Item C12 C.12
Coty f � ,�� ,' BOARD OF COUNTY COMMISSIONERS
�� Mayor David Rice,District 4
The Florida Keys � Mayor Pro Tem Craig Cates,District I
y Michelle Coldiron,District 2
James K.Scholl,District 3
Ij Holly Merrill Raschein,District 5
County Commission Meeting
June 15, 2022
Agenda Item Number: C.12
Agenda Item Summary #10677
BULK ITEM: Yes DEPARTMENT: Social Services
TIME APPROXIMATE: STAFF CONTACT: Sheryl Graham (305) 292-4510
N/A
AGENDA ITEM WORDING: Approval of Amendment 4001 to Contract KCV-2129 between the
Alliance for Aging, Inc. (AAA) and Monroe County Board of County Commissioners/Monroe
County Social Services to de-obligate $71,051.35 due to a surplus in COVID-19 relief funding.
ITEM BACKGROUND: The CCAA program gives preference to citizens aged 60 and above with
(1)the greatest economic/financial need, (2) minority seniors, (3) greatest social need due to
isolation, as well as (4)those who are required to practice social distancing due to COVID-19.
Preference is also given to seniors with(5) limited English proficiency, and those who (6)reside in
rural areas.
PREVIOUS RELEVANT BOCC ACTION: BOCC approved Contract KCV-2129 on
04/21/2021
CONTRACT/AGREEMENT CHANGES:
De-obligation of funds
STAFF RECOMMENDATION: Approval
DOCUMENTATION:
BACKUP fully executed KCV 2129 04_21_2021 Agreement
kcv-2129
FINANCIAL IMPACT:
Effective Date: N/A
Expiration Date: N/A
Total Dollar Value of Contract: $0
Packet Pg.470
C.12
Total Cost to County:
Current Year Portion:
Budgeted:
Source of Funds:
CPI:
Indirect Costs:
Estimated Ongoing Costs Not Included in above dollar amounts:
Revenue Producing: If yes, amount:
Grant:
County Match:
Insurance Required:
Additional Details:
REVIEWED BY:
Sheryl Graham Completed 05/31/2022 12:20 PM
James Molenaar Completed 05/31/2022 2:42 PM
Purchasing Completed 05/31/2022 2:57 PM
Budget and Finance Completed 05/31/2022 3:59 PM
Brian Bradley Completed 05/31/2022 4:19 PM
Lindsey Ballard Completed 05/31/2022 4:21 PM
Board of County Commissioners Pending 06/15/2022 9:00 AM
Packet Pg.471
AMENDMENT 001 CONTRACT KCV- 2129 Page 1
THIS AMENDMENT is entered into between the Alliance for Aging,Inc, hereinafter referred to as the "Alliance",and Monroe County
Board of County Commissioners,Social Services/In-Home Services,hereinafter referred to as the"Contractor"and collectively
referred to as the"Parties."
The purpose of this amendment is to make the following changes to the existing contract funding.
Funding Elimination $ (71,051.35)
This amendment changes the totail CCAA contract funding of: $71,OS1.35 to $0.00
The Budget Summary by Title for the whole Fiscal Year(February 01,2021-September 30,2022)is as follows:
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
Coronavirus Consolidated
Appropriations Act for Nutrition U.S. Health and Human Services 93.045 $0.00
Services under Title Ill-C of the
Older Americans Act
Expanding Access to COVID-19
Vaccines via the,Aging Network U.S.Health and Human Services 93,044
TOTAL FEDERAL AWARD $0.00
The Alliance shall make payment to the provider for the provision of services up to a maximum number
of units of service and at the rate(s)stated below:
Service to be Provided Service Maximum Units of Service Maximum E
Unit Rate Prior Units Additional Total Dollars
Congregate Meals %00 1 11) $0,70 E
("ongregate Meals MLTC` $ 9.00
Congr-egate Meals Guest $ 9.010 CN
Congregate Meals Volunteer $ 9.010 C14
Lmergency Congregate Meals $ 9.00 1 (1) $0.00U
Congregate Meals Screening $ 20.00 1 $0.00
CN
Nutrition Counseling $ 70.56 1 $0.00 V_
CN
Nutrition, Education $ 1.00 1 $0,00 >
U
flame Delivered Meals 5.00 14,170 (14,170) $0.00 -ldc
Emergency Shelf florne Delivered Meals
Screening and Assessment 26.22 1 (1) $0.00 E
Shopping Assistance CV $ 30.90 1
$0.00
11'elephomie Reassurance CV S 27.37 1 $0.00
CONTRACT TOTAL AS AMENDED i 1 $0.00
All provisions in thie contract and any attachments thereto in conflict with this amendment shall be and are hereby changed
to conform with this amendment.All provisions not in conflict with this amendment are stall in effect and are to be performed
at the level specified in the contract are hereby amended to conform with this amendment.
This amendment and all its attachments are hereby made a part of the contract.
IN WITNESS WHEREOF,the parties hiereto have caused this amendment to be executed by their
undersigned officials as duly authorized.
Monroe County Board of County Commissioners, ALLIANCE FORAGING, INC.
Social Services/In-Home Services
SIGNED BY: SIGNED BY:
NAME- NAME: Max B.Rothman,JD,LL.M.
TITLE. TITLE: President&CEO
DATE: DATE:
I Packet Pg.472
CzA
r. Kevin Madok, CPA
r Clerk of the Circuit Court& Comptroller—Monroe County, Florida
C
DATE: May 3, 2021
TO: Slieryl Graliam, Director
Social Services
A7M: Lourdes Francis
FROM: Pancla(_. Hanc4Lkb.C.
SUBJECT": April 21°BOCC Meeting
Attaclied is an electronic copy of ilie fnllowing item,executed on behalf of Monroe
County, for your Iiandling:
C9 Coronavirus Consolidated Appropriations Act Contract.between (lie Alliance for
Ung, Inc.,and Monroe Count),Board of County Commissioners, Social Services/lrr-Home
Senices in order to provide nutrition services to Monroe County citizens (aged 60 and above) and
dreir caregivers. [rant contract is for the period of February 1, 2021 through September 30, 2022,
in die amount of'S71,051.35.
Please be sure to provide diis office with a hilly executeVITy of the agreement.once 11je
Alliance signs. Should you ]lave any questions please feel free to contact me at (305) 292-3 50,
l� 4 201
Isy: ...::..
cc: County Attorney
Finance
File
KEY WEST MARATHON PLANTATION KEY PKIROTH BUILDING
500 Whitehead Street 3117 Overseas Highway 88820 Overseas Highway 50 High Point Road
Key West,Florida 33040 Marathon,Florida 33050 Plantation Key,Florida 33070 Plantation Key,Florida 33070
305-294-4641 305-289-6027 305-852-7145 305-852-7145
KCV.2129
ALLIANCIE FOR AGING,INC.
STANDARD CONTRACT
Coronavirus Consolidated Appropriations A0
THIS CONTRACT is entered into between the Alliance for Aging,Inc,, hereinafter,referred to as the"Alliance,"and
Moorce County Board of Coun(y Commissioners,Social Services/ln-Honle Services,herei 11,111cr referred,to as the
"Provider"', and collectively referred to as the-Parties." The to contractor ibr this 11LUI)OSC,May designate to vendor.
!wb-grantee or stake-rmipien�,the status to(% further idcritified in ATTACHMENT I L, Exhibit-2 rrs nccessim),,
WITNESSEV-1 THAT,
WHEREAS.the Alliance hats e9tablishad,throu4fli the Area Plan on Aging 1hat it is in need ofcertflin services as
Ln
described hrrein,.and
WHEREAS,the Provider has dvunvnslrawtl Ow at has the requisite e.xperuse and ability to faitliCully ped'OV31 SUILI-1
serve ices;as an indepcndent contractor of the Alliance.
