuing waiver and shall not operate to bar or prevent the Board from declaring a forfeiture for any succeeding breach, either of the same conditions or covenants or otherwise. 18. AVAILABILITY OF FUNDS. If funds cannot be obtained or cannot be continued at a level sufficient to allow for continued reimbursement of expenditures for services specified herein, this agreement may be terminated immediately at the option of the Board by written notice of termination delivered to the PROVIDER. The Board shall not be obligated to pay for any services or goods provided by the PROVIDER after the PROVIDER has received written notice of termination, unless otherwise required by law. 19, PURCHASE OF PROPERTY. All property, whether real or personal, purchased with funds provided under this agreement, shall become the property of Monroe County and shall be accounted for pursuant to statutory requirements. 20, ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the parties hereto with respect to the subject matter hereof and supersedes any and all prior agreements with respect to such subject matter between the PROVIDER and the Board. IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed as of the day and year first written above. (SEAL) ATTEST: DANNY L. KOLHAGE, CLERK BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA By By Deputy Clerk Mayor/Chairman PROVIDER (Federal ID No. Witness By Witness President 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 LETIERHEAD 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 2002 by who is personally known to me. Notary Public Notary Stamp ATTACHMENT C DESCRIPTION OF SERVICES TO BE PROVIDED Provision of disaster recovery and emergency management services that benefit residents of Monroe County, including shelter operation. SWORN STATEMENT UNDER ORDINANCE NO. 10-1990 MONROE COUNTY, FLORIDA ETHICS CLAUSE warrants that he/it has not employed, retained or otherwise had act on his/its behalf any former County officer or employee in violation of Section 2 of Ordinance No. 10-1990 or any County officer or employee in violation of Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the County may, in its discretion, terminate this contract without liability and may also, in its discretion, deduct from the contract or purchase price, or otherwise recover, the full amount of any fee, commission, percentage, gift, or consideration paid to the former County officer or employee. (signature) Date: STATE OF COUNTY OF PERSONALLY APPEARED BEFORE ME, the undersigned authority, who, after first being sworn by me, affixed his/her signature (name of individual signing) in the space provided above on this day of ,20~. NOTARY PUBLIC My commission expires: OMB - MCP FORM #4 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. II MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract with: Samuel's House, Inc. Effective Date: 10/01/02 Expiration Date: 9/30/03 Contract Purpose/Description: provide funds for housing for women and children Contract Manager: David P. Owens (Name) 4482 (Ext.) OMB/Grants Mgt. (Department) for BOCC meeting on 10/16/02 Agenda Deadline: 10/02102 CONTRACT COSTS Total Dollar Value of Contract: $21,283.00 Current Year Portion: $21,283.00 Budgeted? Yes X No Account Codes: 001-03214-530340 Grant: $ 0 County Match: $0 Estimated Ongoing Costs: $ (Not included in dollar value above) ADDITIONAL COSTS For: Staff support-filing reports, oversight (eg. Maintenance, utilities, ianitorial, salaries, etc.) CONTRACT REVIEW Changes.\ Date In Needed ~ ~., Division Director /0-2-01- YesDNo~~'--' Risk Management (!(~'-Oo--- YesD No0 )'Ol,S.UuulbJ OM.B.lPurchasing <Z;ku/OZ-YesO NO~ ~~ County Attorney g / I,:;' lo"Z- YesD NOO/ Date Out /,::. ,- '~-c ~ '9-d/-6~ ~ WI02.. c- o/frdJ- Comments: OMB Form Revised 9/11/95 MCP #2 AGREEMENT This Agreement is made and entered into this day of , 2002, between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter referred to as "Board" or "County," and Samuel's House, Inc., hereinafter referred to as "PROVIDER." WHEREAS, the PROVIDER is a not-for-profit corporation established for the provision of women and children's housing and support, and WHEREAS, it is a legitimate public purpose to provide facilities and services for women and children's housing and support, now, therefore, IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed as follows: 1. AMOUNT OF AGREEMENT. The Board, in consideration of the PROVIDER substantially and satisfactorily performing and carrying out the duties of the Board as to providing facilities and services for women and children's housing and support in Monroe County, Florida, shall pay to the PROVIDER the sum of TWENTY-ONE THOUSAND, TWO-HUNDRED, EIGHTY-THREE AND 00/100 DOLLARS ($21,283,00) for fiscal year 2002-2003. 2. TERM This Agreement shall commence on October 1, 2002, and terminate September 30, 2003, unless earlier terminated pursuant to other provisions herein. 3. PAYMENT Payment will be paid periodically, but no more frequently than monthly as hereinafter set forth. Reimbursement requests will be submitted to the Board via the Clerk's Finance Office. The COUNTY shall only reimburse, subject to the funded amounts below, those reimbursable expenses which are reviewed and approved as complying with Florida Statutes 112.061 and Attachment A - Expense Reimbursement Requirements. Evidence of payment by the PROVIDER shall be in the form of a letter, summarizing the expenses, with supporting documentation attached. The letter should contain a certification statement An example of a reimbursement request cover letter is included as Attachment B. The organization's final invoice must be received within sixty days after the termination date of this contract shown in Article 2 above. After the Clerk of the Board examines and approves the request for reimbursement, the Board shall reimburse the PROVIDER. However, the total of said reimbursement expense payments in the aggregate sum shall not exceed the total amount shown in Article 1, above, during the term of this agreement. 4. SCOPE OF SERVICES The PROVIDER, for the consideration named, covenants and agrees with the Board to substantially and satisfactorily perform and carry out the duties of the Board in providing women and children's housing and support to persons living in Monroe County, Florida. PROVIDER shall provide services described in Attachment C, attached hereto and incorporated herein. s. RECORDS The PROVIDER shall maintain appropriate records to insure a proper accounting of all funds and expenditures, and shall provide a clear financial audit trail to allow for full accountability of funds received from said Board. Access to these records shall be provided during weekdays, 8 a.m. to 5 p.m., upon request of the Board, the State of Florida, or authorized agents and representatives of the Board or State. The PROVIDER shall be responsible for repayment of any and all audit exceptions which are identified by the Auditor General of the State of Florida, the Clerk of Court for Monroe County, an independent auditor, or their agents and representatives. In the event of an audit exception, the current fiscal year contract amount or subsequent fiscal year contract amounts shall be offset by the amount of the audit exception. In the event this agreement is not renewed or continued in subsequent years through new or amended contracts, the PROVIDER shall be billed by the Board for the amount of the audit exception and the PROVIDER shall promptly repay any audit exception. 