Item C18Revised 2/95
BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
Meeting Date: October 15, 2003
Bulk Item: Yes x No
Division: Management Services
Department: Administrative Services
AGENDA ITEM WORDING: Approval of contracts with human service organizations
funded by the County for fiscal year 2004, for which funding recommendations are made
by the Human Services Advisory Board.
ITEM BACKGROUND: Funds are provided to various human service organizations
based upon the recommendations of the Monroe County Human Services Advisory
Board, as approved by the BOCC annually. See attached summary of amounts.
PREVIOUS RELEVANT BOCC ACTION: Initial total amount for Human Service
Advisory Board applicants set at $1,064,950.00 at Feb. 27, 2003 meeting. Request
from HSAB for additional funding to bring total to $1,400,000.00 denied at April 2003
meeting. Approval of additional amounts for various organizations that had requested
funding directly from the BOCC between April and July. BOCC sent these organizations
to HSAB in July, along with additional $240,000.00. Approval of HSAB
recommendations, with changes, at August 20, 2003 meeting.
CONTRACT/AGREEMENT CHANGES: Dates and amounts; some organizations are
being funded for the first time.
STAFF RECOMMENDATION: Approval
TOTAL COST: 1,304,950.00 BUDGETED: Yes XX No
COST TO COUNTY: 1,304,950.00 SOURCE OF FUNDS: ad valorem taxes
REVENUE PRODUCING: Yes No XX AMOUNT PER MONTH
YEAR
APPROVED BY:COUNTY ATTY ❑ OMB/PURC SING ❑ RISK MANAGEMENT ❑
DIVISION DIRECTOR APPROVAL:
Sheila A. Barker
DOCUMENTATION: INCLUDED: ❑ TO FOLLOW: ❑ NOT REQUIRED: ❑
DISPOSITION: AGENDA ITEM #:
.f
Agency
Care Center/Lower Keys
FY 03
195,189.00
FY04 req.
195,189.00
HSAB
recommended
195,189.00
%-age of
total
14.96%
% incr
from FY03
0.00%
BOCC
08/20/03
193,035.00
Change
2,154.00
Guidance Clinic/Middle Keys *
324,852.00
324,852.00
324,852.00
24.89%
0.00%
321,267.00
3,585.00
Guidance Clinic/Upper Keys
92,691.00
92,691.00
92,961.00
7.12%
0.29%
91,935.00
1,026.00
Hospice
40,000.00
40,000.00
40,000.00
3.07%
0.00%
39,559.00
441.00
Rural Health Net. Healthy Kids outreach
20,000.00
70,000.00
35,000.00
2.68%1
75.00%
34,614.00
386.00
Womankind
15,000.00
25,000.00
25,000.00
1.92%
66.67%
24,724.00
276.00
0.00
0.00
0.00
0.00%
0.00%
0.00
0.00
Total Medical Services Category
687,732.00
747,732.00
713,002.00
54.64%
3.67%
705,134.00
(7,868.00)
American Red Cross
19,590.00
30,000.00
25,000.00
1.92%
27.62%
24,724.00
276.00
Catholic Charities
19,348.00
19,348.00
19,348.00
1.48%
0.00%
19,135.00
213.00
Domestic Abuse Shelter
29,022.00
29,022.00
29,022.00
2.22%
0.00%
28,702.00
320.00
Florida Keys Children's Shelter
35,020.00
55,020.00
100,000.00
7.66%
185.55%
98,897.00
1,103.00
Florida Keys Outreach Coalition
19,928.00
19,928.00
19,928.00
1.53%
0.00%
19,708.00
220.00
Heron/Peacock
36,911.00
40,000.00
40,000.00
3.07%
8.37%
39,559.00
441.00
Monroe Assoc for Retarded Citizens
48,370.00
48,370.00
48,370.00
3.71 %
0.00%
47,836.00
534.00
PACE Center for Girls
22,250.00
23,000.00
23,000.00
1.76%
3.37%
22,746.00
254.00
Samuel's House
21,283.00
38,000.00
38,000.00
2.91%
78.55%
37,581.00
419.00
Wesley House
48,696.00
64,000.00
92,680.00
7.10%
90.32%
91,657.00
1,023.00
0.00
0.00
0.00
0.00%
0.00%
0.00
0.00
Total Core Services Category
300,418.00
366,688.00
435,348.00
33.36%
44.91%
430,545.00
(4,803.00)
Big Brothers/Big Sisters
12,400.00
30,000.00
21,400.00
1.64%
72.58%
21,164.00
236.00
Big Pine Athletic Association
40,000.00
40,000.00
30,000.00
2.30%
-25.00%
40,000.00
10,000.00
Boys and Girls Club
31,000.00
31,000.00
30,000.00
2.30%
-3.23%
29,669.00
331.00
Caring Friends for Seniors
10,000.00
14,000.00
6,000.00
0.46%
-40.00%
10,000.00
4,000.00
DOLPHINS to Stop Domestic Violence
0.00
32,666.00
0.00
0.00%
0.00%
0.00
0.00
Heart of the Keys Youth Recreation
0.00
50,000.00
30,000.00
2.30%
0.00%
29,669.00
331.00
Hel line
12,400.00
58,689.00
15,000.00
1.15%
20.97%
14,835.00
165.00
Just for Kids
0.00
99,000.00
5,000.00
0.38%
0.00%
4,945.00
55.00
Literacy Volunteers
6,200.00
6,200.00
6,200.00
0.48%
0.00%
6,132.00
68.00
YMCA Upper Keys
0.00
30,000.00
13,000.00
1.00%1
0.00%
12,857.00
143.00
0.00
0.00
0.00
0.00%
0.00%
0.00
0.00
Total Quality of Life Category
112,000.00
391,555.00
156,600.00
12.00%
39.82%
169,271.00
12,671.00
Total
1,100,150.00
1,505,975.00
1,304,950.00
100.00%
88.41%1
1,304,950.00
0.00
Available Funds
1,304,950.00
0.00
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract #
Contract with: American Red Cross Effective Date: 10/01/03
Expiration Date: 9/30/04
Contract Purpose/Description: Provide direct services to the citizens of Monroe County, such as
disaster assistance emergency communications and health and safety training.
Contract Manager: David P. Owens
(Name)
for BOCC meeting on
4482 OMB/Grants
(Ext.) (Department)
Deadline:
CONTRACT COSTS
Total Dollar Value of Contract: $24,724.00 Current Year Portion: $24,724.00
Budgeted? Yes® No ❑ Account Codes: 001-03203-530340- -
Grant: $0.00 - - -
County Match: $ - - - -
ADDITIONAL COSTS
Estimated Ongoing Costs: $ /yr For:
(Not included in dollar value above) (eg. maintenance, utilities, janitorial, salaries, etc
Division Director
Risk Management
O.M.B./Purchasing
County Attorney
Comments:
CONTRACT REVIEW
Changes
Date In Needed
Yes❑ NoE'
�U.3 Yes❑ No[R"'
Yes❑ No >
�-3 Yes❑ No
OMB Form Revised 9/11/95 MCP #2
Date Out
Reviewer
1631a3
cp
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AGREEMENT
This Agreement is made and entered into this day of 2003
between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter
referred to as "Board" or "County," and American Red Cross of Greater Miami and the Keys,
hereinafter referred to as "PROVIDER."
WHEREAS, the PROVIDER is a not -for -profit corporation established for the provision of
disaster services and health, safety and community services, and
WHEREAS, it is a legitimate public purpose to provide disaster services and health, safety
and community services, now, therefore,
IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed
as follows:
1. AMOUNT OF AGREEMENT. The Board, in consideration of the PROVIDER substantially
and satisfactorily performing and carrying out the duties of the Board as to providing disaster
services and health, safety and community services to persons living in Monroe County, Florida,
shall pay to the PROVIDER the sum of TWENTY-FOUR THOUSAND SEVEN HUNDRED TWENTY-
FOUR, AND NO/100 DOLLARS ($24 724 00) for fiscal year 2004.
2. TERM. This Agreement shall commence on October 1, 2003, and terminate September
30, 2004, 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.
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.
S. 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 and
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
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
By.
Deputy Clerk
Witness
Witness
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By
Mayor/Chairman
PROVIDER
(Federal ID No.
By
President
MONROE COUNTY ATTORNEY
ROVED AST OR
UZA NE AUHUTTON
ASSISTANT QL� / T RNEY
Date_ / 12
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 05/28/01 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 2003
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.
ETHICS CLAUSE
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY, FLORIDA
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.
Date:
STATE OF
COUNTY OF
(signature)
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."
0
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract #
Contract with: Big Brothers/Big Sisters Effective Date: 10/01/03
Expiration Date: 9/30/04
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)
for BOCC meeting on
4482 OMB/Grants
(Ext.) (Department)
Deadline: 09/3
CONTRACT COSTS
Total Dollar Value of Contract: $21,164.00 Current Year Portion: $21,164.00
Budgeted? Yes® No ❑ Account Codes: 001-03001-530340- -
Grant: $0.00 - - - -
County Match: $ - - - -
Estimated Ongoing Costs: $
(Not included in dollar value abo`
ADDITIONAL COSTS
/yr For:
(eg. maintenance,
CONTRACT REVIEW
Changes
Date In Needed
Division Director Yes[-] NoO
Risk Management 63103 Yes❑ NoZ
O.M.B./Purchasing ` * Yes[-] No[Q:
County Attorney "Ie3 Yes[-] No[s,'
Comments:
OMB Form Revised 9/11/95 MCP #2
etc.
Date Out
AGREEMENT
This Agreement is made and entered into this day of 2003
between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter
referred to as "Board" or "County," and Big Brothers/Big Sisters of Monroe County, Inc.,
hereinafter referred to as "PROVIDER."
WHEREAS, the PROVIDER is a not -for -profit corporation established for the provision of
companion, mentoring, and tutoring services to the youth of Monroe County, and
WHEREAS, it is a legitimate public purpose to provide facilities and services for the
provision of companion, mentoring, and tutoring services to the youth of Monroe County, now,
therefore,
IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed
as follows:
1. AMOUNT OF AGREEMENT. The Board, in consideration of the PROVIDER substantially
and satisfactorily performing and carrying out the duties of the Board as to providing facilities and
services for companion, mentoring, and tutoring services for young persons living in Monroe
County, Florida, shall pay to the PROVIDER the sum of TWENTY-ONE THOUSAND, ONE HUNDRED,
SIXTY-FOUR, AND 00/100 DOLLARS ($21,164.00) for fiscal year 2004.
2. TERM. This Agreement shall commence on October 1, 2003, and terminate September
30, 2004, 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.
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.
S. 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.
1S. 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 and
Gato Building
1100 Simonton Street
Key West, FL 33040
For PROVIDER
Carmen Turner, Executive Director
Big Brothers/Big Sisters of Monroe County, Inc.
P O Box 505
Key West, FL 33041
305-294-9891
305-294-1551 FAX
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
By.
Deputy Clerk
Witness
Witness
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By.
Mayor/Chairman
PROVIDER
(Federal ID No
By
President
MONROE COUNTY ATTOFINEY
PROVED F .
UZ N A. HUTTON
ASSISTANN7�. AORNEY
;:rate
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 05/28/01
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 2003
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).
ETHICS CLAUSE
SWORN STATEMENT UNDER ORDINANCE NO 10-1990
MONROE COUNTY, FLORIDA
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.
Date:
STATE OF
COUNTY OF
(signature)
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: Big Pine Athletic Assoc. Effective Date: 10/0 1 /03
Expiration Date:9/30/04
Contract Purpose/Description: provides funding for youth programs for children of Monroe
County
Contract Manager: David P. Owens
(Name)
for BOCC meeting on 10/1
4482 OMB/Grants
(Ext.) (Department)
Deadline:
CONTRACT COSTS
Total Dollar Value of Contract: $40,000.00 Current Year Portion: $40,000.00
Budgeted? Yes® No ❑ 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.
Division Director
Risk Management
O.M.B./Purchasing
County Attorney
Comments:
Date In
CONTRACT REVIEW
Changes
Needed
Yes❑ No
pld3 Yes[-] No
'{2'es❑ No
103 Yes❑ No
OMB Form Revised 9/11/95 MCP #2
Date Out
/03
t�
AGREEMENT
This Agreement is made and entered into this day of 2003
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
2004.
2. TERM. This Agreement shall commence on October 1, 2003, and terminate September
30, 2004, 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.
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.
S. 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 and
Gato Building
1100 Simonton Street
Key West, FL 33040
For PROVIDER
Merideth Bliss-Troxel, President
Big Pine Key Athletic Association
P. O. Box 430089
Big Pine Key, Florida 33043
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
By.