NOW THEREFORE', in consideraitan ol'thc services to be: Ilea fanned and payments(o be madc, together with the
mUtUal covenanis anti conditinn hcreinaftcr set r6nh, the partics,agrceas follows:
1. Purpose of Contract
1"he ilurpos�'(,Wlhis contract is to provide sery ice s in accordo'llce w4h the terms and canoition-)specificd in this,
conuraci including afl attachuneflis and exhibits, which constlLute the conuact doctullew,
2. Definitions
ADL,Activities of Da!ly Living,
A PS -Ad u I I Prot cc(i ve Serw i cas
ADA-Arnericans,,vith Disabilili,.-s Act
AlAarice- Area Atericy ori Aging
AFICL-Asscssed Priority Consumer List
CIRTS-Client Informarion and Registration Tracking System,
DOEA-Department of Elder AfCairs(The Department)
f&R-Inforinationand flef'erral
JADL-,Instrutnewal Activities of Daily Living
MOD-Major Disuster Declaration
MOA-rviernarandurn orAgreement
MOU- Mernorandurn of Understajlding
PSAs-Phinning and Service Areas ci:xresponding to Miami-Dad and Monroe Counfic-S
SPA -Servioe Providor Applic,0100,
USDA - United States DcpartineuiL of A0`iCWtUrQ
3. Dicorporatiort of Docurnerm v6thin the Cataract
The contract incotporates by reference attachments, proposal(s),solicitation(s), Providers Service Provider
Applicadun.and the ctirrent DOEA Programs and Services Handbook. Any and all cantrarls or"Agree,nien is
executed betueen the Provider and the Alliance during thecl-17ective Period ofthis contract slial I be governed in
accordancc with the apl)licablc laws and stawles,
4. Term of Contract
This contract shall beg
in on February 1,201.1, or on the date on,which the contract bail been signed by the iast party
required to sign it,whichever is later. It shall end at midnight, local time in Miami, Florida,on September 30, 2022,
urile�s renewed or exteuderl as provided herein,
Page I of 66
5. Contract Amount
The Alliance agrees to Pay 101,Contracted services according to the terms and condi6oris oi'th1.5 contmcL in an
amount not to exceed_S71 5L35 subject to oo availabilityA ,)! a of funds. n ws or services, paid for under aiiy other
.,9_
convact or fron any other s0UrCC are 110t Cfl,�ibiO f0rpklylltelll Under this coraracL,
6 .enewals
By rinutual agreement of the parties, the Alliance may renew the contracl fDr Five addJ6011al One-year.periods.
Contingont upon Sati'sfactory perfonnance evaluations by the MHWILC and the availabil,ity affunds, rainy, rcnewal is
iubjject tk) the sarne territs as the origitial contract, wvitla tile exception of establishing twit rates v.,hich is,described
further in 01i"secdorK ']'lie original conlractual unit rote i are set fi)rfli in the bid propo4 and mply,
RequesLs to renegotiate the original contractual established rates axe provided for in the Alliance's approved
Rc4iiburNcrnent Rate Rcry c%v Policy, which is incorporated by refurerce.
This contra ca rrmy be extended uport Pitutual agreement kg one oxtension period not to exceed six months to ensure
continuity nt'service, Services provided tinder this extension will he paid for OLIt Of the succeeding agroement
7. Coniplionve with Federal Law
7.1 1,11k contract conutins federal funds. The fol,lovving shall apply.
7.1,1, The Providar shall comply with the provisions of 45 CF`R 74 andVar 45 CFR 92, and ollicrapplicablC
regulations.
7,1,2 1 f;his contraet ountuins Cedertil (`urds antl is over$100,000M, the Provider shall coniply with all
applicable standords, orders. or reLTUIR6011S i5suQd under s. 30b of the Clean A4,Aet as aiiieoded (42
UIS.Cr 7401. a sq), s. .508 of the Federal Wmer Rol[ofion Control Av as amended (33 USC, 1251. et
seq). Executive Order 11738, as amended,an(]Miere applicablc Enviroricnental Prr,)jeUjvn Agou�y
reg,u I a.1i oils 10 CFR 370_ The contractor shall report any violations cif the above to the Alliance.
7.1.3, "fhe Provider, or agent acting for the provider, may not use rriny federal funds received 'In connect on
v,iifi this cootract to inniience legislation or,appropriatrons pending before the Cofigress of any State
The Provider rmw conIplete atll disclosure fibrins,as mquisvd�specifically the Cerfitkai,611.
ol"Assuraaces Attachment,which must be completed and returned,with this signed contract.,
7.1,4, In a&ccordarce witli, Appcn&x,A lo 7 CTR )_151 the cryntraciar iliall comply wvilh Executive Order 11246,
Equal Elln P10)"IrIC"t Opportunity, as airiendied by FxcQwive Order 11375 and others. and Is
suppl,ernented in Department oi Labor regulation 41 CFRr 60 and 45 CFK 9,,,-, if applicable.
7..1.5. A contract award with an an'lount expected to cqwal Or e�xceed$250)0 00anrl certain other ciontract
awards shall not be made to parrot s fisted on the Exc ded Parties List Systetn in
accordarwe witk the OMB guidolines at 2 UR 190 that iniplernent Executive Orders 125�9 and 12,689,
"Debarment and S us pension," The,Excluded,Parties List ystern contains the names of parties
debarred.su5peridcd,or otherwise excluded by agencics, as well as parties declared
statutot3p or regulatory auttiority other than Executive Order 125,49, The PrDvidershall comply with
these provisions before doing business or entering''Into subcontracts receiving f dcral funds PUTSUMIL to
this contract. The Provider slwll uornplele and sign the Certification and Assurances Anachment prior,
to execution o1rihis contr-act.
7.1 The Provider shall not employ ar, unauthorized alien. The Alliance shall consider the employment of
unaLfthori7ed afii;ns as violition of the tinmigration and Nationality Act(8 U.&C 1324 a)and the fi=tigration
KeFb,n-ri, and Cortitrul Act of 1 6(S US,C. 1101). SUCh Vi0kifiOn Shall he CaILSC ror unilateral ca,11cell'ation of
tlfls contract by the Alliance.
Page 2 of 66
KCV-2129
7.3. If i lie Provider is at 11011-protlft provider and is sol.1ject 10 1 riterim I Revell Ile SON ice tIR1,S)taN exenlpt
orgarlir,alioji wpurtingrc clirircrrac rrts(filing a Forlii 990 or Forrn 990-N)and has its tax c�Neoipt SWUS VeaVOkOd
for failing to Corriply with 1110 filing requirements ofthe 2(C6 Pension,, Protection Act err tier an;v other reason,
the-Provider must notify flw Atbailce in Writing wi(11i11 thlr(y(30)days of vocQiving t1w IRS nWco of
revocation,
7A. The Provider shall comply with Title 2 CFR Part 175 in Per.5ons.
7,5. Unless txempt tinder 2 CFR Part 170 1 10(b),The Provider shall cornp,ly with the repiorfing 1-CqU40111CM.,OfthO
"frarlsparency Act tis expressed in 2 CrR 170,
7.6, To comply with Presidetitiat Ex,mutive Qr(ICr 12989 amd State of Florida EXtCUUVe Order'Nurnber, 11-116,
Provider agrees to utilize the US, 11!partmont of I-frornetand Secor4y's E-verit`y system to verify the
Ornployl-rew Ofall new erripjoyees hired by Provider dor1q, the contrnt term. Provider shall include- in relatcd
satPmcc:rrtrae is as requirelvent that subconlraellori and/or vendors performing wark or provldingserviccs pursuant
to the state, Conti-act ulilia the E-V�rify syttellr to verily' eulp[oyment of all llow cinpIoyees hired by the
A&contractor the coraral:L lean. Providers rneeting the terrns and condi600s Ofthe C-
Veriry System arc deemed to be in compliance with this jorovision.
8, Compliance i0tb Sure Uvv
8.1. This contract is executed arld entered into in the State offlorida, and shall be construed,perform.ed and
enforced in all respccts ill accordance,with the Florida taw, including Florida provisions for conflict of'laws,
8.2, The Provider shall comply with the requirements of 287158, F,S. as amended.
8,2,L *1 fic Provider shrill provide units of dekyerables, irlClUdillg reporting, fin&ngs, and draft!;,as specified ill
thk conim,ot, Which the Contract Manager must receive;:and accept in writino prior to paymcmi,
8,2,1 A ho Contiactoi
'III L:01111)1ti J'w j[[1 the criteria and [illal dow tlw Nw hikJ1 sUJ) Crit"'I 6 111LI'st t-jo met
1`01., cornlActioo ol,this corlllr,,,lct ,,w. specd"ied in AT1?\(1 I NALIN F 1. Scciiori H I k1cillod of
Paw niml,
8.23. The Provider shall subirlit hill's Star f cs or 001cr c(ln,jPCjtgj(iQgj Jr'U[.survices or expenses, i[ISLIMICiefli
detail ror a proper pre-audit and post-audit.