6. INDEMNIFICATION AND HOLD HARMLESS. The PROVIDER covenants and agrees to indemnify and hold harmless Monroe County Board of County Commissioners from any and all claims for bodily injury (including death), personal injury, and property damage (including property owned by Monroe County) and any other losses, damages, and expenses (including attorney's fees) which arise out of, in connection with, or by reason of services provided by the PROVIDER occasioned by the negligence, errors, or other wrongful act or omission of the PROVIDER's employees, agents, or volunteers. 7, INDEPENDENT CONTRACTOR At all times and for all purposes hereunder, the PROVIDER is an independent contractor and not an employee of the Board. No statement contained in this agreement shall be construed so as to find the PROVIDER or any of its employees, contractors, servants or agents to be employees of the Board. 8. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement, the PROVIDER shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating the provision of such services, including those now in effect and hereinafter adopted. Any violation of said statutes, ordinances, rules and regulations shall constitute a material breach of this agreement and shall entitle the Board to terminate this contract immediately upon delivery of written notice of termination to the PROVIDER. 9. COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the COUNTY: (a) evidence of the organization's SOl(c)(3) status; (b) a list of the organization's Board of Directors of which there must be five or more; (c) evidence of annual election of Officers and Directors; (d) an annual audited financial report ; (e) a copy the organization's Corporate Bylaws, which must address the organization's mission, board and membership composition, election of officers, and so on; (f) a copy of the organization's Corporate Policies and Procedures Manual which must include hiring policies for all staff, drug and alcohol free workplace provisions, equal employment opportunity provisions, and so on; (g) cooperation with County monitoring visits; (h) semi-annual performance reports. These reports should include performance measurements which will demonstrate the level of accomplishment of goals for which funding has been provided. (i) other reasonable reports and information related to compliance with applicable laws, contract provisions and the scope of services that the County may from time to time request. 10. PROFESSIONAL RESPONSIBILITY AND LICENSING. The PROVIDER shall assure that all professionals have current and appropriate professional licenses and professional liability insurance coverage. Funding by the Board is contingent upon retention of appropriate local, state and/or federal certification and/or licensure of the PROVIDER's program and staff. 11. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services and/or reimbursement of services shall be accomplished by an amendment, which must be approved in writing by the COUNTY. 12. NO ASSIGNMENT The PROVIDER shall not assign this agreement except in writing and with the prior written approval of the Board, which approval shall be subject to such conditions and provisions as the Board may deem necessary.' This agreement shall be incorporated by reference into any assignment and any assignee shall comply with all of the provisions herein. Unless expressly provided for therein, such approval shall in no manner or event be deemed to impose any obligation upon the Board in addition to the total agreed upon reimbursement amount for the services of the PROVIDER. 13. NON-DISCRIMINATION The PROVIDER shall not discriminate against any person on the basis race, creed, color, national origin, sex or sexual orientation, age, physical handicap, or any other characteristic or aspect which is not job-related in its recruiting, hiring, promoting, terminating or any other area affecting employment under this agreement. At all times, the PROVIDER shall comply with all applicable laws and regulations with regard to employing the most qualified person(s) for positions under this agreement. The PROVIDER shall not discriminate against any person on the basis of race, creed, color, national origin, sex or sexual orientation, age, physical handicap, financial status or any characteristic or aspect in its providing of services. 14. AUTHORIZED SIGNATURES, The signatory for the PROVIDER below, certifies and warrants that: (a) The PROVIDER's name in this agreement is the full name as designated in its corporate charter, if a corporation, or the full name under which the PROVIDER is authorized to do business in the State of Florida. (b) He or she is empowered to act and contract for the PROVIDER; and (c) This agreement has been approved by the Board of Directors of the PROVIDER if the PROVIDER is a corporation. 15. NOTICE. Any notice required or permitted under this agreement shall be in writing and hand-delivered or mailed, postage pre-paid, by certified mail, return receipt requested, to the other party as follows: For Board: David P. Owens, Grants Administrator Gato Building 1100 Simonton Street Key West, FL 33040 For PROVIDER Elmira Leto, Executive Director Samuel's House 1511 Truman Ave Key West, FL 33040 305-296-0240 305-296-3921 FAX and Monroe County Attorney PO Box 1026 Key West, FL 33041 16. CONSENT TO JURISDICTION. This agreement shall be construed by and governed under the laws of the State of Florida and venue for any action arising under this agreement shall be in Monroe County, Florida. 17. NON-WAIVER. Any waiver of any breach of covenants herein contained to be kept and performed by the PROVIDER shall not be deemed or considered as a continuing waiver and shall not operate to bar or prevent the Board from declaring a forfeiture for any succeeding breach, either of the same conditions or covenants or otherwise. 18. AVAILABILITY OF FUNDS If funds cannot be obtained or cannot be continued at a level sufficient to allow for continued reimbursement of expenditures for services specified herein, this agreement may be terminated immediately at the option of the Board by written notice of termination delivered to the PROVIDER. The Board shall not be obligated to pay for any services or goods provided by the PROVIDER after the PROVIDER has received written notice of termination, unless otherwise required by law. 19. PURCHASE OF PROPERTY. All property, whether real or personal, purchased with funds provided under this agreement, shall become the property of Monroe County and shall be accounted for pursuant to statutory requirements. 20. ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the parties hereto with respect to the subject matter hereof and supersedes any and all prior agreements with respect to such subject matter between the PROVIDER and the Board. IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed as of the day and year first written above. (SEAL) ATTEST: DANNY L. KOLHAGE, CLERK BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA By By Deputy Clerk Mayor/Chairman PROVIDER (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 appreciated to facilitate the audit trail. Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example, taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is considered a reimbursable travel expense at the destination. Airport parking during a business trip is not. A detailed list of charges is required on the lodging invoice. Balance due must be zero. Room must be registered and paid for by traveler. The County will only reimburse the actual room and related bed tax. Room service, movies, and personal telephone calls are not allowable expenses. Meal reimbursement is: breakfast at $3.00, lunch at $6.00, and dinner at $12.00. Meal guidelines state that travel must begin prior to 6 a.m. for breakfast reimbursement, before noon and end after 2 p.m. for lunch reimbursement, and before 6 p.m. and end after 8 p.m. for dinner reimbursement. Mileage reimbursement is calculated at .29 cents per mile for personal auto mileage while on County business. An odometer reading must be included on the state travel voucher for vicinity travel. Mileage is not allowed from a residence or office to a point of departure. For example, driving form one's home to the airport for a business trip is not a reimbursable expense. Non-allowable Expenses The following expenses are not allowable for reimbursement: capital outlay expenditures (unless specifically included in the contract), contributions, depreciation expenses (unless specifically included in the contract), entertainment expenses, fundraising, non-sufficient check charges, penalties and fines. ATTACHMENT B ORGANIZATION LETTERHEAD Monroe County Board of County Commissioners Finance Department 500 Whitehead Street Key West, FL 33040 Date The following is a summary of the expenses for ( Organization name) for the time period of to Check # Payee Reason Amount 101 Company A Rent $ X,XXX.XX 102 Company B Utilities XXX.XX 104 Employee A P/R ending 05/14/01 XXX.XX 105 Employee B P/R ending OS/28/01 XXX.XX (A) Total $ X.XXX.XX (B) Total prior payments $ X,XXX.XX (C) Total requested and paid (A + B) $ X,XXX.XX (D) Total contract amount $ X,XXX.XX Balance of contract (D-C) $ X.XXX.XX I certify that the above checks have been submitted to the vendors as noted and that the expenses are accurate and in agreement with the records of this organization. Furthermore, these expenses are in compliance with this organizations_ contract with the Monroe County Board of County Commissioners and will not be submitted for reimbursement to any other funding source. Executive Director Attachments (supporting documentation) Sworn to and subscribed before me this _ day of 2002 by who is personally known to me. Notary Public Notary Stamp ATTACHMENT C DESCRIPTION OF SERVICES TO BE PROVIDED Housing for women and women with children, including care coordination to help clients access appropriate services and resources to help them become self-sufficient, case management, living skills training, and assistance in obtaining employment. SWORN STATEMENT UNDER ORDINANCE NO. 10-1990 MONROE COUNTY, FLORIDA ETHICS CLAUSE warrants that he/it has not employed, retained or otherwise had act on his/its behalf any former County officer or employee in violation of Section 2 of Ordinance No. 10-1990 or any County officer or employee in violation of Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the County may, in its discretion, terminate this contract without liability and may also, in its discretion, deduct from the contract or purchase price, or otherwise recover, the full amount of any fee, commission, percentage, gift, or consideration paid to the former County officer or employee. (signature) Date: STATE OF COUNTY OF PERSONALLY APPEARED BEFORE ME, the undersigned authority, who, after first being sworn by me, affixed his/her signature (name of individual signing) in the space provided abov.e on this day of ,20_. NOTARY PUBLIC My commission expires: OMB - MCP FORM #4 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." MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract # Contract with: U. S. Fellowship of Florida. Effective Date: 10/01102 d/b/a Heron/Peacock programs Expiration Date: 9/30/03 Contract Purpose/Description: provides funding for assisted living facilities with limited mental health support Contract Manager: David P. Owens (Name) 4482 (Ext. ) OMB/Grants (Department) for BOCC meeting on 10/16/02 Agenda Deadline: 10/02/02 CONTRACT COSTS Total Dollar Value of Contract: $36.911.00 Budgeted? Yes~ No 0 AccOlmt Codes: Grant: $0.00 County Match: $ Current Year Portion: $36.911.00 001-01506-530340-_ - - - ---- - - - ---- - - - ---- ADDITIONAL COSTS Estimated Ongoing Costs: $~yr For: (Not included in dollar value above) (eg. maintenance, utilities, ianitorial, salaries, etc.) CONTRACT REVIEW Changes Date In Needed ..-' ,,~I\ _ Division Director 1'p_)._~L- YesDN~ ~~~ Risk Management %rJ..(,Od-YesDN00 W -~.li~ O.M.B.lPurchasing 8tz.<l Ol--YesD NoQ--:: ~ County Attorney [{II';-! 0 l- YesD No[]--"' ~ Date Out /:::'-2--<> 4-- ~ro-I-C )r ~1()L f5/~2-- Comments: OMB Form Revised 9/11/95 MCP #2 AGREEMENT .' This Agreement is made and entered into this day of between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, referred to as "Board" or "County/' and United States Fellowship of Florida, Inc., referred to as "PROVIDER." . , 2002, hereinafter hereinafter WHEREAS, the PROVIDER is a not-for-profit corporation established for the provision of assisted living facilities with limited mental health support, and WHEREAS, it is a legitimate public purpose to provide assisted living facilities with limited mental health support, now, therefore, IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed as follows: 1. AMOUNT OF AGREEMENT. The Board, in consideration of the PROVIDER substantially and satisfactorily performing and carrying out the duties of the Board as to providing assisted living facilities with limited mental health support for persons living in Monroe County, Florida, shall pay to the PROVIDER the sum of THIRTY-SIX THOUSAND, NINE-HUNDRED, ELEVEN, AND 00/100 DOLLARS ($36,911.00) for fiscal year 2002-2003. 2. TERM. This Agreement shall commence on October 1, 2002, and terminate September 30, 2003, 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 assisted living facilities with limited mental health support to persons living in Monroe County, Florida. PROVIDER shall provide services described in Attachment C, attached hereto and incorporated herein. s. RECORDS. The PROVIDER shall maintain appropriate records to insure a proper accounting of all funds and expenditures, and shall provide a clear financial audit trail to allow for full accountability of funds received from said Board. Access to these records shall be provided during weekdays, 8 A.M. to 5 P.M., upon request of the Board, the State of Florida, or authorized agents and representatives of the Board or State. The PROVIDER shall be responsible for repayment of any and all audit exceptions which are identified by the Auditor General of the State of Florida, the Clerk of Court for Monroe County, an independent auditor, or their agents and representatives. In the event of an audit exception, the current fiscal year contract amount or subsequent fiscal year contract amounts shall be offset by the amount of the audit exception. In the event this agreement is not renewed or continued in subsequent years through new or amended contracts, the PROVIDER shall be billed by the Board for the amount of the audit exception and the PROVIDER shall promptly repay any audit exception. 6. INDEMNIFICATION AND HOLD HARMLESS, The PROVIDER covenants and agrees to indemnify and hold harmless Monroe County Board of County Commissioners from any and all claims for bodily injury (including death), personal injury, and property damage (including property owned by Monroe County) and any other losses, damages, and expenses (including attorney's fees) which arise out of, in connection with, or by reason of services provided by the PROVIDER occasioned by the negligence, errors, or other wrongful act or omission of the PROVIDER'S employees, agents, or volunteers. 