Deputy Clerk
Witness to Provider Signature
Witness to Provider Signature
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By
Mayor/Chairman
PROVIDER
(Federal ID No. )
By
President
MONROE COUNTY ATTORNEY
APPROVED A F M:
UZANNE HUTTON
ASSISTANT402. Y grTJOANEY
Date Z
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 05/28/01
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 2003
by who is personally known to me.
Notary Public Notary Stamp
ATTACHMENT C
Services To Be Provided
Operation of the Blue Heron Park and Youth Center.
Provide wholesome indoor and outdoor recreational activities for youth, six to eighteen
years old, during their free hours from school.
Provide organized sports as well as other activities for youth.
Organizing, promoting, and providing the facilities, insurance, and equipment for sport
teams.
Full-time summer day camp at Blue Heron Park.
Drop -in after school activities such as computers, homework, games, sports and arts and
crafts.
Blue Heron Park availability for community use, e.g. parties and meetings, by
appointment for groups such as Big Pine and Lower Keys AYSO, the Boy Scouts, the Girl
Scouts, the Big Pine Science Club, the Big Pine Moose Club and the Amateur Radio Club.
Regular events, such as the Obstacle Course at Kids Karnival, the Easter Egg Hunt and
the Community Picnic.
ETHICS CLAUSE
SWORN STATEMENT UNDER ORDINANCE NO 10-1990
MONROE COUNTY FLORIDA
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.
Date:
STATE OF
COUNTY OF
(signature)
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: Boys and Girls Club Effective Date: 10/01/03
Expiration Date: 09/30/04
Contract Purpose/Description: Provides funding for facilities and services for recreational use and social
functions of the community in a wholesome environment free from drugs and alcohol.
Contract Manager: David P. Owens
(Name)
for BOCC meeting on 1
4482 OMB/Grants
(Ext.) (Department)
a Deadline:
CONTRACT COSTS
Total Dollar Value of Contract: $29,669.00 Current Year Portion: $29,669.00
Budgeted? Yes X No ❑ Account Codes: 001-03707-530340- -
Grant: $ - - - -
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
Changes
Needed , f Revip�'er
Date Out
Division Director
Yes❑ No®'
Risk Management
�u3
Yes❑ No[?"'
Xh310-3
/ o
O.M.B./Purchasing
Yes❑ Now"
.`
County Attorney
3
Yes❑ Not
�3
Comments:
OMB Form Revised 9/11/95 MCP #2
AGREEMENT
Boys and Girls Club
This Agreement is made and entered into this day of 2003
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
WHEREAS, the Provider is open to the public at least five days a week, three hours a day,
and more usually, nine and one-half hours a day, and
WHEREAS, it is a legitimate public purpose to provide facilities and services for
recreational use and social functions of the community in a wholesome environment free from
drugs and alcohol, now, therefore,
IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed
as follows:
1. AMOUNT OF AGREEMENT. The Board, in consideration of the Provider
substantially and satisfactorily performing and carrying out the duties of the Board as to providing
facilities and services for recreational use for young persons living in Monroe County, Florida, shall
pay to the Provider the sum of TWENTY-NINE THOUSAND, SIX -HUNDRED, SIXTY-NINE, AND
NO/100 DOLLARS ($29,669.00) for fiscal year 2004.
2. TERM. This Agreement shall commence on October 1, 2003, and terminate
September 30, 2004, 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
durin weekdays 8 a m to 5 p.m. upon request of the Board, the State of Florida, or authorized
g . . ,
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.
S. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement,
the Provider shall abide by all statutes, ordinances, rules and regulations pertaining to or
regulating the provision of such services, including those now in effect and hereinafter adopted.
Any violation of said statutes, ordinances, rules and regulations shall constitute a material breach
of this agreement and shall entitle the Board to terminate this contract immediately upon delivery
of written notice of termination to the Provider.
9. COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the
COUNTY:
(a) evidence of the organization's 501(c)(3) status;
(b) a list of the organization's Board of Directors of which there must be five or more;
(c) evidence of annual election of Officers and Directors;
(d) an annual audited financial report ;
(e) a copy the organization's Corporate Bylaws, which must address the organization's
mission, board and membership composition, election of officers, and so on;
(f) a copy of the organization's Corporate Policies and Procedures Manual which must include
hiring policies for all staff, drug and alcohol free workplace provisions, equal employment
opportunity provisions, and so on;
(g) cooperation with County monitoring visits;
(h) semi-annual performance reports. These reports should include performance
measurements which will demonstrate the level of accomplishment of goals for which funding
has been provided.
(i) other reasonable reports and information related to compliance with applicable laws,
contract provisions and the scope of services that the County may from time to time request.
10. PROFESSIONAL RESPONSIBILITY AND LICENSING. The Provider shall assure
that all professionals have current and appropriate professional licenses and professional liability
insurance coverage. Funding by the Board is contingent upon retention of appropriate local, state
and/or federal certification and/or licensure of the Provider's program and staff.
11. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services
and/or reimbursement of services shall be amended by an agreement amendment, which must be
approved in writing by the Board.
12. NO ASSIGNMENT. The Provider shall not assign this agreement except in writing
and with the prior written approval of the Board, which approval shall be subject to such
conditions and provisions as the Board may deem necessary. This agreement shall be
incorporated by reference into any assignment and any assignee shall comply with all of the
provisions herein. Unless expressly provided for therein, such approval shall in no manner or
event be deemed to impose any obligation upon the Board in addition to the total agreed upon
reimbursement amount for the services of the Provider.
13. NON-DISCRIMINATION. The Provider shall not discriminate against any person
on the basis race, creed, color, national origin, sex or sexual orientation, age, physical handicap,
or any other characteristic or aspect which is not job -related in its recruiting, hiring, promoting,
terminating or any other area affecting employment under this agreement. At all times, the
Provider shall comply with all applicable laws and regulations with regard to employing the most
qualified person(s) for positions under this agreement. The Provider shall not discriminate
against any person on the basis of race, creed, color, national origin, sex or sexual orientation,
age, physical handicap, financial status or any characteristic or aspect in its providing of services.
14. AUTHORIZED SIGNATURES. The signatory for the Provider below, certifies and
warrants that:
(a) The Provider's name in this agreement is the full name as designated in its
corporate charter, if a corporation, or the full name under which the Provider is
authorized to do business in the State of Florida.
(b) He or she is empowered to act and contract for the Provider; and
(c) This agreement has been approved by the Board of Directors of the Provider if the
Provider is a corporation.
15. NOTICE Any notice required or permitted under this agreement shall be in writing
and hand -delivered or mailed, postage pre -paid, by certified mail, return receipt requested, to the
other party as follows:
For Board:
Monroe County Attorney and David P. Owens, Grants Administrator
PO Box 1026 Gato Building
Key West, FL 33041 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) BOARD OF COUNTY COMMISSIONERS
ATTEST: DANNY L. KOLHAGE, CLERK OF MONROE COUNTY, FLORIDA
By
Deputy Clerk
Witness to Provider Signature
Witness to Provider Signature
By.
Mayor/Chairman
PROVIDER
(Federal ID No.
By
Executive Director
MONROE COUNTY ATTORN Y
PROV�DA�&O
SUZ .HUTTON
ASSISTANNTY ATTORNEY
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 05/28/01
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 2003
by who is personally known to me.
Notary Public Notary Stamp
ATTACHMENT C
Youth Programs in the Lower Keys area, including prevention activities, education
enhancement (after school homework assistance and tutoring), and high -yield learning
activities (board games and peer mentoring).
ETHICS CLAUSE
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY, FLORIDA
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.
Date:
STATE OF
COUNTY OF
(signature)
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: Care Center for Mental Health Effective Date:10/01/03
Expiration Date:9/30/04
Contract Purpose/Description: Annual appropriation that provides funding for mental health and guidance
services for Monroe County citizens
Contract Manager: David P. Owens
(Name)
for BOCC meetinq on
4482 OMB/Grants
(Ext.) (Department)
Deadline:
CONTRACT COSTS
Total Dollar Value of Contract: $193,035.00 Current Year Portion: $193,035.00
Budgeted? Yes® No ❑ Account Codes: 001-01503-530340- -
Grant: $0.00
County Match: $
Estimated Ongoing Costs: $ /yr
(Not included in dollar value above)
ADDITIONAL COSTS
For:
maintenance, utilities,
CONTRACT REVIEW
Changes
Date In Needed
Division Director Yes❑ Noe
Risk Management (U3 YesEP o❑
O.M.B./Purchasing f '/ Yes❑ No2-.,,,
County Attorney QT___r_ 3 Yes❑ No[�
Comments:_Lr►t30 If 15 'tVd I✓Q`vc,. _z+ Should SPc��� rally r e)u;re ye+�ent
W( L'%(X j ond �Po�eS ai+<< 1r4�o►1i} 6►15UfvnCe —r,a / f:� / d , /
etc.
Date Out
OJ
AGREEMENT
This Agreement is made and entered into this day of , 2003,
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 2004, 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 -THREE -THOUSAND, THIRTY-FIVE, AND NO/100
DOLLARS ($193,035.00) for rendering counseling services.
2. TERM.This Agreement shall commence on October 1, 2003, and terminate
September 30, 2004, 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. 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. INSURANCE. As a pre -requisite of the services supplied under this contract, the
Provider shall obtain, at its own expense, general liability and professional liability 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 and Monroe County Attorney
Gato Building PO Box 1026
1100 Simonton Street Key West, FL 33041
Key West, FL 33040
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
By
Deputy Clerk
(Federal ID No. )
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By
Mayor/Chairman
CARE CENTER FOR MENTAL HEALTH
OF THE LOWER KEYS, INC.
By
Director
By
President
IV1()'sdROE COUNTY ATTORNEY
,AiDPRO'JED F M:
SUZANN A.HUTTON
ASSISTANT CO 7Y A7 0
sate
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 05/28/01 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 2003
by who is personally known to me.
Notary Public Notary Stamp
ATTACHMENT C
County funds will be used as match, pursuant to Florida Statute 394, for alcohol, drug
abuse, and mental health outpatient services, including assessment, crisis intervention,
medical services, case management, and outpatient counseling in the Lower Keys Area.
Services are offered at 1205 4th Street in Key West, and counselors are at Key West High
School, Horace O'Bryant Middle School, Sugarloaf Middle School, Gerald Adams
Elementary School, the Monroe County Detention Center, and the Douglass Community
Center.
ETHICS CLAUSE
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY, FLORIDA
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.
Date:
STATE OF
COUNTY OF
(signature)
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: 10/01/03
Expiration Date: 9/30/04
Contract Purpose/Description: 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)
for BOCC meeting on
4482 OMB/Grants
(Ext.) (Department)
Deadline:
CONTRACT COSTS
Total Dollar Value of Contract: $10,000.00 Current Year Portion: $10,000.00
Budgeted? Yes® No ❑ Account Codes: 001-00506-530340-
Grant: $0.00
County Match: $
ADDITIONAL COSTS
Estimated Ongoing Costs: $ /yr For:
(Not included in dollar value above) (eg. maintenance, utilities, janitorial, sa
CONTRACT REVIEW
Changes
Date In Needed Reviewer
Division Director Yes❑ No❑
Risk Management Y/173/d3 Yes❑ NoQ'
O.M.B./Purchasing" Yes❑ Nop` _
County Attorney 3 YesEl Now /
Comments:
OMB Form Revised 9/11/95 MCP #2
Date Out
AGREEMENT
This Agreement is made and entered into this day of , 2003,
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 2004.
2. TERM. This Agreement shall commence on October 1, 2003, and terminate September
30, 2004, 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.
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.
S. 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 n
o 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 and
Gato Building
1100 Simonton Street
Key West, FL 33040
For PROVIDER
Barbara Fike, Executive Director
Caring Friends for Seniors, Inc.
P O Box 1263
Key Largo, FL 33037
305-453-1166
305-453-3773 FAX
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
By
Deputy Clerk
Witness
Witness
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By
Mayor/Chairman
PROVIDER
(Federal ID No. )
By
President
MONF40E COUNTY ATTORNEY
OVED AS O
UZA NE HUTTON
Date ASSISTANT 0 1TY JMORNEY
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 05/28/01 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 2003
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.
ETHICS CLAUSE
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY, FLORIDA
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.
Date:
STATE OF
COUNTY OF
(signature)
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: 10/01/03
Expiration Date: 9/30/04
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)
for BOCC meeting on
4482 OMB/Grants
(Ext.) (Department)
Deadline:
CONTRACT COSTS
Total Dollar Value of Contract: $19,135.00 Current Year Portion: $19,135.00
Budgeted? Yes® No ❑ Account Codes: 001-03216-530340- -
Grant: $0.00
County Match: $
ADDITIONAL COSTS
Estimated Ongoing Costs: $ /yr For:
(Not included in dollar value above) (ee. maintenance_ utilities innitnrinl en
CONTRACT REVIEW
Changes
Date In
Needed
Division Director
Yes❑ NoO"
Risk Management
/1003
Yes❑ Noe'
O.M.B./Purchasing
ON
Yes❑ No❑`
County Attorney
90 03
Yes❑ NoE2-"
Comments:
—y— I V11111.Gv,Jcu 71 11/7J lvll.r ffL
Date Out
�d1/0-7
AGREEMENT
This Agreement is made and entered into this day of , 2003,
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 is a 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, ONE HUNDRED, THIRTY-FIVE, AND
00/100 DOLLARS ($19,135.00) for fiscal year 2004.