8.2,4, pay ltrent (Or t1t'aVCl eXper[SC$ is pCV0')ntCd in this contract, the contractor%kW submi,t bills ror
any travel expenses in accordance with s, 111061, E&,Of at SUch lowcr rates as may be provided,in
(hi 5 contrClet,
8,2.5u The Provider shall allow ptiblic access to all d1ocUMCITTS, papers, lettors, or other public recolts as
defined in stabsection 11 9M 1(12), F,S, made or received by the contractor in conjunction with this
contract ex-eept for ihoscrecords which are made:confidential or exempt,by law. The Provider's refusal
to comply with this provision shaLl constitute an immediate breach of contract for whkh the Alliance
l'or Aging,Ine. rnay unilaterally tcrinina,LU the Col'rtl'aCt,
0
8,3. If clients. are to be trarvsp*-ted under this,contract, the Provider shall comply %,irh flie provisions of'Chapter
4277,F,&, and Rule 4 1-2, F .C
8.4 SUbcontractors andfor vendors who are on the discriminatory vendor list, orlay not transact hU.S41CISS W'111811Y
public en6ly, in accordance with the provisions of.287.134, FS
8.5, 1"he Provider will cDaiply with the provisions of s, 11,062, ES.. and :s, 216,347. F,S,, which prohibit the
expenditure of contract funds for the purpose of lobb}ying the Mgr anch or a staid*agorlcy,
Page 3 of 66
KCVQ 129
SA, hi accordanet- wIM Seclkm 287J 35 RS. my Cutumow on Me Scrutinized CurrVanics w4h Acbvkes in
Swlhn LAW ScWhhzedCmnlmnies With Amivitics in the Iran Petroleurn fan rgy,
C ;Cetor 1,151,or r the
&ndized Cmvpades tat Boycott krae'l List (Lissy creatcd purquant.to 5u6ofl 21.5,473 FS, atid
215.4 7 2 5, F.S.or i s engaged in a boycott or Israel,0 1: i$elggagcd in buM Maass a pera 0 wn in C1 ba or Syria, is
InAgible to ctuar into or renew as carnti-act m%the DeparMtttw ntfor goods or services of S 1AX),000 or moro,
PUMMOM to SKofl 287.135 F,S., ffie Ail nce inny termhwe N!;contract if the Provider is found to have
suhniitted a tense: certil'indan uFRs stanA an the Lists or Nis been placed curt the Lists or is engaged in as
boyow of lwad cw has been,engaged in busincss operations in Cuba or Syria, rurater,the PrDwidcr is
suWea to All penalties,anomey's fees and costs and any cams for invo6gaHons data! led to the GnWnl;of
fialse ccrtifcation, The Provider sball complete owd sign tbe AWfin'tions and,Assurances AttachnictiL, prcr
to he execution of Ms cwtma
9. Baekground Screening
AL 'Me Pmvicler shall comply With WId elIS'LIFL: subcol itrainom wv 11 cornahme WWI cc w*61mmam of S,
4301402 and Clapter 431 r,S.. as artiendedt are ruct regamling Wkyowwl scruntrig ter full pnons wAo
oreet the definition of at direct service providerand%0to are not exempt Irron-t the Department's level 2
background savmhg purwant to s 430.04102Q(3),F.S.The Provider niust at so comply wiiliany applicable
vanes pronidgmed by% Deprtment and the Agency for lilealth Care Administration regarding
irnoenwnwtJon of s.430.0402 arid Chapter 435, F.S.
12. Rut"hif"omiation conccrnitig Che prriwd= for background 5crceniog is found w
93. Background creenirtg Affidavit ol"Cornplianco -To Con1plianee wa itlt jhj',,CwrJjrraej, tfiL. prow"j(jer
sluff shmi ATTACHMENT D. Rackgomwl Screening AMdavit of Complianec annually. by Janwory I 5ft
10. Grievance Pratedures
'Me Provida 4mll carnpY with and ensure subcontractor anWor verdors compliarice with the MinkIlLIT111 Gillidchnct;
Rw Reciowu Gdevame ProcWurev Append N 1`1 DOEA Pmgmms and Semices FlAn4hook to addmss carnphitS
i,suding the termination,5usponsiort or reduedan of services,is required for receipt of UK,
10.1. Complaint procedures
The Provider shall develop and impletnent,co,jn,plaint ixotedures,and ensure rhar subcontractors and/or
vandars devchp and hnNernent cornplain( procedures to process and restAve client dissafis,factkmi wvilh
wrvices. Coniptaint procedures shall address dw tputlity and Urneliness apt services. provider anJ dirwswrvicc
water complahts,or any other advice ralmed to compQRS U0wr Uml termilt"Aticul, skispension (if reducti"an,
in sentices that require the grievance process as deunbad in Appendix D, Depmrimeitt of Elder ad fairs
Programs wd Services Handbook. The cornplaint proced',�ires shall include natification to all clienLs ofthe
curnphint procedure and include tracking the&te,nature of cornplaint,the dcivratiriation of cach coulplaint,
and the 11191ow-up with the client to ensure satisfaction With the VeSOIL6011
I l4 Pit blir Rcco rd S t.l ad Rctv n 00 it
1 11. R; cNecui On o fth k c N arac t. Co nij,aknor rces t 0 a i t prov w o n s or c haptcr I I I K S. Until un),
o0ic,r- applica.hlc 4ov,and s[Ndl:
I I J J. KcV and nmmW phUc words wqAmd by Ac Dopaninent ki pu5nn the contrautd su%!us,
I I A A kymi wqnst Rurn Ow 11clmrimentS cmundAt of Q& rewrdg p"wido the Deparunent as cop)
01C the requested recows O"Holk 010 rek:ord ro he hapened ov cooed %vhkn a rennnahk 10c,
at as com that dows neat ekwed Me cc*( proOded V Chapior I IQ'. F S- o"m othon1w piavkhl by
low.
Page 4 of 66
KC42129
k! Enswe Ut ptkie recurdi Im wr mumpt- on conlKidauW11 farad exampL 10m pAlfic rnowds,
disclosmv reqWrmwnM mv nw d0kned except as awhorixed by larva Or Ow Awadon I,&be
cunract temi and 615m Ng corrq%hn of cc smuraci Wthle t4mew W W9 wamNr Oro:
record" to the Departnrcul
I I 'l 4, Upon C11111NOW1 ONWOMMUL ow corgmoor Nvill:6111,"r lalr4'el,at 1:1ovosi 1c)the AIlianec-,111
pul"t[io: rec(H-J's, irl possessioll ofdw Coomlcrw% or o ill kectiand ivainla)io public mcords required
by the Depaimmy ir we CaltrUCIOT WrISKS Rh public vcem,ds it, ih,a2 DepartolieW IqWIl
compkilor;orihe ennow. Conimciar slmd I Wiro). an.v dilpljcauc ptallik:records that aiQ
CXCMPL Or confidenthl mild eNarnpi, I"rom public records dAk6ow mquhvivenN. If be
An"wor koqn W oubmins pubNo: p2awds upuii conriplotion of the Contract. the Contriwicti,
,,halt moct all applicaNe WoIfLlire,111C 1&5 poblic records, Ah roo.:0111's mumd
e0bunWHy nHisa he provided lo di c I)Cjpannicni inn Wpm that is cunipalNo: vid, the
in rortilation IC01110logy, 01'LIlC
J,?. The Alfitinct, nia) kuukaletdHl L:anal W5 COHIM aom ithsuanding, aroma ofl%x prm,isk)ns(it' 06s
corlln,tcl, tear refosal b�v O,o('onji-Pvtt),r to comp; m kh MACKIN= I afthis aNOKI by riol akm6m;,
pAdc mxa%w ad dowinumis. pnpery RutTse or otlio nlat�!rial niadc or,r,.c6rr,Qtj I)) the 11 ConlrucLorin
c(
I)t, ,, ,,,r,fcrjtj,)lj 'AlICI C,\t.,jjjjjt" ("'14(yjI S ect,i
Ijunctikon "Th Ohs CMMMCL tn kss 1,�! re�2,ords gars.e xelil oll
240) of Mild 1 or we staw cm4witmi ul,ti s,,c000 11,9.0711 ), F S,
IF THE CONTRACTOR HAS QUES11CINS REGARDINC Till,APPLICATION ()F CHAPTER 119,
FLA)RIDA wrATUTK% TO T1,117 CONTHACTOWS laUrY To PRO'VII)IR PUBLIC RIUVROS
R ELATI NG TO'I'll IS CONTRACT.CONTACr -f I It C'(1STU11I AN OF Pt IIIAC RECANZI)IS AD
Public Records Coonlunator
Florhlu Deportment of Elder
Wrids 4040 Esphunde Wuy
1411ahassee, Florida 32399
850-414-2342
I
12. Audits,Inspections, Investigations, Public Records and Retention
12 1. The Provider,.Alatl establish and inaintain books. rasa* and downwas OnWOg ekumnic womp imck)
sufficient to refled A anow ubhgatAs, wuhijaied balw= AX011W, WtUCSL and,c\periditums offwi&
provided by the All un,dwhh colamet, Providcr shall adequately safeguard call such assets and nsskire
ihey are wied soiely fbr the purposes midwdwd umW dais contract. Whencverappropriatc, rtILIancial
infionniation should be related to perfornianceand orrit coat data.