7. INDEPENDENT CONTRACTOR. At all times and for all purposes hereunder, the PROVIDER is an independent contractor and not an employee of the Board. No statement contained in this agreement shall be construed so as to find the PROVIDER or any of its employees, contractors, servants or agents to be employees of the Board. 8. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement, the PROVIDER shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating the provision of such services, including those now in effect and hereinafter adopted. Any violation of said statutes, ordinances, rules and regulations shall constitute a material breach of this agreement and shall entitle the Board to terminate this contract immediately upon delivery of written notice of termination to the PROVIDER. 9. COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the COUNTY: (a) evidence of the organization's SOl(c)(3) status; (b) a list of the organization's Board of Directors of which there must be five or more; (c) evidence of annual election of Officers and Directors; (d) an annual audited financial report; (e) a copy the organization's Corporate Bylaws, which must address the organization's mission, board and membership composition, election of officers, and so on; (f) a copy of the organization's Corporate Policies and Procedures Manual which must include hiring policies for all staff, drug and alcohol free workplace provisions, equal employment opportunity provisions, and so on; (g) cooperation with County monitoring visits; (h) semi-annual performan"ce 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 Gato Building 1100 Simonton Street Key West, FL 33040 and Monroe County Attorney PO Box 1026 Key West, FL 33041 For PROVIDER Cathy Harpe, Executive Director United States Fellowship of Florida, Inc. 1320 Coco Plum Drive Marathon, FL 33050 305-743-4129 305-743-5137 FAX 16. CONSENT TO JURISDICTION. This agreement shall be construed by and governed under the laws of the State of Florida and venue for any action arising under this agreement shall be in Monroe County, Florida. 17. NON-WAIVER. Any waiver of any breach of covenants herein contained to be kept and performed by the PROVIDER shall not be deemed or considered as a continuing waiver and shall not operate to bar or prevent the Board from declaring a forfeiture for any succeeding breach, either of the same conditions or covenants or otherwise. 18. AVAILABILITY OF FUNDS. If funds cannot be obtained or cannot be continued at a level sufficient to allow for continued reimbursement of expenditures for services specified herein, this agreement may be terminated immediately at the option of the Board by written notice of termination delivered to the PROVIDER. The Board shall not be obligated to pay for any services or goods provided by the PROVIDER after the PROVIDER has received written notice of termination, unless otherwise required by law. 19. PURCHASE OF PROPERTY, All property, whether real or personal, purchased with funds provided under this agreement, shall become the property of Monroe County and shall be accounted for pursuant to statutory requirements. 20. ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the parties hereto with respect to the subject matter hereof and supersedes any and all prior agreements with respect to such subject matter between the PROVIDER and the Board. IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed as of the day and year first written above. (SEAL) ATTEST: DANNY L. KOLHAGE, CLERK BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA By By Deputy Clerk Mayor/Chairman PROVIDER (Federal ID No. ) Witness By Witness President ATTACHMENT A EXPENSE REIMBURSEMENT REQUIREMENTS This document is intended to provide basic guidelines to Human Service Organizations, county travelers, and contractual parties who have reimbursable expenses associated with Monroe County business. These guidelines, as they relate to travel, are from Florida Statute 112.061. A cover letter summarizing the major line items on the reimbursable expense request needs to also contain a notarized certified statement such as: "I certify that the attached expenses are accurate and in agreement with the records of this organization. Furthermore, these expenses are in compliance with this organization's contract with the Monroe County Board of County Commissioners." Invoices should be billed to the contracting agency. Third party payments will not be considered for reimbursement. Remember, the expense should be paid prior to requesting a reimbursement. Only current charges will be considered, no previous balances. Reimbursement requests will be monitored in accordance with the level of detail in the contract. This document should not be considered all-inclusive. The Clerk's Finance Department reserves the right to review reimbursement requests on an individual basis. Any questions regarding these guidelines should be directed to 305-292-3534. Data Processing, PC Time, etc. The vendor invoice is required for reimbursement. Inter-company allocations are not considered reimbursable expenditures unless appropriate payroll journals for the charging department are attached and certified. Payroll A certified statement verifying the accuracy and authenticity of the payroll expense is needed. If a Payroll Journal is provided, it should include: dates, employee name, salary or hourly rate, total hours worked, withholding information and payroll taxes, check number and check amount. If a Payroll Journal is not provided, the following information must be provided: check amount, check number, date, payee, support for applicable payroll taxes. Postage, Overnight Deliveries, Courier, etc. A log of all postage expenses as they relate to the County contract is required for reimbursement. For overnight or express deliveries, the vendor invoice must be included. Rents, Leases, etc. A copy of the rental or lease agreement is required. Deposits and advance payments are not allowable expenses, Reproductions, Copies, etc. A log of copy expenses as they relate to the County contract is required for reimbursement. The log must define the date, number of copies made, source document, purpose, and recipient. A reasonable fee for copy expenses will be allowable. For vendor services, the vendor invoice and a sample of the finished product are required. Supplies, Services, etc. For supplies or services ordered, a vendor invoice is required. Telefax, Fax, etc. A fax log is required. The log must define the sender, the intended recipient, the date, the number called, and the reason for sending the fax. Telephone Expenses A user log of pertinent information must be remitted including: the party called, the caller, the telephone number, the date, and the purpose of the call. Travel Expenses Travel expenses must be submitted on a State of Florida Voucher for Reimbursement of Travel Expenses. Travel must be submitted in accordance with Florida Statute 112.061. Credit card statements are not acceptable documentation for reimbursement. If attending a conference or meeting a copy of the agenda is needed. Airfare reimbursement requires the original passenger receipt portion of the airline ticket. A travel itinerary is appreciated to facilitate the audit trail. Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example, taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is considered a reimbursable travel expense at the destination. Airport parking during a business trip is not. A detailed list of charges is required on the lodging invoice. Balance due must be zero. Room must be registered and paid for by traveler. The County will only reimburse the actual room and related bed tax. Room service, movies, and personal telephone calls are not allowable expenses. Meal reimbursement is: breakfast at $3.00, lunch at $6.00, and dinner at $12.00. Meal guidelines state that travel must begin prior to 6 a.m. for breakfast reimbursement, before noon and end after 2 p.m. for lunch reimbursement, and before 6 p.m. and end after 8 p.m. for dinner reimbursement. Mileage reimbursement is calculated at .29 cents per mile for personal auto mileage while on County business. An odometer reading must be included on the state travel voucher for vicinity travel. Mileage is not allowed from a residence or office to a point of departure. For example, driving form one's home to the airport for a business trip is not a reimbursable expense. Non-allowable Expenses The following expenses are not allowable for reimbursement: capital outlay expenditures (unless specifically included in the contract), contributions, depreciation expenses (unless specifically included in the contract), entertainment expenses, fundraising, non-sufficient check charges, penalties and fines. ATTACHMENT B ORGANIZATION LETTERHEAD Monroe County Board of County Commissioners Finance Department 500 Whitehead Street Key West, FL 33040 Date The following is a summary of the expenses for ( Organization name) for the time period of to Check # Payee Reason Amount 101 Company A Rent $ X,XXX.XX 102 Company B Utilities XXX,XX 104 Employee A P/R ending 05/14/01 XXX,XX 105 Employee B P/R ending OS/28/01 XXX,XX (A) Total $ X.XXX.XX (B) Total prior payments $ X,XXX,XX (C) Total requested and paid (A + B) $ X,XXX,XX (D) Total contract amount $ X,XXX,XX Balance of contract (D-C) $ X.XXX.XX I certify that the above checks have been submitted to the vendors as noted and that the expenses are accurate and in agreement with the records of this organization. Furthermore, these expenses are in compliance with this organizations_ contract with the Monroe County Board of County Commissioners and will not be submitted for reimbursement to any other funding source, Executive Director Attachments (supporting documentation) Sworn to and subscribed before me this _ day of 2002 by who is personally known to me. Notary Public Notary Stamp ATTACHMENT C DESCRIPTION OF SERVICES TO BE PROVIDED Assisted living facilities with limited mental health support, SWORN STATEMENT UNDER ORDINANCE NO. 10-1990 MONROE COUNTY. FLORIDA ETHICS CLAUSE warrants that he/it has not employed, retained or otherwise had act on his/its behalf any former County officer or employee in violation of Section 2 of Ordinance No. 10-1990 or any County officer or employee in violation of Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the County may, in its discretion, terminate this contract without liability and may also, in its discretion, deduct from the contract or purchase price, or otherwise recover, the full amount of any fee, commission, percentage, gift, or consideration paid to the former County officer or employee. (signature) Date: STATE OF COUNTY OF PERSONALLY APPEARED BEFORE ME, the undersigned authority, who, after first being sworn by me, affixed his/her signature (name of individual signing) in the space provided above on this day of , 20---:.....-. NOTARY PUBLIC My commission expires: OMB - MCP FORM #4 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. II MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract # Contract with: Wesley House, Inc. Effective Date: 10/01102 Expiration Date: 9/30/03 Contract Purpose/Description: provides funding for day care, education. and skill development services for children of Monroe County Contract Manager: David P. Owens (Name) 4482 (Ext. ) OMB/Grants (Department) for BOCC meeting on 10/16/02 Agenda Deadline: 10/02/02 CONTRACT COSTS Total Dollar Value of Contract: $48.696.00 Budgeted? Yesl:8J No 0 Account Codes: Grant: $0.00 County Match: $ Current Year Portion: $48,696.00 001-03003-530340-_ - - - ---- - - - ---- - - - ---- ADDITIONAL COSTS Estimated Ongoing Costs: $_/yr For: (Not included in dollar value above) (eg. maintenance, utilities, ianitorial, salaries, etc.) CONTRACT REVIEW Changes Needed....,- ~~e DivisionDirector I~-l-",- YesDN~ ~~ RiskManagement '6'~I'Da- YesD No0 ~11.~ -- O.M.B.!PurchasingllWIOl-X esO NoQ/~ CountyAttorney 9/IS/()~ YesDNoCiV': ~~ Date Out Date In /0- 1.- -...-- ~"d-I-u)- ~1-w) ~fS Comments: OMB Form Revised 9/11/95 MCP #2 - AGREEMENT This Agreement is made and entered into this day of between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, referred to as "Board" or "County," and Wesley House Community Center, Inc., referred to as "PROVIDER." , 2002, hereinafter hereinafter WHEREAS, the PROVIDER is a not-for-profit corporation established for the provision of child care services, and WHEREAS, it is a legitimate public purpose to provide facilities and services for child care, now, therefore, IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed as follows: 1. AMOUNT OF AGREEMENT. The Board, in consideration of the PROVIDER substantially and satisfactorily performing and carrying out the duties of the Board as to providing facilities and services for child care for persons living in Monroe County, Florida, shall pay to the PROVIDER the sum of FORTY-EIGHT-THOUSAND, SIX HUNDRED, NINETY-SIX AND 00/100 DOLLARS ($48,696.001 for fiscal year 2002-2003. 2. TERM This Agreement shall commence on October 1, 2002, and terminate September 30, 2003, 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 child care services to persons living in Monroe County, Florida. PROVIDER shall provide services described in Attachment C, attached hereto and incorporated herein. s. RECORDS The PROVIDER shall maintain appropriate records to insure a proper accounting of all funds and expenditures, and shall provide q clear financial audit trail to allow for full accountability of funds received from said Board. Access to these records shall be provided during weekdays, 8 a.m. to 5 p.m., upon request of the Board, the State of Florida, or authorized agents and representatives of the Board or State. The PROVIDER shall be responsible for repayment of any and all audit exceptions which are identified by the Auditor General of the State of Florida, the Clerk of Court for Monroe County, an independent auditor, or their agents and representatives. In the event of an audit exception, the current fiscal year contract amount or subsequent fiscal year contract amounts shall be offset by the amount of the audit exception. In the event this agreement is not renewed or continued in subsequent years through new or amended contracts, the PROVIDER shall be billed by the Board for the amount of the audit exception and the PROVIDER shall promptly repay any audit exception. 6. INDEMNIFICATION AND HOLD HARMLESS. The PROVIDER covenants and agrees to indemnify and hold harmless Monroe County Board of County Commissioners from any and all claims for bodily injury (including death), personal injury, and property damage (including property owned by Monroe County) and any other losses, damages, and expenses (including attorney's fees) which arise out of, in connection with, or by reason of services provided by the PROVIDER occasioned by the negligence, errors, or other wrongful act or omission of the PROVIDER's employees, agents, or volunteers. 7. INDEPENDENT CONTRACTOR At all times and for all purposes hereunder, the PROVIDER is an independent contractor and not an employee of the Board. No statement contained in this agreement shall be construed so as to find the PROVIDER or any of its employees, contractors, servants or agents to be employees of the Board. 8. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement, the PROVIDER shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating the provision of such services, including those now in effect and hereinafter adopted. Any violation of said statutes, ordinances, rules and regulations shall constitute a material breach of this agreement and shall entitle the Board to terminate this contract immediately upon delivery of written notice of termination to the PROVIDER. 9. COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the COUNTY: (a) evidence of the organization's SOl(c)(3) status; (b) a list of the organization's Board of Directors of which there must be five or more; (c) evidence of annual election of Officers and Directors; (d) an annual audited financial report ; (e) a copy the organization's Corporate Bylaws, which must address the organization's mission, board and membership composition, election of officers, and so on; (f) a copy of the organization's Corporate Policies and Procedures Manual which must include hiring policies for all staff, drug and alcohol free workplace provisions, equal employment opportunity provisions, and so on; (g) cooperation with County monitoring visits; (h) semi-annual performance reports. These reports should include performance measurements which will demonstrate the level of accomplishment of goals for which funding has been provided. (i) other reasonable reports and information related to compliance with applicable laws, contract provisions and the scope of services that the County may from time to time request. 10. PROFESSIONAL RESPONSIBILITY AND LICENSING. The PROVIDER shall assure that all professionals have current and appropriate professional licenses and professional liability insurance coverage. Funding by the Board is contingent upon retention of appropriate local, state and/or federal certification and/or licensure of the PROVIDER's program and staff. 11. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services and/or reimbursement of services shall be accomplished by an amendment, which must be approved in writing by the COUNTY. 12. NO ASSIGNMENT The PROVIDER shall not assign this agreement except in writing and with the prior written approval of the Board, which approval shall be subject to such conditions and provisions as the Board may deem necessary. This agreement shall be incorporated by reference into any assignment and any assignee shall comply with all of the provisions herein. Unless expressly provided for therein, such approval shall in no manner or - event be deemed to impose any obligation upon the Board in addition to the total agreed upon reimbursement amount for the services of the PROVIDER. 13. NON-DISCRIMINATION The PROVIDER shall not discriminate against any person on the basis race, creed, color, national origin, sex or sexual orientation, age, physical handicap, or any other characteristic or aspect which is not job-related in its recruiting, hiring, promoting, terminating or any other area affecting employment under this agreement. At all times, the PROVIDER shall comply with all applicable laws and regulations with regard to employing the most qualified person(s) for positions under this agreement. The PROVIDER shall not discriminate against any person on the basis of race, creed, color, national origin, sex or sexual orientation, age, physical handicap, financial status or any characteristic or aspect in its providing of services. 14. AUTHORIZED SIGNATURES. The signatory for the PROVIDER below, certifies and warrants that: (a) The PROVIDER's name in this agreement is the full name as designated in its corporate charter, if a corporation, or the full name under which the PROVIDER is authorized to do business in the State of Florida. (b) He or she is empowered to act and contract for the PROVIDER; and (c) This agreement has been approved by the Board of Directors of the PROVIDER if the PROVIDER is a corporation. 15. NOTICE. Any notice required or permitted under this agreement shall be in writing and hand-delivered or mailed, postage pre-paid, by certified mail, return receipt requested, to the other party as follows: For Board: David P. Owens, Grants Administrator Gato Building 1100 Simonton Street Key West, FL 33040 For PROVIDER Joseph Barker, Executive Director Wesley House Community Center, Inc, 1304 Truman Avenue Key West, FL 33040 305-292-7150 305-292-7156 FAX and Monroe County Attorney PO Box 1026 Key West, FL 33041 16. CONSENT TO JURISDICTION. This agreement shall be construed by and governed under the laws of the State of Florida and venue for any action arising under this agreement shall be in Monroe County, Florida. 17. NON-WAIVER. Any waiver of any breach of covenants herein contained to be kept and performed by the PROVIDER shall not be deemed or considered as a continuing waiver and shall not operate to bar or prevent the Board from declaring a forfeiture for any succeeding breach, either of the same conditions or covenants or otherwise. 18. AVAILABILITY OF FUNDS If funds cannot be obtained or cannot be continued at a level sufficient to allow for continued reimbursement of expenditures for services specified herein, this agreement may be terminated immediately at the option of the Board by written notice of termination delivered to the PROVIDER. The Board shall not be obligated to pay for any services or goods provided by the PROVIDER after the PROVIDER has received written notice of termination, unless otherwise required by law. 19. PURCHASE OF PROPERTY. All property, whether real or personal, purchased with funds provided under this agreement, shall become the property of Monroe County and shall be accounted for pursuant to statutory requirements. 20, ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the parties hereto with respect to the subject matter hereof and supersedes any and all prior agreements with respect to such subject matter between the PROVIDER and the Board. IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed as of the day and year first written above. (SEAL) ATTEST: DANNY L. KOLHAGE, CLERK BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA By Deputy Clerk By Mayor/Chairman Witness PROVIDER (Federal ID No. ) Witness 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 meeting a copy of the agenda is needed. Airfare reimbursement requires the original passenger receipt portion of the airline ticket. A travel itinerary is appreciated to facilitate the audit trail. Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example, taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is considered a reimbursable travel expense at the destination. Airport parking during a business trip is not. A detailed list of charges is required on the lodging invoice. Balance due must be zero. Room must be registered and paid for by traveler. The County will only reimburse the actual room and related bed tax. Room service, movies, and personal telephone calls are not allowable expenses. Meal reimbursement is: breakfast at $3.00, lunch at $6.00, and dinner at $12.00. Meal gUidelines state that travel must begin prior to 6 a.m. for breakfast reimbursement, before noon and end after 2 p.m. for lunch reimbursement, and before 6 p.m. and end after 8 p.m. for dinner rei m bu rsement. Mileage reimbursement is calculated at .29 cents per mile for personal auto mileage while on County business, An odometer reading must be included on the state travel voucher for vicinity travel. Mileage is not allowed from a residence or office to a point of departure, For example, driving form one's home to the airport for a business trip is not a reimbursable expense. Non-allowable Expenses The following expenses are not allowable for reimbursement: capital outlay expenditures (unless specifically included in the contract), contributions, depreciation expenses (unless specifically included in the contract), entertainment expenses, fundraising, non-sufficient check charges, penalties and fines. ATTACHMENT B ORGANIZATION 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 5; 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) 5; 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 2002 by who is personally known to me, Notary Public Notary Stamp DESCRIPTION OF SERVICES TO BE PROVIDED ATTACHMENT C Early childhood information and financial assistance. In-home services to enhance the family quality of life. Early childhood quality improvement initiatives and training, Advocacy on issues to improve the lives of children, including health, nutrition, and education. SWORN STATEMENT UNDER ORDINANCE NO. 10-1990 MONROE COUNTY. FLORIDA ETHICS CLAUSE warrants that he/it has not employed, retained or otherwise had act on his/its behalf any former County officer or employee in violation of Section 2 of Ordinance No. 10-1990 or any County officer or employee in violation of Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the County may, in its discretion, terminate this contract without liability and may also, in its discretion, deduct from the contract or purchase price, or otherwise recover, the full amount of any fee, commission, percentage, gift, or consideration paid to the former County officer or employee. (signature) Date: STATE OF COUNTY OF PERSONALLY APPEARED BEFORE ME, the undersigned authority, who, after first being sworn by me, affixed his/her signature (name of individual signing) in the space provided above on this day of , 20---,--. NOTARY PUBLIC My commission expires: OMB - MCP FORM #4 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." MONROE COUNTY BOARD OF COUNTY COMMISSIONERS CONTRACT SUMMARY Contract # Contract with: Womankind. Inc. Effective Date: 10/01102 Expiration Date: 9/30/03 Contract Purpose/Description: provides funding for women's health care services Contract Manager: David P. Owens (Name) 4482 (Ext. ) OMB/Grants (Department) for BOCC meeting on 10/16/02 Agenda Deadline: 10/02/07 CONTRACT COSTS Total Dollar Value of Contract: $15.000.00 Budgeted? YeslZl No 0 Account Codes: Grant: $0.00 County Match: $ Current Year Portion: $15,000.00 001- 03215 -530340-_ - - ---- - - - ---- - - - ---- ADDITIONAL COSTS Estimated Ongoing Costs: $_/yr For: eN ot included in dollar value above) (eg. maintenance, utilities, ianitorial, salaries, etc.) CONTRACT REVIEW Changes Date In Needed ft. DivisionDirector /'::>-)...-01- YesDN~~ _:;= ~ Risk Management <;\"0. ~O o-YesD Nog "'(1). .. - _ O.M.B.lPurchasing7Q ~()LYesD No~ ~ County Attorney 8/ l ~ Ie> L- YesD NO~ . ~ Date Out /u-)...-~ 5i ~Ol-c) if- 3/m)DL ~(OL- Comments: OMB Form Revised 9/11/95 MCP #2 AGREEMENT This Agreement is made and entered into this day of , 2002, between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter referred to as "Board" or "County," and Womankind, Inc., hereinafter referred to as "PROVIDER." WHEREAS, the PROVIDER is a not-for-profit corporation established for the provision of women's health care, and WHEREAS, it is a legitimate public purpose to provide facilities and services for women's health care, now, therefore, IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed as follows: 1. AMOUNT OF AGREEMENT. The Board, in consideration of the PROVIDER substantially and satisfactorily performing and carrying out the duties of the Board as to providing facilities and services for women's health care for persons living in Monroe County, Florida, shall pay to the PROVIDER the sum of FIFTEEN THOUSAND AND 00/100 DOLLARS ($15,000.00) for fiscal year 2002-2003. 2. TERM This Agreement shall commence on October 1, 2002, and terminate September 30, 2003, unless earlier terminated pursuant to other provisions herein. 3. PAYMENT Payment will be paid periodically, but no more frequently than monthly as hereinafter set forth. Reimbursement requests will be submitted to the Board via the Clerk's Finance Office. The COUNTY shall only reimburse, subject to the funded amounts below, those reimbursable expenses which are reviewed and approved as complying with Florida Statutes 112.061 and Attachment A - Expense Reimbursement Requirements. Evidence of payment by the PROVIDER shall be in the form of a letter, summarizing the expenses, with supporting documentation attached. The letter should contain a certification statement An example of a reimbursement request cover letter is included as Attachment B. The organization's final invoice must be received within sixty days after the termination date of this contract shown in Article 2 above. After the Clerk of the Board examines and approves the request for reimbursement, the Board shall reimburse the PROVIDER. However, the total of said reimbursement expense payments in the aggregate sum shall not exceed the total amount shown in Article 1, above, during the term of this agreement. 4. SCOPE OF SERVICES The PROVIDER, for the consideration named, covenants and agrees with the Board to substantially and satisfactorily perform and carry out the duties of the Board in providing women's health care to persons living in Monroe County, Florida. PROVIDER shall provide services described in Attachment C, attached hereto and incorporated herein. 5. RECORDS The PROVIDER shall maintain appropriate records to insure a proper accounting of all funds and expenditures, and shall provide a clear financial audit trail to allow for full accountability of funds received from said Board. Access to these records shall be provided during weekdays, 8 a.m. to 5 p.m., upon request of the Board, the State of Florida, or authorized agents and representatives of the Board or State. The PROVIDER shall be responsible for repayment of any and all audit exceptions which are identified by the Auditor General of the State of Florida, the Clerk of Court for Monroe County, an independent auditor, or their agents and representatives. In the event of an audit exception, the current fiscal year contract amount or subsequent fiscal year contract amounts shall be offset by the amount of the audit exception. In the event this agreement is not renewed or continued in subsequent years through new or amended contracts, the PROVIDER shall be billed by the Board for the amount of the audit exception and the PROVIDER shall promptly repay any audit exception. 6. INDEMNIFICATION AND HOLD HARMLESS. The PROVIDER covenants and agrees to indemnify and hold harmless Monroe County Board of County Commissioners from any and all claims for bodily injury (including death), personal injury, and property damage (including property owned by Monroe County) and any other losses, damages, and expenses (including attorney's fees) which arise out of, in connection with, or by reason of services provided by the PROVIDER occasioned by the negligence, errors, or other wrongful act or omission of the PROVIDER's employees, agents, or volunteers. 7. INDEPENDENT CONTRACTOR At all times and for all purposes hereunder, the PROVIDER is an independent contractor and not an employee of the Board. No statement contained in this agreement shall be construed so as to find the PROVIDER or any of its employees, contractors, servants or agents to be employees of the Board. 8. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement, the PROVIDER shall abide by all statutes, ordinances, rules and regulations pertaining to or regulating the provision of such services, including those now in effect and hereinafter adopted. Any violation of said statutes, ordinances, rules and regulations shall constitute a material breach of this agreement and shall entitle the Board to terminate this contract immediately upon delivery of written notice of termination to the PROVIDER. 9. COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the COUNTY: (a) evidence of the organization's SOl(c)(3) status; (b) a list of the organization's Board of Directors of which there must be five or more; (c) evidence of annual election of Officers and Directors; (d) an annual audited financial report ; (e) a copy the organization's Corporate Bylaws, which must address the organization's mission, board and membership composition, election of officers, and so on; (f) a copy of the organization's Corporate Policies and Procedures Manual which must include hiring policies for all staff, drug and alcohol free workplace provisions, equal employment opportunity provisions, and so on; (g) cooperation with County monitoring visits; (h) semi-annual performance reports. These reports should include performance measurements which will demonstrate the level of accomplishment of goals for which funding has been provided. (i) other reasonable reports and information related to compliance with applicable laws, contract provisions and the scope of services that the County may from time to time request. 10. PROFESSIONAL RESPONSIBILITY AND LICENSING. The PROVIDER shall assure that all professionals have current and appropriate professional licenses and professional liability insurance coverage. Funding by the Board is contingent upon retention of appropriate local, state and/or federal certification and/or licensure of the PROVIDER's program and staff. 11. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services and/or reimbursement of services shall be accomplished by an amendment, which must be approved in writing by the COUNTY. 12. NO ASSIGNMENT The PROVIDER shall not assign this agreement except in writing and with the prior written approval of the Board, which approval shall be subject to such conditions and provisions as the Board may deem necessary. This agreement shall be incorporated by reference into any assignment and any assignee shall comply with all of the provisions herein. Unless expressly provided for therein, such approval shall in no manner or event be deemed to impose any obligation upon the Board in addition to the total agreed upon reimbursement amount for the services of the PROVIDER. 13. NON-DISCRIMINATION The PROVIDER shall not discriminate against any person on the basis race, creed, color, national origin, sex or sexual orientation, age, physical handicap, or any other characteristic or aspect which is not job-related in its recruiting, hiring, promoting, terminating or any other area affecting employment under this agreement. At all times, the PROVIDER shall comply with all applicable laws and regulations with regard to employing the most qualified person(s) for positions under this agreement. The PROVIDER shall not discriminate against any person on the basis of race, creed, color, national origin, sex or sexual orientation, age, physical handicap, financial status or any characteristic or aspect in its providing of services. 14. AUTHORIZED SIGNATURES. The signatory for the PROVIDER below, certifies and warrants that: (a) The PROVIDER's name in this agreement is the full name as designated in its corporate charter, if a corporation, or the full name under which the PROVIDER is authorized to do business in the State of Florida. (b) He or she is empowered to act and contract for the PROVIDER; and (c) This agreement has been approved by the Board of Directors of the PROVIDER if the PROVIDER is a corporation. 15. NOTICE. Any notice required or permitted under this agreement shall be in writing and hand-delivered or mailed, postage pre-paid, by certified mail, return receipt requested, to the other party as follows: For Board: David P. Owens, Grants Administrator Gato Building 1100 Simonton Street Key West, FL 33040 For PROVIDER Renee Grier, President Womankind, Inc. 3142 Northside Dr., Suite 101 Key West, FL 33040 305-294-4004 305-294-6043 FAX and Monroe County Attorney PO Box 1026 Key West, FL 33041 16. CONSENT TO JURISDICTION. This agreement shall be construed by and governed under the laws of the State of Florida and venue for any action arising under this agreement shall be in Monroe County, Florida. 17. NON-WAIVER. Any waiver of any breach of covenants herein contained to be kept and performed by the PROVIDER shall not be deemed or considered as a continuing waiver and shall not operate to bar or prevent the Board from declaring a forfeiture for any succeeding breach, either of the same conditions or covenants or otherwise, 18. AVAILABILITY OF FUNDS If funds cannot be obtained or cannot be continued at a level sufficient to allow for continued reimbursement of expenditures for services specified herein, this agreement may be terminated immediately at the option of the Board by written notice of termination delivered to the PROVIDER. The Board shall not be obligated to pay for any services or goods provided by the PROVIDER after the PROVIDER has received written notice of termination, unless otherwise required by law. 19. PURCHASE OF PROPERTY. All property, whether real or personal, purchased with funds provided under this agreement, shall become the property of Monroe County and shall be accounted for pursuant to statutory requirements. 20. ENTIRE AGREEMENT. This agreement constitutes the entire agreement of the parties hereto with respect to the subject matter hereof and supersedes any and all prior agreements with respect to such subject matter between the PROVIDER and the Board. IN WITNESS WHEREOF, the parties hereto have caused these presents to be executed as of the day and year first written above. (SEAL) ATTEST: DANNY L. KOLHAGE, CLERK BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA By By Deputy Clerk Mayor/Chairman PROVIDER (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 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 2002 by who is personally known to me. Notary Public Notary Stamp ATTACHMENT C DESCRIPTION OF SERVICES TO BE PROVIDED Secondary care procedures for women who qualify based on income. SWORN STATEMENT UNDER ORDINANCE NO. 10-1990 MONROE COUNTY. FLORIDA ETHICS CLAUSE warrants that he/it has not employed, retained or otherwise had act on his/its behalf any former County officer or employee in violation of Section 2 of Ordinance No, 10-1990 or any County officer or employee in violation of Section 3 of Ordinance No. 10-1990. For breach or violation of this provision the County may, in its discretion, terminate this contract without liability and may also, in its discretion, deduct from the contract or purchase price, or otherwise recover, the full amount of any fee, commission, percentage, gift, or consideration paid to the former County officer or employee. (signature) Date: STATE OF COUNTY OF PERSONALLY APPEARED BEFORE ME, the undersigned authority, who, after first being sworn by me, affixed his/her signature (name of individual signing) in the space provided above on this day of , 20---,--. NOTARY PUBLIC My commission expires: OMB - MCP FORM #4 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,"