2. TERM. This Agreement shall commence on October 1, 2003, and terminate September
30, 2004, 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.
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.
S. 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. 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 and
Gato Building
1100 Simonton Street
Key West, FL 33040
For PROVIDER
Richard Turcotte, Ph.D., Chief Executive Officer
Catholic Charities
2700 Flagler Avenue
Key West, FL 33040
305-292-9790
305-292-5257 FAX
Local Contact: Anita Brackett, Program Administrator
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. 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
By
Deputy Clerk
Witness
---------- --------------------------------------
Witness
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By
Mayor/Chairman
PROVIDER
(Federal ID No
President
MONROE COUNTY ATTORINE`{
OVED A FO.<.
UZA NE . UTTON- u "'
ASSISTANT OUNT
t1ate_a._ L ATTORN�y
ATTACHMENT A
EXPENSE REIMBURSEMENT REQUIREMENTS
This document is intended to provide basic guidelines to Human Service Organizations, county
travelers, and contractual parties who have reimbursable expenses associated with Monroe
County business. These guidelines, as they relate to travel, are from Florida Statute 112.061.
A cover letter summarizing the major line items on the reimbursable expense request needs to
also contain a notarized certified statement such as:
"I certify that the attached expenses are accurate and in agreement with the records of
this organization. Furthermore, these expenses are in compliance with this organization's
contract with the Monroe County Board of County Commissioners."
Invoices should be billed to the contracting agency. Third party payments will not be considered
for reimbursement. Remember, the expense should be paid prior to requesting a reimbursement.
Only current charges will be considered, no previous balances.
Reimbursement requests will be monitored in accordance with the level of detail in the contract.
This document should not be considered all-inclusive. The Clerk's Finance Department reserves
the right to review reimbursement requests on an individual basis. Any questions regarding these
guidelines should be directed to 305-292-3534.
Data Processing, PC Time, etc.
The vendor invoice is required for reimbursement. Inter -company allocations are not considered
reimbursable expenditures unless appropriate payroll journals for the charging department are
attached and certified.
Payroll
the _ c;i and authenticity of the payroll expense is needed. If
dates, employee name, salary or hourly rate, total
hours worked, w ��olding 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 05/28/01 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 2003
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.
ETHICS CLAUSE
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY, FLORIDA
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.
Date:
STATE OF
COUNTY OF
(signature)
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: 10/01/03
Expiration Date: 9/30/04
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)
for BOCC meeting on 10/15/03
4482 OMB/Grants
(Ext.) (Department)
Deadline:
CONTRACT COSTS
Total Dollar Value of Contract: $28,702.00 Current Year Portion: $28,702.00
Budgeted? Yes® No ❑ Account Codes: 001-03201-530340- -
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 Yes❑ No0-"'
Risk Management Y1.131v3
O.M.B./Purchasing
County Attorney t3
Comments:
n?%4D T�- D — : - - A nit i inc w,-- -,
Yes❑ Noo'
Yes❑ No[jf f
Yes❑ No[;3�
Date Out
AGREEMENT
This Agreement is made and entered into this day of , 2003,
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-EIGHT
THOUSAND, SEVEN HUNDRED, TWO, AND 00/100 DOLLARS ($28,702.00) for fiscal year 2004.
2. TERM. This Agreement shall commence on October 1, 2003, and terminate September
30, 2004, 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.
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
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.
S. 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 and
Gato Building
1100 Simonton Street
Key West, FL 33040
For PROVIDER
Venita Garvin, Executive Director
Domestic Abuse Shelter, Inc.
P O Box 522696
78 Coco Plum Drive
Marathon, FL 33052
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
By
Deputy Clerk
Witness
Witness
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By
Mayor/Chairman
PROVIDER
(Federal ID No
By
President
MONROE COUNTY ATTORNEY
APP TQFORM:
PANNE A. MUTTON
ASSISTANJ90 i A' TOR,( NEY
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 05/28/01 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 2003
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.
ETHICS CLAUSE
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990 '
MONROE COUNTY, FLORIDA
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.
Date:
STATE OF
COUNTY OF
(signature)
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 /03
Shelter
Expiration Date: 9/30/04
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
(Name)
for BOCC meeting on
4482 OMB/Grants
(Ext.) (Department)
Deadline:
CONTRACT COSTS
Total Dollar Value of Contract: $98,897.00 Current Year Portion: $98,897.00
Budgeted? Yes® No ❑ Account Codes: 001-03002-530340- -
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
Yes❑ Nog --
Risk Management &d-6-3
Yes❑ NoR
O.M.B./Purchasing
Yes❑ No
County Attorney �3
Yes❑ No
Comments:
v+a✓ i v1u1 AV V13l u 7/ 11/7J lvll.r tt4
Date Out
r Reviewer
i/.a3/oC 4u,2�"- 1
AGREEMENT
This Agreement is made and entered into this day of , 2003,
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 NINETY-EIGHT THOUSAND, EIGHT HUNDRED, NINETY-SEVEN,
AND 00/100 DOLLARS ($98,897.00) for fiscal year 2004.
2. TERM. This Agreement shall commence on October 1, 2003, and terminate September
30, 2004, 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.
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.
S. 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 and
Gato Building
1100 Simonton Street
Key West, FL 33040
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
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
By
Deputy Clerk
Witness
Witness
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By
Mayor/Chairman
PROVIDER
(Federal ID No.
By
President
MONROE COUNTY ATTORNEY
ROVED AS
UZA NE . HUTTON
ASSISTANT "0' NT' TORNEY
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 05/28/01 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 2003
by who is personally known to me.
Notary Public Notary Stamp
ATTACHMENT C
DESCRIPTION OF SERVICES TO BE PROVIDED
Shelter for youth in need aged ten through seventeen.
Community -based counseling program at schools throughout the Keys.
ETHICS CLAUSE
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY, FLORIDA
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.
Date:
STATE OF
COUNTY OF
(signature)
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: 10/0 1/03
Coalition
Expiration Date:9/30/04
Contract Purpose/Description: provides funding to perform services such as shelter, and other
services for homeless persons in Monroe County.
Contract Manager: David P. Owens
(Name)
for BOCC meeting on 1
4482 OMB/Grants
(Ext.) (Department)
Deadline:
CONTRACT COSTS
Total Dollar Value of Contract: $19,708.00 Current Year Portion: $19,708.00
Budgeted? Yes® No ❑ Account Codes: 001-03206-530340- -
Grant: $0.00 - - - -
County Match: $ - - - -
ADDITIONAL COSTS
Estimated Ongoing Costs: $ /yr For:
(Not included in dollar value above) (eg. maintenance, utilities, janitorial, salaries, etc.)
Division Director
Risk Management
O.M.B./Purchasing
County Attorney
Comments:
CONTRACT REVIEW
Changes
Date In Needed
Yes❑ Noa:
%IO3 Yes❑ Noz
�40
Yes❑ No�
y��-3 Yes❑ No❑�
OMB Form Revised 9/11/95 MCP #2
Date Out
AGREEMENT
This Agreement is made and entered into this day of 2003
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, SEVEN -HUNDRED EIGHT AND 001100 DOLLARS
($19,708.001 for fiscal year 2004.
2. TERM. This Agreement shall commence on October 1, 2003, and terminate September
30, 2004, 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.
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.
S. 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 and
Gato Building
1100 Simonton Street
Key West, FL 33040
For PROVIDER
Rev. Stephen E. Braddock, Executive Director
Florida Keys Outreach Coalition, Inc.
P O Box 4767
(1615-A Truesdell Court)
Key West, FL 33040
305-293-0641
305-293-8276 FAX
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
By
Deputy Clerk
Witness
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
QI
Mayor/Chairman
PROVIDER
(Federal ID No
By
Witness President
MONROE COUNTY ATTORNEY
,,APPROVED A 0 RM:
SU ANN A. HUTTON
ASSISTA T 2T ORNEY
Date___..._
ATTACHMENT A
EXPENSE REIMBURSEMENT REQUIREMENTS
This document is intended to provide basic guidelines to Human Service Organizations, county
travelers, and contractual parties who have reimbursable expenses associated with Monroe
County business. These guidelines, as they relate to travel, are from Florida Statute 112.061.
A cover letter summarizing the major line items on the reimbursable expense request needs to
also contain a notarized certified statement such as:
"I certify that the attached expenses are accurate and in agreement with the records of
this organization. Furthermore, these expenses are in compliance with this organization's
contract with the Monroe County Board of County Commissioners."
Invoices should be billed to the contracting agency. Third party payments will not be considered
for reimbursement. Remember, the expense should be paid prior to requesting a reimbursement.
Only current charges will be considered, no previous balances.
Reimbursement requests will be monitored in accordance with the level of detail in the contract.
This document should not be considered all-inclusive. The Clerk's Finance Department reserves
the right to review reimbursement requests on an individual basis. Any questions regarding these
guidelines should be directed to 305-292-3534.
Data Processing, PC Time, etc.
The vendor invoice is required for reimbursement. Inter -company allocations are not considered
reimbursable expenditures unless appropriate payroll journals for the charging department are
attached and certified.
Payroll
A certified statement verifying the accuracy and authenticity of the payroll expense is needed. If
a Payroll Journal is provided, it should include: dates, employee name, salary or hourly rate, total
hours worked, withholding information and payroll taxes, check number and check amount. If a
Payroll Journal is not provided, the following information must be provided: check amount, check
number, date, payee, support for applicable payroll taxes.
Postage, Overnight Deliveries, Courier, etc.
A log of all postage expenses as they relate to the County contract is required for reimbursement.
For overnight or express deliveries, the vendor invoice must be included.
Rents, Leases, etc.
A copy of the rental or lease agreement is required. Deposits and advance payments are not
allowable expenses.
Reproductions, Copies, etc.
A log of copy expenses as they relate to the County contract is required for reimbursement. The
log must define the date, number of copies made, source document, purpose, and recipient. A
reasonable fee for copy expenses will be allowable. For vendor services, the vendor invoice and a
sample of the finished product are required.
Supplies, Services, etc.
For supplies or services ordered, a vendor invoice is required.
Telefax, Fax, etc.
A fax log is required. The log must define the sender, the intended recipient, the date, the
number called, and the reason for sending the fax.
Telephone Expenses
A user log of pertinent information must be remitted including: the party called, the caller, the
telephone number, the date, and the purpose of the call.
Travel Expenses
Travel expenses must be submitted on a State of Florida Voucher for Reimbursement of Travel
Expenses. Travel must be submitted in accordance with Florida Statute 112.061. Credit card
statements are not acceptable documentation for reimbursement. If attending a conference or
meeting a copy of the agenda is needed. Airfare reimbursement requires the original passenger
receipt portion of the airline ticket. A travel itinerary is appreciated to facilitate the audit trail.
Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented
with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example,
taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is
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 05/28/01 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 2003
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.
ETHICS CLAUSE
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY, FLORIDA
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.
Date:
STATE OF
COUNTY OF
(signature)
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: Guidance Clinic of the Middle Effective Date: 10/0 1 /03
Keys
Expiration Date:9/30/04
Contract Purpose/Description: provide funding for various mental health and transportation -
disadvantaged services in Monroe County.
Contract Manager: David P. Owens 4482 OMB/Grants
(Name) (Ext.) (Department)
I for BOCC meeting on 10/15/03 Agenda Deadline:
CONTRACT COSTS
Total Dollar Value of Contract: $754,549.00 Current Year Portion:
$750,964.00
Budgeted? Yes® No ❑ Account Codes: 001-01501-530340-
-528,019.00
Grant: $0.00
102-01507-530340-
-94,307.00
County Match: $
102-04542-530340-
-42,351.00
101-68607-530340-
-86,287.00
ADDITIONAL COSTS
Estimated Ongoing Costs: $ /yr
For:
Not included in dollar value above
e . maintenance, utilities, janitorial, salaries, etc.)