112. The NoWder MWI mmirl all d Ent records, fillanclal records,supporting d'o,curnents,statistical records,and
any rather clocumenm(QUAg deawnt storage-inedia)pertinent to this clathract for a pedod of A(6)yew
after completion of Ke corumn or longer w1ren required by law. in die event all audit is reqdmd by dais
mrac,tecards shall be rmahwd for La minimurn,period of six(6)years after theakidit report is issued car Until
resolution of any audit f-indigs or Uguiun,bawd oil the terms of thils Contract, at no addidonal cost to Vic
Wwlen
111 Upon deniand, at no additional cost,to Me ARiame.the Provider vvill faciflratC[he duplication and transfier of
any records OF dUCLIVnelItS dWing theeVC-qUAd mumlon pubd 11 Paragraph 121,
12.4 r The Provider.W assum dwhe records dcseribed in ifils scction shall be suyea at PH remonWe 6mcs to
inspection, review,copy ng.or audlt I,)' V.'JCral. Staab., M oath personael duly aUth0tized by the alliance.
foge 5 of 66
KCV-2129
121.5, At aU reasonable Ornes tbr as long as records are maintained, persoms duly uitha6yed by the Altiam,,,e, DOUA
0
and -nine arly
Fcde ral auditors, pivsuant to 45 CrR, Part 75, shall I)c allowc Rill d aL tr
y o and the ri obt to exar
of the Provider's contracts and related records and docomorits perfinum to this speciflic contract, re,ardless of
01
t1he form in which kopt,
116 The Provider shall provide:a financial and cotripliance audit to the Alliance as slic6fied in this contract and
ensure that all related third-party iransactklnq tire disclosed to the aoditm
117. 1"he PrDvider shall conriply and cooperme immediately%kh any insR-ections, revicms, inves�dgations,or
audits deemed necessary by the office of the DOEA's Inspector General pursuant to s, 20.055,17.8. Providcr
furflicr a-rm, thm it shilh nICIMIC in Wlated S'll,hC0110'WtS il that,sijbcootractors .md,'or
wVIHJOTw work or proN idili- sk:ryic,Cs 1JU1-',,WMt it) 01i5 C0MfTfCt aqlnvc IoQkloperat,®r 6`1111[ie
rO'tL." or hema irh- ptirsu,int to
Section 20,055( ) F S, By execPcioll ol,thil';cofllnlQt Ike ProvidQr understaods wid �N all with thE�
suLiwWon.
11 Nondiscrintinadon-Civit Rights Compliance
13.1 The,Novidci-shall d$SUMMCS in, M-I'ACHMENT V1 that it will not discriminate agminst any person
in t[ic provision oriervices or bencrils andel,this contract or in einployment beCCILASe Of ZiLIO, VC110100,
color, disability, national orilgin,marital status or sex in compliasice wvith maic and fiederal la%v and.rCgUlafi01'lS.
The 11ro,vider further assures,iha( all t;ontractor5.$UbMitractors, vondors, sub-grantees, or m1lim with,%%liont it
arranges to provide service,s or bcncfiir in connection vJth ally Df its prot,,,rams and acLiviLies are not
discriminaling ag,�Mnst clients or eviployees because of-age,race, relivion, color,disoliffity, naiicimal origirl,
rnarital status or sex.
13.2 During the tenn,ofifiN contract, the Provider shall Qornpllcie and r�-taairr oil file a timely,complete and accurate
Civil Rights Coirpliance Checklist artachcd to this contract.
11 3 The Provider shall esiaWish, p,rocedares pursaam to,federal lar"% to handle coiliplairas Of(,hSC6fT1 i Ila 6LM
involving scrvices or benefits through this contram� Thew procedures will includiv aotil'yin li
0 ,
employees., and.parlicipams offlIC right to JUe a cornplaint wYah the appropriate federal or state entity.
1.3.4 If this contract corltains fetteral rands,these assurajicc,titre a receipt oaf arbcnefit firorn
federai financial aisistance, and are bi,ndirig upon Oic Provider, its succc�ssor-s, transferets,and assiigueesi for
(lie perlod durin_g which such assastancc Is provided. The Pro vidcr furtim assures that all sitheonaractom
vendors, or others with yaw horn it arranges to providc services or benefits to participants or cmplo,ees M
comlecGon with any rX its progmms and ac6vi;6es are not discriaiinating against thase participants or
emplIcyces in viahnion of the above statlAcs, regulations, guidelines, and smuclards. In the event ofCailure to
zaillply, the Provider UJI(leTS1,1nds that the Alliance may, at its discretion,seek a court order YeqUIF1116-
compliance with the terms of this assurance ol-suck other appropriate jndicW or administrative relief,
includine,0 bw not limited to, terinn� ation o l of further deriafurther assistancc,
14, Provision of Services
The Provider shall provide the services referred to in ATTACHMENT'VII in the rnariner described in ihe DOEA
Programs &Scrviccs Handbook&Rd the Ptovider's Service Provider Application(SPA). In the event oaf at conflict
hetween,the Service, Provder Application and tNs contract, the mntract laT)guage prcvaHs,
15, Monitoring by the Alliance
,rhe Provider shall permit per;,cons duly aothorizcd ley the Alliance to inspevt and copy a r eco ny rds, papers,
'
docurnoras, facilhies, goods and services of lie Provider avhiclh are relevant to this comract,and to intervlew arly
Page 6 of 66
KCV-2129
clients, employces'and cmployecs o!'the Frovidcr to assurc the Alflance toll the
porfiornanco of'thc icrnis and conditioti.s ofihis r ontract. FWIOWiI16 SUCh revicw, the Miance%011 dcliverto the
Provider a wvrilten report W'its firidingMs—and where appropriate. the VrovWer shill develop as Correctivc Action F'Ian
(CA P),. The Provider herehy agrecs to firnely correct all de1cleticles WentifIed in dic CAP,
1C Coordinated Monitoringwith Other Agencies
111,vic Providel.receives Rvnding 1rorn one or morc of the State of'Florida,huntart scrvice agetwics, in addition to
AllianLC funding,then ajolm monitoring visit inch dhip swdi other igoicias may be sehedtilcL For lfiupurposus of
this contract, and pursuant to,s. 287.0575, F.S.as amended,Florida'shurnan service agerocies shall include the
Dclianwent of'Children and Families, the Deparlinant of"Heakh,the Agency t1or Persons t6!h, D sablh6er ,the
oCVctcsarrs A.0airs.alld lilt Dtplirtfflellt of Elder AR'mrs. Upon notificallurt arki the wt,,bst?quorlt
scheduling of such a visit by the designated a ency's kad administrative coordinator, the f"rovider shall coInply and
Cooperate With all mortilo'I's,twipectors,and/or investigators,
M Indeo-mificatiou
The Provider shall indeninity, save.defend,and hold harniless the Alliance and,its agents and ciliployces finial a,ily
and all claims, dernands,actions. causes afaction orwhwever nature Or character. arising 0! DLJtOf'0rbVrDt1SQI1 i'the
exect&oli 01"Illis ag"rectIlLni or performance of the services proOded 1"or lie rc!Ira. It is understood and agreed that the
Frovider is not required to indcrnniN the Alliance for claims, demands.,actions or,CEIUSCS Of'adiOn dfkillg SCICk, trot
of Tho Mliance's negligence.