CONTRACT REVIEW
Date In
Changes
Needed 'Review r
Date Out
Division Director
Yes[- No[- '�°t`: c.=�: f
Risk Management
( 9 3
Yes❑ No[�r'
O.M.B./Purchasing
Yes❑ No❑"
County Attorney
0.5-A 3
Yes❑ Noa-� "
Comments:
IJwID rurrn Revised ut i -i/95 IVll..r fFL
AGREEMENT
This Agreement is made and entered into this day of 2003
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 2003-2004, 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 THOUSAND, NINE -HUNDRED, SIXTY-FOUR, AND NO/100 DOLLARS
($750,964.00), during the fiscal year 2003-2004, payable as follows:
a) Pay to the Provider the sum of FORTY-TWO THOUSAND, THREE -HUNDRED, FIFTY-
ONE, AND NO/100 DOLLARS ($42,351.00) for Community Transportation Coordinator services.
b) Pay to the Provider the sum of FIVE -HUNDRED TWENTY-EIGHT THOUSAND,
NINETEEN, AND NO/100 DOLLARS ($528,019.00) 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-SIX THOUSAND, TWO -HUNDRED EIGHTY-
SEVEN, AND NO/100 DOLLARS ($86,287.00) 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 NO/100 DOLLARS ($94,307.00) for Baker Act transportation.
2. TERM. This Agreement shall commence on October 1, 2003, and terminate
September 30, 2004, 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.
5. RECORDS. The Provider shall maintain appropriate records to insure a proper
accounting of all funds and expenditures, and shall provide a clear financial audit trail to allow for
full accountability of funds received from said Board. Access to these records shall be provided
during weekdays, 8 a.m. to 5 p.m., upon request of the Board, the State of Florida, or authorized
agents and representatives of the Board or State.
The Provider shall be responsible for repayment of any and all audit exceptions which are
identified by the Auditor General of the State of Florida, the Clerk of Court for Monroe County, an
independent auditor, or their agents and representatives. In the event of an audit exception, the
current fiscal year contract amount or subsequent fiscal year contract amounts shall be offset by
the amount of the audit exception. In the event this agreement is not renewed or continued in
subsequent years through new or amended contracts, the Provider shall be billed by the Board for
the amount of the audit exception and the Provider shall promptly repay any audit exception.
6. INDEMNIFICATION AND HOLD HARMLESS. The Provider covenants and agrees
to indemnify and hold harmless Monroe County Board of County Commissioners from any and all
claims for bodily injury (including death), personal injury, and property damage (including
property owned by Monroe County) and any other losses, damages, and expenses (including
attorney's fees) which arise out of, in connection with, or by reason of services provided by the
Provider occasioned by the negligence, errors, or other wrongful act or omission of the Provider's
employees, agents or volunteers. The extent of liability is in no way limited to, reduced, or
lessened by the insurance requirements contained elsewhere within this agreement.
7. INDEPENDENT CONTRACTOR. At all and for all purposes hereunder, the
Provider is an independent contractor and not an employee of the Board. No statement contained
in this agreement shall be construed so as to find the Provider or any of its employees,
contractors, servants or agents to be employees of the Board.
8. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement,
the Provider shall abide by all statutes, ordinances, rules and regulations pertaining to or
regulating the provision of such services, including those now in effect and hereinafter adopted.
Any violation of said statutes, ordinances, rules and regulations shall constitute a material breach
of this agreement and shall entitle the Board to terminate this contract immediately upon delivery
of written notice of termination to the Provider.
9. 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. INSURANCE.As a pre -requisite of the services supplied under this contract, the
Provider shall obtain, at its own expense, general liability and professional liability 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 and
1100 Simonton Street
Key West, FL 33040
For Provider:
Dr. David Rice, Executive Director
Guidance Clinic of the Middle Keys, Inc.
3000 41st Street
Marathon, Florida 33050
Monroe County Attorney
PO Box 1026
Key West, FL 33041
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) BOARD OF COUNTY COMMISSIONERS
ATTEST: DANNY L. KOLHAGE, CLERK OF MONROE COUNTY, FLORIDA
By
Deputy Clerk
MONROE i.OUNiY Af"rORNEY
PROVED 0 RM:
SUZAN A. HUTTON
`f ASSISTANT ,NTYd ORNEY
Date—____
�
By.
Mayor/Chairman
GUIDANCE CLINIC OF THE MIDDLE KEYS, INC.
(Federal ID No. )
By.
By
Director
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 05/28/01 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 2003
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.
ETHICS CLAUSE
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY, FLORIDA
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.
Date:
STATE OF
COUNTY OF
(signature)
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: Guidance Clinic of the Upper Effective Date:10/01/03
Keys
Expiration Date:09/30/04
Contract Purpose/Description: provides funding to perform mental health services such as counseling in
Monroe County.
Contract Manager: David P. Owens
(Name)
for BOCC meeting on
4482 OMB/Grants
(Ext.) (Department)
a Deadline:
CONTRACT COSTS
Total Dollar Value of Contract: $91,935.00 Current Year Portion: $91,935.00
Budgeted? Yes® No ❑ Account Codes: 001-01502-530340- -
Grant: $0.00 - - - -
County Match:
ADDITIONAL COSTS
Estimated Ongoing Costs: $ /yr For:
Not included in dollar value above) e . maintenance, utilities, janitorial, salaries, etc.)
Division Director
Risk Management
O.M.B./Purchasing
County Attorney
Comments:
CONTRACT REVIEW
Changes Date Out
Date In Needed Rvsr . vieer r ,
Yes[-] NdQ:E ._ (tt :
1 1u3 Yes�o❑ �i�/ yl-ldc3
Yes[--] No�.''
f
Yes❑ Nop,-- *03
OMB Form Revised 9/11/95 MCP #2 n/{
L-i{eox �I 400 vF d-F . Sti%rjA rjfec,+c,(C' �e4v�r-e lreh�nc� (taW,�t��
ahc� �ruiass�ontl i' «,� y �y15driy4'�--.
AGREEMENT
This Agreement is made and entered into this day of 2003
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 2004, 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-ONE THOUSAND, NINE -HUNDRED, THIRTY-
FIVE, AND NO/100 DOLLARS ($91,935.00) for fiscal year 2003-2004.
2. TERM.This Agreement shall commence on October 1, 2003, and terminate
September 30, 2004, unless earlier terminated pursuant to other provisions herein.
3. PAYMENT. Payment will be paid monthly as hereinafter set forth. Certified
monthly financial and service load reports will be made available to the Board to validate the
delivery of services under this contract. The monthly financial report is due in the office of the
Clerk of the Board no later than the 15th day of the following month. After the Clerk of the Board
pre -audits the certified report, the Board shall reimburse the Provider for its monthly expenses.
However, the total of said monthly payments in the aggregate sum shall not exceed the total
amount shown in Article 1, above, during the term of this agreement. To preserve client
confidentiality required by law, copies of individual client bills and records shall not be available to
the Board for reimbursement purposes but shall be made available only under controlled
conditions to qualified auditors for audit purposes. The organization's final invoice must be
received within sixty days after the termination date of this contract shown in Article 2 above.
4. SCOPE OF SERVICES. The Provider, for the consideration named, covenants and
agrees with the Board to substantially and satisfactorily perform and carry out the duties of the
Board in rendering counsel in the matter of mental health and guidance to the citizens of the
Upper Keys, Monroe County, Florida. The Provider shall provide these services in compliance with
Florida Statutes Chapter 394. Said services shall include, but are not limited to, those services
described in Provider's Details of Specific Program for Which Funding is Requested, attached
hereto as Exhibit C and incorporated herein.
5. RECORDS. The Provider shall maintain appropriate records to insure a proper
accounting of all funds and expenditures, and shall provide a clear financial audit trail to allow for
full accountability of funds received from said Board. Access to these records shall be provided
during weekdays, 8 a.m. to 5 p.m., upon request of the Board, the State of Florida, or authorized
agents and representatives of the Board or State.
The Provider shall be responsible for repayment of any and all audit exceptions which are
identified by the Auditor General of the State of Florida, the Clerk of Court for Monroe County, an
independent auditor, or their agents and representatives. In the event of an audit exception, the
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. 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. INSURANCE. As a pre -requisite of the services supplied under this contract, the
Provider shall obtain, at its own expense, general liability and professional liability 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 and Monroe County Attorney
Gato Building PO Box 1026
1100 Simonton Street Key West, FL 33041
Key West, FL 33040
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) BOARD OF COUNTY COMMISSIONERS
ATTEST: DANNY L. KOLHAGE, CLERK OF MONROE COUNTY, FLORIDA
By
Deputy Clerk
Witness
Witness
By
Mayor/Chairman
GUIDANCE CLINIC OF THE UPPER KEYS, INC.
(Federal ID No. )
By.
By
Director
President
MONROE COUNTY ATTORNEY
1-4 PROVED AS
SUZA NE A. HUTTON
ASSISTANT GO NTY d TORNEY
Date
ATTACHMENT A
EXPENSE REIMBURSEMENT REQUIREMENTS
This document is intended to provide basic guidelines to Human Service Organizations, county
travelers, and contractual parties who have reimbursable expenses associated with Monroe
County business. These guidelines, as they relate to travel, are from Florida Statute 112.061.
A cover letter summarizing the major line items on the reimbursable expense request needs to
also contain a notarized certified statement such as:
"I certify that the attached expenses are accurate and in agreement with the records of
this organization. Furthermore, these expenses are in compliance with this organization's
contract with the Monroe County Board of County Commissioners."
Invoices should be billed to the contracting agency. Third party payments will not be considered
for reimbursement. Remember, the expense should be paid prior to requesting a reimbursement.
Only current charges will be considered, no previous balances.
Reimbursement requests will be monitored in accordance with the level of detail in the contract.
This document should not be considered all-inclusive. The Clerk's Finance Department reserves
the right to review reimbursement requests on an individual basis. Any questions regarding these
guidelines should be directed to 305-292-3534.
Data Processing, PC Time, etc.
The vendor invoice is required for reimbursement. Inter -company allocations are not considered
reimbursable expenditures unless appropriate payroll journals for the charging department are
attached and certified.
Payroll
A certified statement verifying the accuracy and authenticity of the payroll expense is needed. If
a Payroll Journal is provided, it should include: dates, employee name, salary or hourly rate,
total hours worked, withholding information and payroll taxes, check number and check amount.
If a Payroll Journal is not provided, the following information must be provided: check amount,
check number, date, payee, support for applicable payroll taxes.
Postage, Overnight Deliveries, Courier, etc.
A log of all postage expenses as they relate to the County contract is required for reimbursement
For overnight or express deliveries, the vendor invoice must be included.
Rents, Leases, etc.
A copy of the rental or lease agreement is required. Deposits and advance payments are not
allowable expenses.
Reproductions, Copies, etc.
A log of copy expenses as they relate to the County contract is required for reimbursement. The
log must define the date, number of copies made, source document, purpose, and recipient. A
reasonable fee for copy expenses will be allowable. For vendor services, the vendor invoice and a
sample of the finished product are required.
Supplies, Services, etc.
For supplies or services ordered, a vendor invoice is required.
Telefax, Fax, etc.
A fax log is required. The log must define the sender, the intended recipient, the date, the
number called, and the reason for sending the fax.
Telephone Expenses
A user log of pertinent information must be remitted including: the party called, the caller, the
telephone number, the date, and the purpose of the call.
Travel Expenses
Travel expenses must be submitted on a State of Florida Voucher for Reimbursement of Travel
Expenses. Travel must be submitted in accordance with Florida Statute 112.061. Credit card
statements are not acceptable documentation for reimbursement. If attending a conference or
meeting a copy of the agenda is needed. Airfare reimbursement requires the original passenger
receipt portion of the airline ticket. A travel itinerary is appreciated to facilitate the audit trail.
Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented
with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example,
taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is
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 05/28/01
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 2003
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.
ETHICS CLAUSE
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY, FLORIDA
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.
Date:
STATE OF
COUNTY OF
(signature)
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: Heart of the Keys Recreation Effective Date:10/01/03
Expiration Date:09/30/04
Contract Purpose/Description: provides funding for youth programs for children of Monroe County
Contract Manager: David P. Owens
(Name)
for BOCC meeting on
4482 OMB/Grants
(Ext.) (Department)
a Deadline:
CONTRACT COSTS
Total Dollar Value of Contract: $29,669.00 Current Year Portion: $29,669.00
Budgeted? Yes® No ❑ Account Codes: 001-03703-530340- -
Grant: $0.00 - - - -
County Match:
ADDITIONAL COSTS
Estimated Ongoing Costs: $ /yr For:
Not included in dollar value above) (eg. maintenance, utilities, janitorial, salaries, etc.)
Division Director
Risk Management
O.M.B./Purchasing
County Attorney
Comments:
CONTRACT REVIEW
Changes Date Out
Date In Needed eviewer!
Yes❑ Now
-o3 Yes❑ No[ illy
Yes❑ No❑ "
93 Yes❑ NoD--
UMti Form Revised 9/11/95 MCP #2
AGREEMENT
Heart of the Keys Recreation
This Agreement is made and entered into this day of _
2003, between the BOARD OF COUNTY COMMISSIONERS OF MONROE
hereinafter referred to as 'Board" or "County," and HEART OF THE
ASSOCIATION, INC., hereinafter referred to as 'Provider."
COUNTY, FLORIDA,
KEYS RECREATION
WHEREAS, the Provider is a not -for -profit corporation established for the provision of
activities for the wholesome development of youths' personal, social, physical, emotional and
spiritual growth, and
WHEREAS, the Provider provides such activities in a wholesome, alcohol -free and drug -
free environment for young people of Monroe County, and
WHEREAS, it is a legitimate public purpose to provide facilities and services for
recreational use and social functions of the community in a wholesome environment free from
drugs and alcohol, now, therefore,
IN CONSIDERATION of the mutual promises and covenants contained herein, it is agreed
as follows:
1. AMOUNT OF AGREEMENT. The Board, in consideration of the Provider substantially
and satisfactorily performing and carrying out the duties of the Board as to providing facilities and
services for recreational use for young persons living in Monroe County, Florida, shall pay to the
Provider the sum of TWENTY-NINE THOUSAND, SIX HUNDRED, SIXTY-NINE AND NO/100
DOLLARS ($29,669.00) for fiscal year 2004.
2. TERM. This Agreement shall commence on October 1, 2003, and terminate September
30, 2004, unless earlier terminated pursuant to other provisions herein.
3. PAYMENT.Payment will be paid periodically, but no more frequently than monthly as
hereinafter set forth. Reimbursement requests will be submitted to the Board via the Clerk's
Finance Office. The County shall only reimburse, subject to the funded amounts below, those
reimbursable expenses which are reviewed and approved as complying with Florida Statutes
112.061 and Attachment A - Expense Reimbursement Requirements. Evidence of payment by
the Provider shall be in the form of a letter, summarizing the expenses, with supporting
documentation attached. The letter should contain a certification statement as well as a notary
stamp and signature. An example of a reimbursement request cover letter is included as
Attachment B. The organization's final invoice must be received within sixty days after the
termination date of this contract shown in Article 2 above.
After the Clerk of the Board examines and approves the request for reimbursement, the
Board shall reimburse the Provider. However, the total of said reimbursement expense payments
in the aggregate sum shall not exceed the total amount shown in Article 1, above, during the
term of this agreement.
4. SCOPE OF SERVICES. The Provider, for the consideration named, covenants and
agrees with the Board to substantially and satisfactorily perform and carry out the duties of the
Board in providing activities in a wholesome environment free from drugs and alcohol to young
persons living in Monroe County, Florida. Provider shall provide services described in Attachment
C, attached hereto and incorporated herein.
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.
S. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement,
the Provider shall abide by all statutes, ordinances, rules and regulations pertaining to or
regulating the provision of such services, including those now in effect and hereinafter adopted.
Any violation of said statutes, ordinances, rules and regulations shall constitute a material breach
of this agreement and shall entitle the Board to terminate this contract immediately upon delivery
of written notice of termination to the Provider.
9. COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the
COUNTY:
(a) evidence of the organization's 501(c)(3) status;
(b) a list of the organization's Board of Directors of which there must be five or more;
(c) evidence of annual election of Officers and Directors;
(d) an annual audited financial report ;
(e) a copy the organization's Corporate Bylaws, which must address the organization's
mission, board and membership composition, election of officers, and so on;
(f) a copy of the organization's Corporate Policies and Procedures Manual which must include
hiring policies for all staff, drug and alcohol free workplace provisions, equal employment
opportunity provisions, and so on;
(g) cooperation with County monitoring visits;
(h) semi-annual performance reports. These reports should include performance
measurements which will demonstrate the level of accomplishment of goals for which funding
has been provided.
(i) other reasonable reports and information related to compliance with applicable laws,
contract provisions and the scope of services that the County may from time to time request.
10. PROFESSIONAL RESPONSIBILITY AND LICENSING. The Provider shall assure
that all professionals have current and appropriate professional licenses and professional liability
insurance coverage. Funding by the Board is contingent upon retention of appropriate local, state
and/or federal certification and/or licensure of the Provider's program and staff.
11. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services
and/or reimbursement of services shall be amended by an agreement amendment, which must be
approved in writing by the Board.
12. NO ASSIGNMENT. The Provider shall not assign this agreement except in writing
and with the prior written approval of the Board, which approval shall be subject to such
conditions and provisions as the Board may deem necessary. This agreement shall be
incorporated by reference into any assignment and any assignee shall comply with all of the
provisions herein. Unless expressly provided for therein, such approval shall in no manner or
event be deemed to impose any obligation upon the Board in addition to the total agreed upon
reimbursement amount for the services of the Provider.
13. NON-DISCRIMINATION. The Provider shall not discriminate against any person
on the basis race, creed, color, national origin, sex or sexual orientation, age, physical handicap,
or any other characteristic or aspect which is not job -related in its recruiting, hiring, promoting,
terminating or any other area affecting employment under this agreement. At all times, the
Provider shall comply with all applicable laws and regulations with regard to employing the most
qualified person(s) for positions under this agreement. The Provider shall not discriminate
against any person on the basis of race, creed, color, national origin, sex or sexual orientation,
age, physical handicap, financial status or any characteristic or aspect in its providing of services.
14. AUTHORIZED SIGNATURES. The signatory for the Provider below, certifies and
warrants that:
(a) The Provider's name in this agreement is the full name as designated in its
corporate charter, if a corporation, or the full name under which the Provider is authorized to do
business in the State of Florida.
(b) He or she is empowered to act and contract for the Provider; and
(c) This agreement has been approved by the Board of Directors of the Provider if the
Provider is a corporation.
15. NOTICE. Any notice required or permitted under this agreement shall be in writing
and hand -delivered or mailed, postage pre -paid, by certified mail, return receipt requested, to the
other party as follows:
For Board:
Monroe County Attorney and David P. Owens, Grants Administrator
PO Box 1026 Gato Building
Key West, FL 33041 1100 Simonton Street
Key West, FL 33040
For Provider:
Raymond Kitchener, President
Heart of the Keys Recreation Association, Inc.
810 33rd Street
Marathon, Florida 33050
16. CONSENT TO JURISDICTION. This agreement shall be construed by and governed
under the laws of the State of Florida and venue for any action arising under this agreement shall
be in Monroe County, Florida.
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
By
Deputy Clerk
Witness
Witness
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By
Mayor/Chairman
HEART OF THE KEYS
RECREATION ASSOCIATION, INC.
(Federal ID No.
By
President
Mi.iiVROE: %OUNTY ATTORNEY
PROVED AS TPP R
�. SUZAiVNE A. UTTON
ASSiSTANT C NNTY TORNEY
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 05/28/01
XXX.XX
(A) Total $ X.XXX XX
(B) Total prior payments $ X,XXX.XX
(C) Total requested and paid (A + B) $ X,XXX.XX
(D) Total contract amount $ X,XXX.XX
Balance of contract (D-C) $ X.XXX XX
I certify that the above checks have been submitted to the vendors as noted and that
the expenses are accurate and in agreement with the records of this organization.
Furthermore, these expenses are in compliance with this organizations_ contract with
the Monroe County Board of County Commissioners and will not be submitted for
reimbursement to any other funding source.
Executive Director
Attachments (supporting documentation)
Sworn to and subscribed before me this day of 2001
by who is personally known to me.
Notary Public Notary Stamp
ATTACHMENT C
Recreational and educational activities for youth from age eight through eighteen in the
middle keys area, including arts and crafts, sports, homework assistance, dances, and
youth seminars.
ETHICS CLAUSE
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY, FLORIDA
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.
Date:
STATE OF
COUNTY OF
(signature)
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: 10/01 /03
Expiration Date: 09/30/04
Contract Purpose/Description: provides funding for crisis intervention and referral services
Contract Manager: David P. Owens
(Name)
for BOCC meeting on
4482 OMB/Grants
(Ext.) (Department)
Deadline:
CONTRACT COSTS
Total Dollar Value of Contract: $14,835.00 Current Year Portion: $14,835.00
Budgeted? Yes® No ❑ Account Codes: 001-03200-530340- -
Grant: $0.00 - - - -
County Match: $ - - - -
ADDITIONAL COSTS
Estimated Ongoing Costs: $ /yr. For:
(Not included in dollar value above) (e.g. maintenance, utilities, janitorial, salaries, etc.)
CONTRACT REVIEW
Changes Date Out
Date In Needed / r' Reviewer
Division Director Yes❑ NoEj ' -
Risk Management ola3 Yes❑ No�
O.M.B./Purchasing Yes[:] No[o
County Attorney 3 Yes❑ NoEr z �3
Comments:
OMB Form Revised 9/11/95 MCP #2
AGREEMENT
This Agreement is made and entered into this day of 2003
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 FOURTEEN THOUSAND, EIGHT HUNDRED, THIRTY-FIVE, AND 00/100
DOLLARS ($14,835.00) for fiscal year 2004.
2. TERM. This Agreement shall commence on October 1, 2003, and terminate September
30, 2004, 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.
S. 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 and
Gato Building
1100 Simonton Street
Key West, FL 33040
For PROVIDER
Lou Hernandez, Executive Director
Helpline, Inc.
P O Box 2186
1923-1 Spalding Court
Key West, FL 33040
305-292-8445
305-292-8447 FAX
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
By
Deputy Clerk
Witness
Witness
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By,
Mayor/Chairman
PROVIDER
(Federal ID No.
By
President
MONROE COUNTY ATTORNEY
A OVED AS 1" R
UZANNE . UTTON
ASiIS'rANI' '17Y ATjT�
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 05/28/01
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 2003
by who is personally known to me.
Notary Public Notary Stamp
ATTACHMENT C
DESCRIPTION OF SERVICES TO BE PROVIDED
Telephone hotline services for crisis intervention and referral.
Telephone link for Alcoholics Anonymous and Narcotics Anonymous.
Periodic reassurance calls to disabled, elderly and homebound individuals.
ETHICS CLAUSE
SWORN STATEMENT UNDER ORDINANCE NO 10-1990
MONROE COUNTY, FLORIDA
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.
Date:
STATE OF
COUNTY OF
(signature)
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: Hospice of the Florida Keys Effective Date: 10/01 /03
Expiration Date:9/30/04
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)
for BOCC meeting on 10/15/03
4482 OMB/Grants
(Ext.) (Department)
Deadline:
CONTRACT COSTS
Total Dollar Value of Contract: $39,559.00 Current Year Portion: $39,559.00
Budgeted? Yes® No ❑ Account Codes: 001-03202-530340- -
Grant: $0.00
County Match: $
ADDITIONAL COSTS
Estimated Ongoing Costs: $ /yr For:
(Not included in dollar value above) (eP- maintenance ntiliti
CONTRACT REVIEW
Changes
Date In Needed , Reyiewer
Division Director Yes❑ No❑ �' E ;)•,:7 Z.
Risk Management 3 Yes❑ NOE-
O.M.B./Purchasing Lt '.._Yes❑ No�'
County Attorney Yes❑ NoQ
Comments:
�a.rri r_-
va.ia� i --... 111 VlaGu 7111/7J 1V11.r YFL
Date Out
AGREEMENT
This Agreement is made and entered into this day of , 2003,
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 THIRTY-NINE THOUSAND, FIVE HUNDRED, FIFTY-NINE AND 00/100
DOLLARS ($39,559.00) for fiscal year 2004.
2. TERM. This Agreement shall commence on October 1, 2003, and terminate September
30, 2004, 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.
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.
S. 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 and
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
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
By
Deputy Clerk
Witness
Witness
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By
Mayor/Chairman
PROVIDER
(Federal ID No.
By
President
MONROE COUNTY ATTORNEY
ARWOVED A5 TOi5WM/
U'---SOZANf* A. t9U iTr N
ASSISTANT C' tlNTY ?.-TvF::h�_Y
Date-dl......
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 05/28/01
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 2003
by who is personally known to me.
Notary Public
Notary Stamp
ATTACHMENT C
DESCRIPTION OF SERVICES TO BE PROVIDED
Comprehensive direct services to patients and their families experiencing a life -
threatening illness (generally those with a prognosis of six months of less). Services
include, but are not limited to, pain and symptom management, medical consultation,
skilled nursing, personal care, counseling, spiritual advising, rehabilitation therapies,
nutrition consultation, medical social work and bereavement programs. Most services
are provided at the client's residence.
ETHICS CLAUSE
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY, FLORIDA
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.
Date:
STATE OF
COUNTY OF
(signature)
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: 10/01 /03
America - Monroe County, Inc.
Expiration Date: 9/30/04
Contract Purpose/Description: provides funding for literacy training of citizens of Monroe
Count
Contract Manager: David P. Owens
(Name)
for BOCC meeting on
4482 OMB/Grants
(Ext.) (Department)
Deadline:
CONTRACT COSTS
Total Dollar Value of Contract: $6,132.00 Current Year Portion: $6,132.00
Budgeted? Yes® No ❑ 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.)