I7J Except to the extent permittled by s 76M8, F.S., or wher Florida haw, Para,gtaph 15 is oot applicable to
cooltracts exectited botwvcen the Alhanceai,id state agericies tar sobdMi.i�tons defined iri s. 768.28(2,1. RS,
18. Insurance tined Bonding
18.1 The Provider,0,1H 111,ovide ccintinkjous adequaio I iability insorance covcrage clud ne,the existence ofthk
contract and any rcnew tl(s)and c tension(s)ol"it. By executio,n ofthiS CORiracl, LHIlQ,55 it 1$0 smite,agCllcy 01'
su[xJivision as defined by stjbsee6on 768,28(2), ["S_the f1rovider accepts fWl responsibdity for identifyin g and deterrn ningthe. type(s)and cxtent of 'habilily insurance necossiry to provide, reasoniblo financiat
protccl ons for the Provideraad the clients to be served under thist contract. The Alliance shall be inclUded as
an additional insured on the provider's liability insurance policy ar policies,anda copy of the Certificate of
Insorance shrill be provided annuall, or wtu�n"any Changes--0CCUr The limits of caverage undier each poficy
y a 0
maintained by the Provider do riot limit the Provider's liability and obligations,under this contract. The
Provider shall ensure that the Alliatice has copy or the most Qwiew wriltoo verification Of in$UMT.GCC 00%,Qj'3g0
throughout the lei-in offt contract.Such co,erapye,inaY be provided by a scIf-inskironce,protgrajr established
and operaflqlrc, orldor the laws of,the Slate ol"FIorida, 'Flee AWATNe re.Serves i4e right to require ad(Wionai
insurance as specified in this contract.
182 Throughout the term of this agreement, the Provider shall maintain ari insiTancv burid frorn a responsibla
commercial insIarancecompany covering all officers,directors.employces and agents ofthe Provider
authorized to, handle funds received or disbursed torider all agreenients aricVor contrads incoKporatin,r�this
coluract,by reference,in an arnouri.1 commensta-ate with the funds handIed, the degree ofrisk is determined by
the insurarice coInpany and con_%rMertt with good business practices.
19, Coul"identiality of Information
The Provider shaRziot use or-dis6osc artN information concerf3ifflg 0, FeLipiCllt Of SefVicraS Under this con[ract for ally
purpose prohibited by state or federal law of regufalions except with the vvr4ten consent Ofa PUS011 legally
authorized to Live~that consent or when authorized by law,
Pa8e 7 of 66
KCV-2129
2R Health Insurance Portabilityand Accountability Act
Whore applicabic, the Provider shall cornply with,the Ficatth ltisttrance Portability and Accci,tinitibility Act(4-2 USC
1320d.), as wcll w all regOations Promulgated Lhereutider(45 Cf-A t60, it aiid 164),
21. Incident Reporting
21,I r rhcflrovid,: r shall nuffy the Mhance i nim cd lately but,no later dian forty-eight(48) hours from the Provider's
awareness or discovery orcon&ilons that may materially affcet the F'rovidWs,subconLraclor's or vendor's
ability to perf'orm the services requircd to by pk rforvicd undcran.y convact- Such notice shall be made oratly
to (lie Contract Manager(by telephone)Nvith an email to immediately fallow,
21„2 The Provider shall i rnmedi ente ly report knowledge or reasonable suspicion a I'abuse, ncglccla or explaitittion of
a,child,aged Person, or disabled WL&,to tfic i"loridu AbL15C Hotinicon Oie slatcmidc loll-free telephone
number(I-800-96AFIUSE), As requirvd by Ctiapters 39 and 415, P,S-,this provislon is bindiog kupon the
Provider, s0contractors, veridors, and their ejnployecs,
TZI WnUrnptcy Notiricotion
Ir,art RRY One during.IhQ wrin of this contract, die Provider, its a-.,si-ntes,subcoraractors, vcndors or arfifialc%filcs,a
clahn for htinkrUJMC),, HIC Provider must inimccliately notify the Altiance, Within ten(10)days after notificatiort, the
Provider to alSO PrOVdty the 11)0o%ying kiformotion w the All ance: (I) the date ol'fifing of the bankruptcy
petition; - Lo
etition-, (2)the case number;(3)the cotirl name and the division in Miich the pe6dun was Mvd, �e, g,NotjjjCj
District of Flor"Lda, Tallahassee Divis on)-,and, (4)the narne.address,and telephont number ol'thc bankruptcy
altumey.
23. Sponsorship and Publicity
2 3.1 As requirt',xi by s. 7186�5, It il`The, Ptovidcr is a organization which sponsors a prograrn
financed wholly or in parl b, state funds, including any funds oblaiacdi throu.01 dik",
Y 9� C('n)tMct. it Shalt in
publicizing,adverfising, or describing the sportsorship of the program,statc. -Sponsored by(Novider's
narne),the State offlorida Department of'Elder All'airs and the Alliance fbr Aging, Inc," Ifthe sponsorship
reference is in written mwerial,the words"State ofHorida, Departrnent of Elder Affairs'*and"Alliance tor
Aving, Inc,"shall appear in it Icast tho same size letters or type as the name of the organization.
P
T11 1hz Provider shall not use the words,"The State offlodda Department of Elder Affairs"or"Affiance for
Aging, Inc."to indicate sponsorship of a progmrn ather-wisefinanced,unless specific authorization has been
D
obtained by the Alliance prior to L1,9C.
24. Assignments
24,1 The Provider shall not assign the rights and rcsporwbi;htiQs under this Contract without [lie prior wrir(rr)
appixwal of the Alliance,%Nhich shall not be unreasonably ",ithlick'L Any sAlicense,assignment,ur transfer
othervii,90 occurring withVLA Prior iw,ritten approval of theAlliarice will constitute a jnateriai breach ofthe
contracL
24.2 The Alliance shall at all times be entitled to aMigrl OF 11'anSfQr,in whole or pairt, its rights,dt i ,x es or
obliga,fions under l4is contract 10 111101heF age]ICY upon giving Prior NvHtten notice to the Provider. In the event
the Alliance approves;rxansfer of the Provider's obligations, theProvider remains responsible for all Nvork
perf"arnied and all expoww,5 inckirred in connection kvith the contract.
24.3 This contract shall reivain binding,upon the succcssors in interest of'Other the Provider i,)r the Altiapice.
Page!9 of 66
KCV-2129
25. Subcantracts
25A The Prcwider is,responsible for-Ill work perfunfled pUrsuallt to tl"Iis contract Whelhoractually lurnk-hed by Lhe
provider or hs SUK-MIttaClOrs and/or vendors. Ali'v s obcontracis sha'I Ix,evidianced by a wrliten LjoctrIm a ent nd
sLibject to any conditions ol'ttppruval tire Ahiance Cor Aging deerics necessary Tklc Provider must cosure NIT
the Alliance has a CUrrent list of all subcontractors and/or vendom, The Provider furilier agrees that the
Alliance shall not be kable to the subcontimetor and/or vQndor in any way or f7or any reason. The Provider, at
its,expense,shall defoid the Alliance agminst any such Ckiiiils-.
2 55,2 Ttic Provider shall promptly pay any subcontractors and/or vendors uj,,,an receipt orpayment rrorntiw,
Athamcc Faiklfe to n'takc jmymeTAS 10 rdrvY -SLhUCOO1t1UC(Or an(Vol,vet,rdor in accordanct with s: 287MS5, F.q,
unless otherwise stated in the contract between the Provider and SUbcontractor arldior vundor. will result in at
pCnaliyl ilS pl-OVidd by SUIWW
26. ladependent Capacity of Provitler
It is the invent acid under-standing oftho Parties that flw Frovider,or any of its SUbcontrwors and/or vendcprs, are
indeperld'ent contractors and, aro not employees of ilw Alliance arid sluill not hold themselves out as employces or
agems ofthe,Alliance without specific audiorization from Llic Alliame, It is the further iritent and undcustanding of
the Parties that the Adlaoce does not controt the eniployment practices orthe Provider and shall not be tiabte liar arty
NN14ge 111(t hOLIT', employment discrimination, ar other kibor and employment claiins against the Providercr its
subcontractom andlor vendors. All cleductions, ror social seckrrily, withholding imes, income t-axes,corstributions to
Ihnornploymient cornpensation functs and ah neeCSSUry InSUrance, For the Provider shall be the sole resp,cris-ibility at'
the Provider-
27. Payment
27,1, Pa mr.-rits lit to s as
y will be ma&(o the Novider,pursua 2 15.422, FS,� , services are rondered,and irivoiced by
the Providor. The Alliance will have Final approval of flie invoice Cot, payment,and vfll appmvc the, invok;Q
liar payment only if the Provido has me al I terms and conditions ofthe contract, mil.ess,the bid specifications,
purchase order, or this contract specif otherwise, The approved invoice will be submitted to the Alliance's
fiscal section filar bildgewry approvol and procesbhivo, Dkpkire arWng river invoicing,and payinents will lie
resolved irl accordancc with,the proviskms of s. 2 5A'22 FS,
247,�,Thcc Provider agrees to sul-miii bills: for Fees o,r other(:ornpens"ation for servicos or expenses in Sufficient detailIm
Cor at proper pre audit and post audilthereoL The conti-war shall comply with Hie particular rQquire'inents,
Under the rohowing laws ind guidelines that are applicable to the contracis or agreements incorp orating,jii this
Contrama by reference:,(a)paragrapl,i 6)(b)ot'scclion 216,1 tS 1, FS, regarding advances;(b) Rule 69 Inv
40.103 F.A.C, pertaining to Restriction of'Expenditurts from state ftmds; and, (c) the Invoice RectOrenwnts of
(lie Rererence Masai for Staw Expenditurcs from the Services a,L
Fhe Provider will certify that detailed documentation is avaiiIable to support each item on the itemized invoice
or payment rcqucst for cost reWim-iod expenirs, fixed rate cir deliverables contracts or agreeir[Oits
incorporating dils Comma by refercoce, including paid subcontractof and/or vendor invoices,and will be
produced upon tequest by the Alliance, ThQ Provider wwill farther certify that reinibursement requests arc curly
ror allmvablc expenses as defincd in the laws acid guicfin6 g circtrilarr cited in�cctiorrs 4 arthis Coritrixt, In the
Peference Guide for , tate Expend it ures., and any a')ther laws or regulations,as applicable.