Division Director
Risk Management
O.M.B./Purchasing
County Attorney
Comments:
CONTRACT REVIEW
Changes
Date In Needed
Yes❑ No[:4'`
% /03 Yes❑ NoR"q
*/WesF] No
063 Yes❑ No[j-/
VIVID FU1111 rWvlseu y/ 1 1/yJ lvIt. r TTI
Date Out
AGREEMENT
This Agreement is made and entered into this day of , 2003,
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, ONE HUNDRED, THIRTY-TWO, AND 00/100 DOLLARS
($6,132.00) for fiscal year 2004.
2. TERM. This Agreement shall commence on October 1, 2003, and terminate September
30, 2004, 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.
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.
S. 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 Iicensure 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 and
Gato Building
1100 Simonton Street
Key West, FL 33040
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
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
By.
Deputy Clerk
Witness
Witness
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By
Mayor/Chairman
PROVIDER
(Federal ID No.
By
President
MONROE COUNTY ATTORNEY
APPROVED AS T F M
e�� r_.._
IzANN A. " f TAN
ASSISTANT U
Date z.
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 05/28/01 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 2003
by who is personally known to me.
Notary Public Notary Stamp
DESCRIPTION OF SERVICES TO BE PROVIDED
ATTACHMENT C
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.
ETHICS CLAUSE
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY, FLORIDA
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.
Date:
STATE OF
COUNTY OF
(signature)
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: 10/01/03
Retarded Citizens Inc.
Expiration Date: 9/30/04
Contract Purpose/Description: provides funding for services for retarded citizens of Monroe
County
Contract Manager: David P. Owens
(Name)
for BOCC meetinLy on 10/15/03
4482 OMB/Grants
(Ext.) (Department)
Deadline:
CONTRACT COSTS
Total Dollar Value of Contract: $47,836.00 Current Year Portion: $47,836.00
Budgeted? YesN No ❑ Account Codes: 001-01505-530340- -
Grant: $0.00
County Match: $
ADDITIONAL COSTS
Estimated Ongoing Costs: $ /yr For:
(Not included in dollar value above) (eg. maintenance, utilities, janitorial, sa
CONTRACT REVIEW
Changes
Date Out
Date In
Division Director
Needed
Yes❑ NoD`
Reviewer::"
!. . .
Risk Management 3 U 3
Yes❑ No[v]'
%1dp3
O.M.B./Purchasing
Yes❑ No❑-'-,--�
-
T
County Attorney qf-�
Yes❑ No[;I-'
Comments:
OMB Form Revised 9/11/95 MCP #2
AGREEMENT
This Agreement is made and entered into this day of , 2003,
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-SEVEN THOUSAND, EIGHT HUNDRED, THIRTY-SIX, AND 00/100
DOLLARS ($47,836.00) for fiscal year 2004.
2. TERM. This Agreement shall commence on October 1, 2003, and terminate September
30, 2004, 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 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.
S. 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 and
Gato Building
1100 Simonton Street
Key West, FL 33040
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
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
By
Deputy Clerk
Witness
Witness
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By
Mayor/Chairman
PROVIDER
(Federal ID No
By
President
MONROE COUNTY ATTORNEY
OVER AST M�
ZAN E A. U'i TOE!
C77A'�S S I S TA N TC U,d;Y. T`0RNEY
Date-
ATTACHMENT A
EXPENSE REIMBURSEMENT REQUIREMENTS
This document is intended to provide basic guidelines to Human Service Organizations, county
travelers, and contractual parties who have reimbursable expenses associated with Monroe
County business. These guidelines, as they relate to travel, are from Florida Statute 112.061.
A cover letter summarizing the major line items on the reimbursable expense request needs to
also contain a notarized certified statement such as:
"I certify that the attached expenses are accurate and in agreement with the records of
this organization. Furthermore, these expenses are in compliance with this organization's
contract with the Monroe County Board of County Commissioners."
Invoices should be billed to the contracting agency. Third party payments will not be considered
for reimbursement. Remember, the expense should be paid prior to requesting a reimbursement.
Only current charges will be considered, no previous balances.
Reimbursement requests will be monitored in accordance with the level of detail in the contract.
This document should not be considered all-inclusive. The Clerk's Finance Department reserves
the right to review reimbursement requests on an individual basis. Any questions regarding these
guidelines should be directed to 305-292-3534.
Data Processing, PC Time, etc.
The vendor invoice is required for reimbursement. Inter -company allocations are not considered
reimbursable expenditures unless appropriate payroll journals for the charging department are
attached and certified.
Payroll
A certified statement verifying the accuracy and authenticity of the payroll expense is needed. If
a Payroll Journal is provided, it should include: dates, employee name, salary or hourly rate, total
hours worked, withholding information and payroll taxes, check number and check amount. If a
Payroll Journal is not provided, the following information must be provided: check amount, check
number, date, payee, support for applicable payroll taxes.
Postage, Overnight Deliveries, Courier, etc.
A log of all postage expenses as they relate to the County contract is required for reimbursement
For overnight or express deliveries, the vendor invoice must be included.
Rents, Leases, etc.
A copy of the rental or lease agreement is required. Deposits and advance payments are not
allowable expenses.
Reproductions, Copies, etc.
A log of copy expenses as they relate to the County contract is required for reimbursement. The
log must define the date, number of copies made, source document, purpose, and recipient. A
reasonable fee for copy expenses will be allowable. For vendor services, the vendor invoice and a
sample of the finished product are required.
Supplies, Services, etc.
For supplies or services ordered, a vendor invoice is required.
Telefax, Fax, etc.
A fax log is required. The log must define the sender, the intended recipient, the date, the
number called, and the reason for sending the fax.
Telephone Expenses
A user log of pertinent information must be remitted including: the party called, the caller, the
telephone number, the date, and the purpose of the call.
Travel Expenses
Travel expenses must be submitted on a State of Florida Voucher for Reimbursement of Travel
Expenses. Travel must be submitted in accordance with Florida Statute 112.061. Credit card
statements are not acceptable documentation for reimbursement. If attending a conference or
meeting a copy of the agenda is needed. Airfare reimbursement requires the original passenger
receipt portion of the airline ticket. A travel itinerary is appreciated to facilitate the audit trail.
Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented
with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example,
taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is
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 05/28/01 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 2003
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.
ETHICS CLAUSE
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY, FLORIDA
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.
Date:
STATE OF
COUNTY OF
(signature)
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: 10/01/03
Expiration Date: 9/30/04
Contract Purpose/Description: provides funding for educational services for at -risk adolescent
girls and young women of Monroe County
Contract Manager: David P. Owens
(Name)
for BOCC meeting on 10/1
4482 OMB/Grants
(Ext.) (Department)
Deadline:
CONTRACT COSTS
Total Dollar Value of Contract: $22,746.00 Current Year Portion: $22,746.00
Budgeted? Yes® No ❑ 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.)
Date In
Division Director
�43
Risk Management
O.M.B./Purchasing
County Attorney
Comments:
OMB Form Revised 9/11/95 MCP #2
CONTRACT REVIEW
Changes
Needed �j Reviewq
Yes[:] Noa
Yes❑ NoQ-
Yes❑ No❑',
{
Yes[:] No�
Date Out
AGREEMENT
This Agreement is made and entered into this day of 2003
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, SEVEN
HUNDRED, FORTY-SIX, AND 00/100 DOLLARS ($22,746.00) for fiscal year 2004.
2. TERM This Agreement shall commence on October 1, 2003, and terminate September
30, 2004, 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.
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.
S. 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 and
Gato Building
1100 Simonton Street
Key West, FL 33040
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
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
By
Deputy Clerk
Witness
Witness
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By
Mayor/Chairman
PROVIDER
(Federal ID No
By
MONROE COUNTY ATTORNEY
AP ROVED AST R
SUZANN A. TTON
SSISTANT CT A
NEY
Date
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 05/28/01
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 2003
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.
ETHICS CLAUSE
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY, FLORIDA
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.
Date:
STATE OF
COUNTY OF
(signature)
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 with: Samuel's House, Inc. Effective Date: 10/01/03
Expiration Date: 9/30/04
Contract Purpose/Description: provide funds for housing for women and children
Contract Manager: David P. Owens 4482 OMB/Grants Mgt.
(Name) (Ext.) (Department)
for BOCC meeting on 10/15/03
Deadline: 09/30/03
CONTRACT COSTS
Total Dollar Value of Contract: $37,581.00 Current Year Portion: $37,581.00
Budgeted? Yes X No Account Codes: 001-03214-530340
Grant: $ 0
County Match: $0
ADDITIONAL COSTS
Estimated Ongoing Costs: $ For: Staff support -filing reports, oversight
(Not included in dollar value above) (eg. Maintenance, utilities, janitorial, salaries, etc.)
CONTRACT REVIEW
Changes
Date Out
Date In
Needed _ _ ." ,% Reviewer
Division Director
Yes❑ No[] -Y7 IF-
Risk Management We
Yes❑ NoZ
O.M.B./Purchasing
Yes❑ NoE;I,,-/
County Attorney ��j
t
Yes No
Comments:
OMB Form Revised 9/11/95 MCP #2
AGREEMENT
This Agreement is made and entered into this day of 2003
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 THIRTY-SEVEN THOUSAND, FIVE -HUNDRED, EIGHTY-ONE AND 00/100
DOLLARS ($37,581.00) for fiscal year 2004.
2. TERM This Agreement shall commence on October 1, 2003, and terminate September
30, 2004, 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.
S. 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 and
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
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
By
Deputy Clerk
Witness
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By
PROVIDER
(Federal ID No
Mayor/Chairman
By
Witness President
MONROE ;;OUNIY' Ai ORNEY
RU'Jki> A M:
iJ? i EttJ T TON
A TORNEY
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 contrac), 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 05/28/01 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 2003
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.
ETHICS CLAUSE
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY, FLORIDA
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.
Date:
STATE OF
COUNTY OF
(signature)
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."
f
MONROE COUNTY BOARD OF COUNTY COMMISSIONERS
CONTRACT SUMMARY
Contract #
Contract with: U. S. Fellowship of Florida, Effective Date: 10/01 /03
d/b/a Heron/Peacock programs
Expiration Date: 9/30/04
Contract Purpose/Description: provides funding for assisted living facilities with limited mental
health support
Contract Manager: David P. Owens
(Name)
for BOCC meeting on 1
4482 OMB/Grants
(Ext.) (Department)
Deadline:
CONTRACT COSTS
Total Dollar Value of Contract: $39,559.00 Current Year Portion: $39,559.00
Budgeted? Yes® No ❑ Account Codes: 001-01506-530340- -
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
Yes❑ No❑'
Risk Management /�3
Yes❑ No[a""
O.M.B./Purchasing
Yes❑ Nog'
County Attorney /
Yes❑ NoD
Comments:
OMB norm Revised 9/11/95 MCP #2
Date Out
AGREEMENT
This Agreement is made and entered into this day of 2003
between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter
referred to as "Board" or "County," and United States Fellowship of Florida, Inc., hereinafter
referred to as "PROVIDER."
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-NINE THOUSAND, FIVE HUNDRED, FIFTY-NINE,
AND 00/100 DOLLARS ($39,559.00) for fiscal year 2004.
2. TERM. This Agreement shall commence on October 1, 2003, and terminate September
30, 2004, 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.
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.
S. 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 and
Gato Building
1100 Simonton Street
Key West, FL 33040
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
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
By
Deputy Clerk
Witness
Witness
E
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By
Mayor/Chairman
PROVIDER
(Federal ID No.
0
By
President
MONROE COUNTY ATTORNEY
OVED A' 0
ZA NE . UTTON
AS ISTAN O ATTORNEY
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 05/28/01 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 2003
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.
ETHICS CLAUSE
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990 -
MONROE COUNTY, FLORIDA
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.
Date:
STATE OF
COUNTY OF
(signature)
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: Wesley House, Inc. Effective Date: 10/01/03
Expiration Date: 9/30/04
Contract Purpose/Description: provides funding for day care, education, and skill development
services for children of Monroe County
Contract Manager: David P. Owens
(Name)
for BOCC meeting on
Total Dollar Value of Contract
Budgeted? Yes® No ❑
Grant: $0.00
County Match: $
Estimated Ongoing Costs: $_
(Not included in dollar value above
4482 OMB/Grants
(Ext.) (Department)
Deadline:
CONTRACT COSTS
$91,657.00 Current Year Portion: $91,657.00
Account Codes: 001-03003-530340- -
ADDITIONAL COSTS
/yr For:
CONTRACT REVIEW
ities, janitorial, salaries, etc.