27.3- file P1`0VidCr, its SUbcontractons incVar vendors shall provide units of detiverabies, Including repcirts, Firidings,
and drafts as specified in the contracts or and attachlnentS wkich,lucorporate this Contract to be
received and keep pedal by t1je Coruract Manager prior to payment.
Page Slof 66
KCV-2129
2 T4� Paynionis will be niodle to the Provider hased an as ecnnpleto and correct invoice. invoices that art iiiconlplcte
or,with incurfect total wid not be.processed and wHl be retoraed to the Flroxid,cr For correction. Fiscal stalff
wlil not be able w correct or make chlwges to the invoices. Returning invwces fOr COrr'"flOnS MU'11 WS'Llit ill
flaih,irc to receive payment for th"'11 mortill, h1voices SlI411 be $Lli)Mitted Ornely as per ATTACHMENI" V111 in
order to avold any payment delays,
2 T,5, Each service performed sliall be recorded as specified in the clicrit information and registration tracking
z
system tcllk-fs)guidelines, Supporting docullienliation,orservices provided mittv,be adequate w permit Fiscal
and programinatic t-VaILU16011, and casure irriernal Inaliagenient,
Z R. Roturn of Funds
The Provider%vM return to the Alliancearry overpaylrents dve to onearrwd funds or fands disallowed and aruy
iritercst vtribuhWe to gttcl,, funds purstiant to the ternis and conditions of this contract that were,&;bursed to the
Ortivider by the Allianco, In the event that tires Provider or its indcpenrdent auditor discovers that an avQrpayrnent bras
been madc, the Provider shall repay said ovc4rpaynicnt inannudiately without prior notitication from the Affiance. In
Ow event that the,Alliance First diScoverS 491(Werpayllient has been rnadc. the Contract Manager, on belialf of the
Alhan,cc,will nolitv' the Frovider,by,letter Of'SUCh Findings., Should repgyrriont not be rna&forth,,°,iih,the Provider
will be chargcd at the lawfLO rates of'interest on the owstanding balkince pursviant to s, 55,01, P".S.,after Altiancte
notification or Provider discoycry-
Z9, Data Integrity itud Safegmstdiag Iri foji,rfliari(jil
'rite Provider and its subcontractors and/or vendors shall insure an appropriale levc af'data swirity tbr the
kil'ormation the Provider is collecting or using in the performance of this contract, An uppropriaie level or'securit'v
6cladcs approving anti trackino all Provider CITIPlOYCC5 thal request systorn or infori-na(lon access W)d LMSUring that
User access has been removed front all tenrinated employccs.The PrDVider, arriorig other icquirernerits,must
Inucipale and Prcp"'Ire for the lo s of information processing capabilities.All data and sofiNvare strail be routinely
backed tip to cnmre reservers,, frorn losses or outagin of the computer-,ysten-i, The sate runty over the, hacked-up tiara
is to be ag stringent as the proLeCtif,in required of the priniarysysterris. The Provider shall ensure all,stflicuntractors
und/or vendor's mainttairr written procedures for clompoter system back-up,and recovery,. The Provider shall corriplcie
and sign ATTACljNjFNT IV prior to, (lie cxecution ofthis cowract,
3 0� Computer Use and Social Media Policy
The DOEA has implemented as new Social Media Policy, in addition to its Computer Use Policy, Which applies to
all employees,contracted ernploye�%s,corrskiltants, QRS and vuRintkvo,,.,jtrrlwdiqig all personnel affiliared With third
partie, sue b as,bLjt aot lini lied to, Area Agencies on Aging and vendurs. Arty entity that uses the DOEWS
cornputer resource systems must comply Mth the DOEA's policy regarding social media. Social Media inelludes,
bi-It iS not lirniw�,d to btogi, podeags,discuss4on ft)rr Uffig, Wik�s. RSS feeds, videc)sfia6n,-,, social[ networks like
1v1yS;,.)ac-e, Facebook and Twitter, Is,wcI as conterti shaHng networks such as Flickr arid YOUTUbe.Tlli� P01ILY iS
available on DOEA's website atN (J�L�"Jfl 4411
31, Conflict of Interest
'Vitus Pro�Oder shall cstabLsh safeguards to prohibit emplovecs,bwtrd members,manavenWilt and subcontractors
andk),r venctors- rrorn using their posifiums Fora purpose that COTiStitUICS Or PMSCUU1 the appearance of personal,or
or�anizafiotufl conflict oCinlerest or personal gairi, No L�rnplayee. orrjcer or agent of the Provider or subcontractor
t1airticipace iii selection, or in the vard of an agreernent SLApported by State or Federal Cunds il7a
conflict of interest, real or apparent, ,astral Lc involved. Such a cciTiflict would arise Mien (a)the ernployee, officer
or ageor (b)any niernber ofhislher il-RinediaTe farnily; (c)his or her partner,or; (d)an or anzaflon which employs.
or is about to employ,any of the ab()rye,has a financial or When interest in the firm selected ror award. The Provider
or any subcontractor's and/or vendor's ofiFicers, employees or agents wfl neither solich nnraccept pra.16fies, favors
or anytIbing of nnonetary value from,contractors, potential contractors, or parties to subcontracts. The Provider's
board niembers and managernent,must disclose to the Alliance any rchrtio,nsfiip which may be.or may Lie perceived
to be,a conflict of interest within thirty�30)calendar days of an individual's original appointment or placement in
Page 10 of 66
KCV-2129,
that position,or ifthe individual is scrVing as 211 incumbent, Withiji thirty(30)calcrldar days of the,commenctment
of this oontract, 'rhe Provider's employees and subcontractors and/orveadurs must make the same disclosures
described abo�ve to the Provider's board of dircclors.Compliance with this provision will be monitored,
32, Public Entity Crime
PUSLIWIA to sw 287,133, P.S.,the ('611owing restrictions are placrd on the ability of persons convicted of ptMic untity
crhne,s to transact bushiess With the Alliance. A person or affiliate Mia has been placed ori the convicted vendor list
fbilovoing as e()nViCtioll fC)IL as PrJbljC ejItity Crime may not submit a bid, proposal, or mply on contract to provide any
goods or semicc to as pubhe entftyj may not submit as bid, proposal,or reply oil sa contract with a public entity J"br
the constl,Oction or repair ofa public building or public%vork,Irlay not submit kids, proposals. or replies on Icases of
real property to a public cntiq-,may not,be a%Nardcd ar perform ,vork ats as contractor, SLIJ-1plier,subcontractor,
ventlor,or consuhant under a contract with Garay pubfic utility'; and may not,transact busiaes5 with any public entity in
exceiF of the threshotcl anlotint,provided in s. 287.0 17, F.S., for CA I'LGORY 1"WO for a Ix:rirld of 36 months
followin.g the date ol"being placed on tlae convicted vendor list,
33, Emergency Preparetltie�s and Continuity of Operations
33,1 lfthe tasks to be performcd pursuant to this contract include t1le physical care. and conlrol of dients,car the
tadministration,and coordination ofscrvices nece,tis.ary [,or client health,safety or vvelfare,the ProvWer shall,
a%-ithin thirty (30),cialcridar day;a of 1110 execution arthis,contract, submit to the Contract Manager vcrification
ot,an ernerge'uy prepal,edviess plan(Continuity of0perations Plan.) Ili the event cat an e tile r,61C'Icy,the
Provider shall notify the Mliance of enierguncy provisions, Tho Contimiily of"Operations Plan(COOP)niust
address condmiky ol'services, especially for meal, providers,in Nveather and non-weathcr-related emergencies,
31,2 1 n the event as ,iwation rcsLlltS in a CC%SatiOn Of'SCI-vices by a subcontractor and/or Velld0r, 010 Provider shall
j Hain responsibility for performance nilder this contract and must follow procedures to ensure continuity of
operations without interruptions.