Changes Date Out
Date In Needed / i' Reviewey
Division Director Yes❑ No
Risk Management 1/0/03 Yes[:] Noz- y�c3/fi3
O.M.B./Purchasing l Yes[:] No12
County Attorney �1' 610 Yes❑ NoE;K a} 03
Comments:
UMB norm 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."
_, 2003,
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 NINETY-ONE THOUSAND, SIX HUNDRED, FIFTY-SEVEN, AND 00/100 DOLLARS
($91,657.001 for fiscal year 2004.
2. TERM This Agreement shall commence on October 1, 2003, and terminate September
30, 2004, 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 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 and
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
Monroe County Attorney
PO Box 1026
Key West, FL 33041
16. CONSENT TO 3URISDICTION. 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
By
Deputy Clerk
Witness
Witness
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By.
Mayor/Chairman
PROVIDER
(Federal ID No.
By
President
MONROE C OGIi±Y ATTORNEY
^;Uvl AS R
iJ CA itl N E A. i-i u ['T' Kl
1
ATTACHMENT A
EXPENSE REIMBURSEMENT REQUIREMENTS
This document is intended to provide basic guidelines to Human Service Organizations, county
travelers, and contractual parties who have reimbursable expenses associated with Monroe
County business. These guidelines, as they relate to travel, are from Florida Statute 112,061.
A cover letter summarizing the major line items on the reimbursable expense request needs to
also contain a notarized certified statement such as:
"I certify that the attached expenses are accurate and in agreement with the records of
this organization. Furthermore, these expenses are in compliance with this organization's
contract with the Monroe County Board of County Commissioners."
Invoices should be billed to the contracting agency. Third party payments will not be considered
for reimbursement. Remember, the expense should be paid prior to requesting a reimbursement.
Only current charges will be considered, no previous balances.
Reimbursement requests will be monitored in accordance with the level of detail in the contract.
This document should not be considered all-inclusive. The Clerk's Finance Department reserves
the right to review reimbursement requests on an individual basis. Any questions regarding these
guidelines should be directed to 305-292-3534.
Data Processing, PC Time, etc.
The vendor invoice is required for reimbursement. Inter -company allocations are not considered
reimbursable expenditures unless appropriate payroll journals for the charging department are
attached and certified.
Payroll
A certified statement verifying the accuracy and authenticity of the payroll expense is needed. If
a Payroll Journal is provided, it should include: dates, employee name, salary or hourly rate, total
hours worked, withholding information and payroll taxes, check number and check amount. If a
Payroll Journal is not provided, the following information must be provided: check amount, check
number, date, payee, support for applicable payroll taxes.
Postage, Overnight Deliveries, Courier, etc.
A log of all postage expenses as they relate to the County contract is required for reimbursement.
For overnight or express deliveries, the vendor invoice must be included.
Rents, Leases, etc.
A copy of the rental or lease agreement is required. Deposits and advance payments are not
allowable expenses.
Reproductions, Copies, etc.
A log of copy expenses as they relate to the County contract is required for reimbursement. The
log must define the date, number of copies made, source document, purpose, and recipient. A
reasonable fee for copy expenses will be allowable. For vendor services, the vendor invoice and a
sample of the finished product are required.
Supplies, Services, etc.
For supplies or services ordered, a vendor invoice is required.
Telefax, Fax, etc.
A fax log is required. The log must define the sender, the intended recipient, the date, the
number called, and the reason for sending the fax.
Telephone Expenses
A user log of pertinent information must be remitted including: the party called, the caller, the
telephone number, the date, and the purpose of the call.
Travel Expenses
Travel expenses must be submitted on a State of Florida Voucher for Reimbursement of Travel
Expenses. Travel must be submitted in accordance with Florida Statute 112.061. Credit card
statements are not acceptable documentation for reimbursement. If attending a conference or
meeting a copy of the agenda is needed. Airfare reimbursement requires the original passenger
receipt portion of the airline ticket. A travel itinerary is appreciated to facilitate the audit trail.
Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented
with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example,
taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is
considered a reimbursable travel expense at the destination. Airport parking during a business
trip is not.
A detailed list of charges is required on the lodging invoice. Balance due must be zero. Room
must be registered and paid for by traveler. The County will only reimburse the actual room and
related bed tax. Room service, movies, and personal telephone calls are not allowable expenses.
Meal reimbursement is: breakfast at $3.00, lunch at $6.00, and dinner at $12.00. Meal
guidelines state that travel must begin prior to 6 a.m. for breakfast reimbursement, before noon
and end after 2 p.m. for lunch reimbursement, and before 6 p.m. and end after 8 p.m. for dinner
reimbursement.
Mileage reimbursement is calculated at .29 cents per mile for personal auto mileage while on
County business. An odometer reading must be included on the state travel voucher for vicinity
travel. Mileage is not allowed from a residence or office to a point of departure. For example,
driving form one's home to the airport for a business trip is not a reimbursable expense.
Non -allowable Expenses
The following expenses are not allowable for reimbursement: capital outlay expenditures (unless
specifically included in the contract), contributions, depreciation expenses (unless specifically
included in the contract), entertainment expenses, fundraising, non -sufficient check charges,
penalties and fines.
ATTACHMENT B
ORGANIZATION
LETTERHEAD
Monroe County Board of County Commissioners
Finance Department
500 Whitehead Street
Key West, FL 33040
Date
The following is a summary of the expenses for ( Organization name) for the time period
of to
Check # Payee
Reason
Amount
101 Company A Rent $ X,XXX.XX
102 Company B Utilities XXX.XX
104 Employee A P/R ending 05/14/01 XXX.XX
105 Employee B P/R ending 05/28/01 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 2003
by who is personally known to me.
Notary Public Notary Stamp
ATTACHMENT C
DESCRIPTION OF SERVICES TO BE PROVIDED
Early childhood information and financial assistance.
In -home services to enhance the family quality of life.
Early childhood quality improvement initiatives and training.
Advocacy on issues to improve the lives of children, including health, nutrition, and education.
ETHICS CLAUSE
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY, FLORIDA
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.
Date:
STATE OF
COUNTY OF
(signature)
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: 10/01 /03
Expiration Date: 9/30/04
Contract Purpose/Description: provides funding for women's health care services
Contract Manager: David P. Owens
(Name)
for BOCC meeting on 1
4482 OMB/Grants
(Ext.) (Department)
Agenda Deadline: 09/30/04
CONTRACT COSTS
Total Dollar Value of Contract: $24,724.00 Current Year Portion: $24,724.00
Budgeted? Yes® No ❑ Account Codes: 001- 03215-530340- -
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 Out
Date In Needed �f' Reviewer
Division Director Yes[:] No❑'"
&3
Risk Management /;J Yes❑ NoZ'
O.M.B./Purchasing cl �'l kWes❑ NoD'
County Attorney �*3 Yes[:] No[j�
Comments:
OMB Form Revised 9/11/95 MCP #2
AGREEMENT
This Agreement is made and entered into this day of , 2004,
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 TWENTY-FOUR THOUSAND, SEVEN HUNDRED, TWENTY-FOUR,
AND 00/100 DOLLARS ($24,724.00) for fiscal year 2004.
2. TERM This Agreement shall commence on October 1, 2003, and terminate September
30, 2004, 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.
S. 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 and
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
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
By
Deputy Clerk
Witness
Witness
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By
Mayor/Chairman
PROVIDER
(Federal ID No.
By
President
MONROE COUNTY ATTORNEY
OVED AS T
UZANNE A. U ON
A SISTANT 4TY A BEY
Date
---�'
ATTACHMENT A
EXPENSE REIMBURSEMENT REQUIREMENTS
This document is intended to provide basic guidelines to Human Service Organizations, county
travelers, and contractual parties who have reimbursable expenses associated with Monroe
County business. These guidelines, as they relate to travel, are from Florida Statute 112.061.
A cover letter summarizing the major line items on the reimbursable expense request needs to
also contain a notarized certified statement such as:
"I certify that the attached expenses are accurate and in agreement with the records of
this organization. Furthermore, these expenses are in compliance with this organization's
contract with the Monroe County Board of County Commissioners."
Invoices should be billed to the contracting agency. Third party payments will not be considered
for reimbursement. Remember, the expense should be paid prior to requesting a reimbursement
Only current charges will be considered, no previous balances.
Reimbursement requests will be monitored in accordance with the level of detail in the contract.
This document should not be considered all-inclusive. The Clerk's Finance Department reserves
the right to review reimbursement requests on an individual basis. Any questions regarding these
guidelines should be directed to 305-292-3534.
Data Processing, PC Time, etc.
The vendor invoice is required for reimbursement. Inter -company allocations are not considered
reimbursable expenditures unless appropriate payroll journals for the charging department are
attached and certified.
Payroll
A certified statement verifying the accuracy and authenticity of the payroll expense is needed. If
a Payroll Journal is provided, it should include: dates, employee name, salary or hourly rate, total
hours worked, withholding information and payroll taxes, check number and check amount. If a
Payroll Journal is not provided, the following information must be provided: check amount, check
number, date, payee, support for applicable payroll taxes.
Postage, Overnight Deliveries, Courier, etc.
A log of all postage expenses as they relate to the County contract is required for reimbursement
For overnight or express deliveries, the vendor invoice must be included.
Rents, Leases, etc.
A copy of the rental or lease agreement is required. Deposits and advance payments are not
allowable expenses.
Reproductions, Copies, etc.
A log of copy expenses as they relate to the County contract is required for reimbursement. The
log must define the date, number of copies made, source document, purpose, and recipient. A
reasonable fee for copy expenses will be allowable. For vendor services, the vendor invoice and a
sample of the finished product are required.
Supplies, Services, etc.
For supplies or services ordered, a vendor invoice is required.
Telefax, Fax, etc.
A fax log is required. The log must define the sender, the intended recipient, the date, the
number called, and the reason for sending the fax.
Telephone Expenses
A user log of pertinent information must be remitted including: the party called, the caller, the
telephone number, the date, and the purpose of the call.
Travel Expenses
Travel expenses must be submitted on a State of Florida Voucher for Reimbursement of Travel
Expenses. Travel must be submitted in accordance with Florida Statute 112.061. Credit card
statements are not acceptable documentation for reimbursement. If attending a conference or
meeting a copy of the agenda is needed. Airfare reimbursement requires the original passenger
receipt portion of the airline ticket. A travel itinerary is appreciated to facilitate the audit trail.
Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented
with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example,
taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is
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 05/28/01 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 2004
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.
ETHICS CLAUSE
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY, FLORIDA
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.
Date:
STATE OF
COUNTY OF
(signature)
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 with: Rural Health Network Effective Date: 10/1/03
Expiration Date: 9/30/04
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)
for BOCC meetine on 10/15/03
Total Dollar Value of Contract
Budgeted? Yes X No
Grant: $0.00
County Match: $0.00
4482 OMB/Grants Mgt.
(Ext.) (Department)
Deadline: 10/2/03
CONTRACT COSTS
$34,614.00 Current Year Portion: $34,614.00
Account Codes: 001-0321 5'-530340
ADDITIONAL COSTS
Estimated Ongoing Costs: $0.00 For:
(Not included in dollar value above) (eg. Maintenance
CONTRACT REVIEW
Changes
Date In
Needed
Division Director
Yes❑ NoQ
Risk Management Y a3�a 3
Yes❑ NoR
O.M.B./Purchasing C11 �,)
-Y�s❑ No�
County Attorney 43
Yes❑ No�
Comments:
vcJ
uivin rorm icevisea Y/ i i/yJ mur iTz
etc.
Date Out
9113% 3
0.3
AGREEMENT
Rural Health Network of Monroe County, Florida, Inc.
This Agreement is made and entered into this day of
, 2003, 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
enrollment activities for the Florida Kid Care Program and dental clinic 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 outreach and enrollment activities for the Florida Kid Care Program
and dental clinic services in Monroe County, Florida, shall pay to the Provider the
sum of THIRTY-FOUR THOUSAND, SIX HUNDRED, FOURTEEN, AND NO/100
DOLLARS ($34,614.00) for fiscal year 2004.
2. TERM. This Agreement shall commence on October 1, 2003, and
terminate September 30, 2004, 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 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.
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.
S. 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) 501(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 and
Gato Building
1100 Simonton Street
Key West, FL 33040
For Provider
Mark L. Szurek
Executive Director
Rural Health Network of Monroe County
Post Office Box 4966
Key West, FL 33041-4966
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
SO
Deputy Clerk
Witness
Witness
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
a
Mayor/Chairman
RURAL HEALTH NETWORK OF
MONROE COUNTY, FLORIDA, INC.
(Federal ID No.
By
President
MONROE COUNTY ATTORNEY
PROVED AS F
"SIUZ ' E A. HUTTON
STA.N i COU!'ITY T ORNEY
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 05/28/01
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 2003
by who is personally known to me.
Notary Public Notary Stamp
ETHICS CLAUSE
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY, FLORIDA
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.
Date:
STATE OF
COUNTY OF
(signature)
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
My commission expires:
OMB - MCP FORM #4
NOTARY PUBLIC
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: YMCA of Greater Miami, Inc. Effective Date: 10/01/03
Expiration Date: 09/30/04
Contract Purpose/Description: Provides funding for youth programs, such as after -school care,
summer camp sports and tennis at Key Largo Community Park.
Contract Manager: David P. Owens
(Name)
for BOCC meeting on
4482 OMB/Grants
(Ext.) (Department)
a Deadline:
CONTRACT COSTS
Total Dollar Value of Contract: $12,857.00 Current Year Portion: $12,857.00
Budgeted? Yes X No ❑ Account Codes: 00129 9-530340- -
Grant: $-
County Match:
ADDITIONAL COSTS
Estimated Ongoing Costs: $ /yr For:
(Not included in dollar value above) (eg. maintenance, utilities, janitorial, salaries, etc.)
Division Director
Risk Management
O.M.B./Purchasing
County Attorney
Comments:
CONTRACT REVIEW
Changes
Date In Needed
Yes❑ No0-''
Yes❑ No[QI*�
Yes❑ NoErl_*�
"49O3 Yes❑ No[,]/
OMB Form Revised 9/11/95 MCP #2
Date Out
AGREEMENT
YMCA of Greater Miami, Inc.
This Agreement is made and entered into this day of 2003
between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter
referred to as "Board" or "County," and YMCA OF GREATER MIAMI, INC., hereinafter referred to
as "Provider."
WHEREAS, the Provider is a not -for -profit corporation that provides youth programs, and
WHEREAS, it is a legitimate public purpose to provide youth programs, such as after -
school care, summer camp, sports and tennis at the Key Largo Community Park, 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
youth programs, such as after -school care, summer camp, sports and tennis at the Key Largo
Community Park for young persons living in Monroe County, Florida, shall pay to the Provider the
sum of TWELVE THOUSAND, EIGHT -HUNDRED, FIFTY-SEVEN, AND NO/100 DOLLARS
($12,857.00) for fiscal year 2004.
2. TERM. This Agreement shall commence on October 1, 2003, and terminate
September 30, 2004, 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 youth programs, such as after -school care, summer camp, sports and tennis at
the Key Largo Community Park for the children of Monroe County, Florida.
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.
S. COMPLIANCE WITH LAW. In providing all services pursuant to this agreement,
the Provider shall abide by all statutes, ordinances, rules and regulations pertaining to or
regulating the provision of such services, including those now in effect and hereinafter adopted.
Any violation of said statutes, ordinances, rules and regulations shall constitute a material breach
of this agreement and shall entitle the Board to terminate this contract immediately upon delivery
of written notice of termination to the Provider.
9. COMPLIANCE WITH COUNTY GUIDELINES. The PROVIDER must furnish to the
COUNTY:
(a) evidence of the organization's 501(c)(3) status;
(b) a list of the organization's Board of Directors of which there must be five or more;
(c) evidence of annual election of Officers and Directors;
(d) an annual audited financial report ;
(e) a copy the organization's Corporate Bylaws, which must address the organization's
mission, board and membership composition, election of officers, and so on;
(f) a copy of the organization's Corporate Policies and Procedures Manual which must include
hiring policies for all staff, drug and alcohol free workplace provisions, equal employment
opportunity provisions, and so on;
(g) cooperation with County monitoring visits;
(h) semi-annual performance reports. These reports should include performance
measurements which will demonstrate the level of accomplishment of goals for which funding
has been provided.
(i) other reasonable reports and information related to compliance with applicable laws,
contract provisions and the scope of services that the County may from time to time request.
10. PROFESSIONAL RESPONSIBILITY AND LICENSING. The Provider shall assure
that all professionals have current and appropriate professional licenses and professional liability
insurance coverage. Funding by the Board is contingent upon retention of appropriate local, state
and/or federal certification and/or licensure of the Provider's program and staff.
11. MODIFICATIONS AND AMENDMENTS. Any and all modifications of the services
and/or reimbursement of services shall be amended by an agreement amendment, which must be
approved in writing by the Board.
12. NO ASSIGNMENT. The Provider shall not assign this agreement except in writing
and with the prior written approval of the Board, which approval shall be subject to such
conditions and provisions as the Board may deem necessary. This agreement shall be
incorporated by reference into any assignment and any assignee shall comply with all of the
provisions herein. Unless expressly provided for therein, such approval shall in no manner or
event be deemed to impose any obligation upon the Board in addition to the total agreed upon
reimbursement amount for the services of the Provider.
13. NON-DISCRIMINATION. The Provider shall not discriminate against any person
on the basis race, creed,. color, national origin, sex or sexual orientation, age, physical handicap,
or any other characteristic or aspect which is not job -related in its recruiting, hiring, promoting,
terminating or any other area affecting employment under this agreement. At all times, the
Provider shall comply with all applicable laws and regulations with regard to employing the most
qualified person(s) for positions under this agreement. The Provider shall not discriminate
against any person on the basis of race, creed, color, national origin, sex or sexual orientation,
age, physical handicap, financial status or any characteristic or aspect in its providing of services.
14. AUTHORIZED SIGNATURES. The signatory for the Provider below, certifies and
warrants that:
(a) The Provider's name in this agreement is the full name as designated in its
corporate charter, if a corporation, or the full name under which the Provider is
authorized to do business in the State of Florida.
(b) He or she is empowered to act and contract for the Provider; and
(c) This agreement has been approved by the Board of Directors of the Provider if the
Provider is a corporation.
15. NOTICE Any notice required or permitted under this agreement shall be in writing
and hand -delivered or mailed, postage pre -paid, by certified mail, return receipt requested, to the
other party as follows:
For Board:
Monroe County Attorney and David P. Owens, Grants Administrator
PO Box 1026 Gato Building
Key West, FL 33041 1100 Simonton Street
Key West, FL 33040
For Provider:
President/CEO
YMCA OF GREATER MIAMI, INC.
Alfred Sanchez
Suite 120
1320 South Dixie Highway
Coral Gables, FL 33146
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
ZA
Deputy Clerk
Witness to Provider Signature
Witness to Provider Signature
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By
Mayor/Chairman
PROVIDER
(Federal ID No. )
By
Chief Executive Officer
MONROE COUN'i'Y AXT0-P%NEY
AP ROVED HST R
UZANN A. TTG+`I
ASSISTAN u BYO
Date _ .
ATTACHMENT A
EXPENSE REIMBURSEMENT REQUIREMENTS
This document is intended to provide basic guidelines to Human Service Organizations, county
travelers, and contractual parties who have reimbursable expenses associated with Monroe
County business. These guidelines, as they relate to travel, are from Florida Statute 112.061.
A cover letter summarizing the major line items on the reimbursable expense request needs to
also contain a notarized certified statement such as:
"I certify that the attached expenses are accurate and in agreement with the records of
this organization. Furthermore, these expenses are in compliance with this organization's
contract with the Monroe County Board of County Commissioners."
Invoices should be billed to the contracting agency. Third party payments will not be considered
for reimbursement. Remember, the expense should be paid prior to requesting a reimbursement
Only current charges will be considered, no previous balances.
Reimbursement requests will be monitored in accordance with the level of detail in the contract.
This document should not be considered all-inclusive. The Clerk's Finance Department reserves
the right to review reimbursement requests on an individual basis. Any questions regarding these
guidelines should be directed to 305-292-3534.
Data Processing, PC Time, etc.
The vendor invoice is required for reimbursement. Inter -company allocations are not considered
reimbursable expenditures unless appropriate payroll journals for the charging department are
attached and certified.
Payroll
A certified statement verifying the accuracy and authenticity of the payroll expense is needed. If
a Payroll Journal is provided, it should include: dates, employee name, salary or hourly rate,
total hours worked, withholding information and payroll taxes, check number and check amount.
If a Payroll Journal is not provided, the following information must be provided: check amount,
check number, date, payee, support for applicable payroll taxes.
Postage, Overnight Deliveries, Courier, etc.
A log of all postage expenses as they relate to the County contract is required for reimbursement.
For overnight or express deliveries, the vendor invoice must be included.
Rents, Leases, etc.
A copy of the rental or lease agreement is required. Deposits and advance payments are not
allowable expenses.
Reproductions, Copies, etc.
A log of copy expenses as they relate to the County contract is required for reimbursement. The
log must define the date, number of copies made, source document, purpose, and recipient. A
reasonable fee for copy expenses will be allowable. For vendor services, the vendor invoice and a
sample of the finished product are required.
Supplies, Services, etc.
For supplies or services ordered, a vendor invoice is required.
Telefax, Fax, etc.
A fax log is required. The log must define the sender, the intended recipient, the date, the
number called, and the reason for sending the fax.
Telephone Expenses
A user log of pertinent information must be remitted including: the party called, the caller, the
telephone number, the date, and the purpose of the call.
Travel Expenses
Travel expenses must be submitted on a State of Florida Voucher for Reimbursement of Travel
Expenses. Travel must be submitted in accordance with Florida Statute 112.061. Credit card
statements are not acceptable documentation for reimbursement. If attending a conference or
meeting a copy of the agenda is needed. Airfare reimbursement requires the original passenger
receipt portion of the airline ticket. A travel itinerary is appreciated to facilitate the audit trail.
Auto rental reimbursement requires the vendor invoice. Fuel purchases should be documented
with paid receipts. Taxis are not reimbursed if taken to arrive at a departure point: for example,
taking a taxi from one's residence to the airport for a business trip is not reimbursable. Parking is
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 05/28/01
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 2003
by who is personally known to me.
Notary Public
Notary Stamp
ETHICS CLAUSE
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY, FLORIDA
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.
Date:
STATE OF
COUNTY OF
(signature)
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: National Heritage Foundation Effective Date: 10/01/03
Expiration Date: 09/30/04
Contract Purpose/Description: Provides funding the Just 4 Kids program, which serves the needs of
school -age children in Monroe County.
Contract Manager: David P. Owens
(Name)
for BOCC meeting on
4482 OMB/Grants
(Ext.) (Department)
a Deadline: 09/30/03
CONTRACT COSTS
Total Dollar Value of Contract: $4,945.00 Current Year Portion: $4,945.00
Budgeted? Yes X No ❑ Account Codes: 001=9999-530340- -
Grant: $-
County Match:
ADDITIONAL COSTS
Estimated Ongoing Costs: $ /yr For:
(Not included in dollar value above) e . maintenance, utilities, janitorial, salaries, etc.
CONTRACT REVIEW
Changes
Date In
Needed
Division Director
Yes[-] NoQ
/
Risk Management
3f03
Yes❑ NoR-
O.M.B./Purchasing
Yes❑ No�
County Attorney
�f'
Yes❑ No2-�
Comments:
OMB Form Revised 9/11/95 MCP #2
�i
-x Reviewer
,t
Date Out
_L-
;ZO3
AGREEMENT
National Heritage Foundation
This Agreement is made and entered into this day of 2003
between the BOARD OF COUNTY COMMISSIONERS OF MONROE COUNTY, FLORIDA, hereinafter
referred to as "Board" or "County," and NATIONAL HERITAGE FOUNDATION, hereinafter referred
to as "Provider."
and WHEREAS, the Provider is a not -for -profit corporation that provides assistance to children,
WHEREAS, it is a legitimate public purpose to provide services such as assistance with
clothing, personal hygiene supplies, and school supplies, 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
services such as assistance with clothing, personal hygiene supplies, and school supplies for
young persons living in Monroe County, Florida, shall pay to the Provider the sum of FOUR
THOUSAND, NINE -HUNDRED, FORTY-FIVE, AND NO/100 DOLLARS ($4,945.00) for fiscal year
2004.
2. TERM. This Agreement shall commence on October 1, 2003, and terminate
September 30, 2004, 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 assistance with clothing, personal hygiene supplies, and school supplies for the
children of Monroe County, Florida.
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 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 and David P. Owens, Grants Administrator
PO Box 1026 Gato Building
Key West, FL 33041 1100 Simonton Street
Key West, FL 33040
For Provider:
Executive Director
NATIONAL HERITAGE FOUNDATION
Dr. IT Dock Houk, CEO
Suite 405
6201 Leesburg Pike
Falls Church, VA 22044
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
By
Deputy Clerk
Witness to Provider Signature
Witness to Provider Signature
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
By
Mayor/Chairman
PROVIDER
(Federal ID No
By
Chief Executive Officer
MONROE COUNTY ATTORNEY
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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 05/28/01
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 2003
by who is personally known to me.
Notary Public
Notary Stamp
ETHICS CLAUSE
SWORN STATEMENT UNDER ORDINANCE NO. 10-1990
MONROE COUNTY, FLORIDA
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.
Date:
STATE OF
COUNTY OF
(signature)
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."