3 33.3 Contractors offering outrition services, Inust have an Alkance approved shelf situ blc menu mth at least 3 days'
v. orth of shelfstable meals with reserved funds sl l aside to purchase the lbod items in order to ensure
Continuity orsel,vices vv,Mwot ilnlerruplions hi weather and no-weather rcbued cmugencies.
34 Use(it Contraer Funds to Purchase Equipment
No Funds under this Qoritract N6 H be used by the PloVidCV W PLU-ChaSC CqUiPIM011.
Equipfrient rneans:(a)an article of noncxpeadab[e,tangiNe personal property li;ivirig as Liseftil fil�af more than one
year and an acquisWoii coo which equals or exceeds the,lesser of the capitalization IcM established by the
orvartization ffir Lhe financial sunernent purposes, or$5,000.00[fur fl deral funds], or(1b).- nonexpendable,tangible
personal property ofa non-consumable nature Mth all acqUiMi011 Cost Of 1 r000.00 Or MOW liar`unit, and expected
useful life of at,least one year,and hardback bound books not circulated to students or the general public,Nvith 41
value or cost of$750.00 or more Ifor state funds].
35, The PUR 1000 Form is hereby incorporated by refo-ence and available at:
I 77,Ln PI R,HlUf J),T
--_------_
In the event of any conflict betvvaen the P1 fR 1000 Form and,any terms or vonditions of any contract or agreement
tornisor conditions The contract shall take prcoedence over the PUR '1000 Form. i-lowever, if the conflicting terms or
coilditions in the PUR 1000 Form are required by any section of the Florida Statotes, the ten-n.s or conditions
contained in the PUR 1000 Form shall take precedence,
Paige 11 of 66
KCV-,2,129
36, 'Use of State f7unds to Pumbase or Improve Real Property
No funds tinder di is contract wi I l be tuned by the provider to,ptirthnse or improve heart Pral',)Cily,
Any state funds provided Cor the, purchase ofor improvements to real property, are contingent upon the Provider or
political subdivision granwig to the state at Sr:Curity interest ire the pi"OpOrly ',It le'llSt 10 the AMOU11t Ot'SURIC Cutlds,
providQd For at least 5 years,froill the &ite of poirchase or Ow completion of dw iniprovemerits or as rurther rquired,
by law,
37. Disputr Resolution
Any dkpute wricerning perl'orniance of dre Cont"'act shall be decided by the Contract Manager,Nyho shali reduce the
decision to writing and serve as copy,on the Provider.
38. Financial Couscclucums,of Non-Pti-furtnance
38,1 lf;he Provider fails to ineet,the niiii1murn level ofservice or performance identifiQd in this a�;roerrwjil, or that
is CLAV0111.1,T)l I'ar ilia indUstry, Olen tile Alliance may apply F11111116a] covIrnermwate%N46 tile
dericicricy 4t; rolleremcd in ATTACHMENT 1, Sec. 3.5.2- Firiancila[cotisequences may also Mclude contruct
suspvnsion, refusing paynumt,WicjjJjj)jdj!jlV PrIyflleWS MI(il cleficie,11cy is cured. [endcring only partial
Paylilents" and/Orc<ar#sell rtrcart of Contract and reacquiring, services from ar, altuilate SoUrCe.
38,: The Provi(Iler shag not lie charged WiLh fimiancial consequcrices, when a [ailU1.0 To perform arises outot"causcs
that were the milpons]bi 11ty of the Al I rarlec,
39, No)Vaiver of Sovereign Immunity
Nothing contained in this agrecinem is intended to serve as a kvu vcr oll'sovercign immunity by ail), mity to which
50%'Migll ilTIMIL111ily IMly be applicable.
40,, Ven toe
Kam,dispute arises out of dais contract, the vcnUC Of SLI[Ch k,,gal recourse kvfll; be Mlatni.Dade Counly, [Fiorido,
41. Entire Contract
This contract contains tell Ilia,terrors and coriditions agreed uporl try Lile pal-fittS, No,ora I agrecrnents or
repres,entatioos Aall be vaHd or binding upon the Alliance ol,t,ll,,;, providvc-tirije,ss exp=,sty contained herein or by as
w'ritten aniendmcilt w (his:,conwact signed by both Parties,
42° Force Majeure
The Parties mill not be liable f6r any dclay5 or failures in perforriiance due w6rckmislances beyond, iheircontrol,
provided the 1p",Imy cxperiencing the force ritojeure conditim provide,,, imrviediate tvriticn riolificaLion to[lie other
p,arty and takes all reasonable efforts tro Quru the corldifion.
43, Sever ability Chwe
The Parties agree that ifa court of corripetentjurisdi6ori decir)s any lewl (W COINJiGOII hC1"C"ill void orunenforeeable,
[lie Other pl-cwi,5ions are wverabte to that void pi ovisi'on and sliall rcirain in fult force and effect.
44, Condition Vrecedvatto Conrract: Appropriations
The Parties agree that theAlfiance's perfortnancie and obligation to pay under this contract is contingem upon an
a11111.11,11 apprOpriatiOn by (Ile Le.�'WaWFO.
45, Acid i tia n/D cletio rit
The Parties agrec that,noMilhStanding the tertil's of the pnmirernerit docuivents and actions lead4"$Iwthis coraracl'
the Alliance rescrvLs the riaohl to ridd or to delete any of the set-vices reqUired kinder this conlr,',vr( wholl deer ed to he
in the best interest o-l'the etd.ej,,popubtfion targeted by the Area Nan arld fCCIUCedtO as written amendrnent signed by
both Pmies, The Parties shall neptime compensation for,arry add4ional survices Idded.
Page 17 of 66
KCV-2129
40. Waiver
"I"he(163) 011,640C by the Allimce to exercise or enforce alty of its rights ander this contract sdiali rim QOnstime or
be de reed a waiver of the Alliance's irght thereafter to enforee those rights,Tior shot] any singke or,partial exercise
ot'any such right lorceliudc any other or, forthcr cxcrehe thermfor Ole exerckc of tiny Wier ri gla.
47. Compliance
The Novider Miall abide by ah appkzble current rederal statutes, laws, rules,and reg�JjatjOIIS ZIS %vell as applicable
current Statc slawtts. lawi, rule,,and, rjogulations, The Par6cs agree that IW lure of the Provider to abide by, flicso
law,,shall be deemed an event of defMilt of dw Providor. 'jn(j SIrli)JOCT.thO L:(111'r"et to il"I'lodiatc, Unilateral
"U'lCeI1311011 Uf(JIL COJJ(ratQt al the discretion of the Mljorta;,Q.
48. Final Invoice
The ProViCierr'slIall subm4 iho final invoice for paynient to the Altiance asspecifled in section 3,4,7(date for final
iecluest for paynteat)or'ATTACJINdFNT L if`thc Provider'iaAs to sulrmtlit final roqut�sl Got paynient by the dcadfihied
then all rihts to payrrient may be forfiedted,and die Alfiar)Ce IIM)�410t 1101(101'41MY M+WAS SUbitiltied aller the
a(bresaid time period, Arty payniont due kindor Ole torms oC thig conlract may be WithhOld Until all reports due From
the Provider zand neecssary,acI"justments theruto have bocci ai�rroved by the �Jtiatice,
4% Renegotiations#)r Modifications
Modifications ol"the provisions(if thi Contract shalt be valid idly when they litive been redLiccd to writing and duly
signed by both:pardes.
50. Suspension of Work:
l lie,Mhance many i,n its sole discretion sugPen(I any 01'all activities under this Contract and arry Conti-a" of
agreemem incorporating in this Contract, at any time, "dien in the best interests ol"11he State to do so, T[w Alliance
shall providu(ho, Provider wrltten notice exitlinino flie portictikirs of Examples of the reason for
SLISPO)Si011 41CILIde.,Nit UV!lot limited to, bLridgetary constraints, declaration ofenlergency, or othcrSuch
circurnstances. After receiving a SL[Spe:100n,notice,the iPrcrvidershall ctatttlaly Wkh the i)Oke or.d 511all 1101-,ICCCptl
any parchase orders. Withi i ninoty days. or any longer period agreed to by the Provider, the Alliance sluall either(I
Issue as notice authorizing;restuription of%York, at which time ictivity shall rrsurne, or(2)ierrninate the Cerittact or
purchase order. SL15l)e[15%0o or N,ark shad not erAille the Provider to any additional cornpen.sation,
%I. Termination
5LI This contract may be terminated by either party without cause upon no less than,thirty (30)calendar days'
ftor¢jee ip, writing to the other party unless a sooner time is intitually agreed upon in kk;rIlIng Said notice Oiah
be delivered by U. Postal Service or any expedited defivcry serviLe that Provides Verilkation ofdolivciry or
by hand defiven,to tile mtract Manager or the representative oNhe Provider responsible for admin stration
o0he contract.
S 1.2 In the overt funds,for payMCfIt JILUSIJUnt 'to this Mitract becQ111C UIMVailaNe, the Alliance may m-rninme this,
contract upon no less than twenty-four(24) hours' notice in writing to the Provlder, Said notice shall be
delivered by US, Postal Service or arty eNped,ited delivery service that provides verification of'dellvery or by
hand delivery to the Contract Manager or the representative of the rlrovdcr responsible for adrnin stratwn of'
the coniract, The Alliancc ,vill be, the Fnal atahmity as to the avalkihihiy and adeqmcy of funds, In the event
of Lerminafion of this contract,,the Provider will be compensated T'cr any wark, satiSfaCLUlitY completed prior
to the da te of term i rkat i u n.
Termination for('arts
I"hiS,WntrElCt nl,,ky be WrITI i flat ed lot,causw by the Alliericc Lipari no less Lhan Twenty-rouT(24)houis' notice in
writing tu the Provider. Waiver of breach of any PrOVISIOn.9 Ogfffiis contract shall not be deemed to be a
Plage 13 of 66
KCV-2129
kva vQr ofary other breach and shall I not be corts(rued to he as inf-)diflcatian oftlie terns s and widitions of this
contram, The provisions herein do not firnit (lie All lance's or the Provider's rights to remcclics at law or in
t:cluky.
51.4 Failurc to have performed iny contractual obilgations with the Alliance in a to,(lie
Alliance will lie at sufficient caUSC for terinination. To be,terniinated as a Axalractor UrKler thL,;provasiun, the
Provider must have (1) previously Wled to Satisfactorily perf'onn in a contract with the A[hance, laeen notifled
by ttiu Alliance:Of thC UnsafisfaOoq perrorltwnce and railed to Corr= 01C UnSatisfactory,pci-figinarce to Lhe
satisfaction of lac Alliance,or(2)had i contract terminated icy the Alliance for UIUSe.
5 1.5. Afaiver of'breach of"any provisions ofthis contract shall not be dtenled to be a wvaiver of any other breach and
shaH not be construed to be it modification 01,the terals and conditions of this contract. I lie provisions,herein
do nat limit the Alliance's right to rernedies at law or to damages ora legal or equitable naWre.
51.6. Upon tenrination of this comract,ihe Provider, its and/or its vendors shall, at no cost to the
Alliance. transfer kill public records in their pr(xcssion to the Alliance and destroy any duplicate records, that
are e%ompr.01,coil fidentW and exempt, firom public recurds disciosore reqtdretnanM All records stomd
e[ectroitj,,afly shall be provided to the Alliance in as format that is compatible with tiro inforaiation wchnology
systems of the Alliance.
52, Mettronic Records and Signature
The Alliance authorizes, but does not,requirej the Provider to crf,:ale and retain,electronic records and to ttse
electronic signatures ta,conduct transactions necessary to carry ou:the terris of this Contrict. A contractor that
creates and,retains electronic records and irses clectrork siginatures to conduck,transactions shall cornp y with the
ivquirewerits coiitained in the Uniform Occtronic Transat;tlon Act,, s.,668,30, Pic- Stat. All electronic records must
be fiihy,auditable; are subject to Florida's Public Records Law, ch. 119, Fta, Stat.; must comply with section 29,
Data Integrity and Rd`eguardinr, Inibrinati= must rnaintain all confidentiahty, w, appEcable-, and rnustbc retained
and aviintaired by the Provide rto the siune oldcot as 1)(111-eler-11-onic records are retained and nudntaincd OS Jr,eClUil'ed
by this Contract.
52.1. The Alliance's authorization,pursuant to this section does not authariie electronic transactions bet%vmn thQ
Provider and the Alhanec, f"hc Provider is a-Lahorized to colrduct electronic transactions with the Alliance only
upon further written consent by the Alliance,
52,2 Upon request by the Al,liance, the Provider shall provide the Alliance or DO EA with non-electronic(paper)
copies of records. Man-electronic(paper)copes provided,to the Alliance Of any dOCUMC11t,thilt was originally
in electronic fomi with an electronic Signature must indicate the person and the persona's capacity who
e lectruni call X signed fire docunresit on any non-efectronic copy of the document,
53, Special Provisions:
The Provider agrees to the following pmviksiurts:
53,1 Invcstigation ofCriminal Allegations:
Any report that implies criminal intent on the parr of the Provider or any subcontractors andYor vendors Lind
was rcl'crrcd to it govertunental or i0VeS1i4atO[-Y 36 ZUCy MUSt be sent to the Alhance. If the Provider ha reason
reas
to betieve that the a[legat[ons will be referred to the State Atiornoy,a law enforcement agency,the United
$tates Attorney's office,or other govermnental agency, the Provider shall notify the:Alliance immediately.A
copy of all documents,reports, notes or either written uiaterjjl concerrtiing the investiga6on, whether in the
possession of the Provider, it.,SUbcantractors,or vendors,must be sent,to the Alliance's conrract managej-
with a surd 'nary of the investigation and allqatiows-
Page 14 of GG
KCV-7129
53 3.2 Vokintecrs:
The Provider shall censure dic use oftraivcd voltintcer� in pr(,widing direct services delivered to older
individuals and individi.1,115 With disabilitics,needing such scr-viccs� lfpos�ible, tilie,Pro viler ball work in,
Coardirlatioil with Orpilizations that,have cxperienicc in providing(raining, plaunlent. and Stipends for
C
volonteers oi-paillcipants(stitch as organizations carrying soul federal service prqrarris administered by 111c
Corporation ktr National and Comrjit,ujjty See-vicet), in cointvwjity service settings,
54. Enforcertsent:
54<l hi accordance with Sccfion 430,04, F.S ,the Alliance way. wifl,,,ow raUnp nny interinediate rileasures
avifflable to it a_pinst this Contract rescind this Cotitract H'the Afliance finds that:
542 An Intentional ior negligent act of the Provider has inaterially alf"ted the health. welroret or safely of clients
served putstwilt to ally COIMad oragreenient,at'subsuinfially and ncgative!ly arfected die opQraflon of,services
covered cinder any contract or agrecinatit;
54.3 The Provider lacks financial st-abilky sufficiwnt to rree(contradu4I ObligationS Cjj'tjjIt CrcatjtraCjUaj rtInds have
54.4 The Provider has multiple or rclocatcd viol!attons of l.cvI4kl and NgU111101-Y sumdatds, regardless of
whether such laws or regulations are enillorced by,the Mliance, or data Provider has curriwiitted or repated
violations ofAll4anec standards;
54.5 The Provider has faded to condmiv the provision or expansion of'services after the declaration of state of
eirtergency; awl/Or
CII
6 17he Providcli- has faded to adhere to the terms ofany contract ur agreerwrit incorpOrWing in IlliS Gontracl.
54,7 In the.alternarive,the Alliance may,W its a.ole discrvLion, in accordance w4l) section 430.04,F,S.,take
an"medlate rnea&ires against the Providor, incfudhlg Corrective action, unannclonced special I-Tion to ritlg.
tewporary asiskiniption cal" he operatior,of one or more contractual services, placcmc�nt of the Provider on
probaConany status, irnposing a noratorium on Provider action, iniposinl,,;financial penalties lor
nonpe r for mance, or other adn-iiinistractive adiOn PUI-SWInt, tO Chapter 120, F.S.
54: In makine,any determination under this provision the Afliaticc inay rely upon the findings ofanather state or
f�deral agency, or otllc�r regkilatory body. Any claims for datitages for breach of any oantract or qrc�nllcnt are
exempt from administrative proceedings,and,shah be brought before the appropriale.en6ly in the venire;of
Miatni-Oit& COLIMY,
515. Training
The FlrovidQr wiH attend all required trait inp
,s wid intotings sche&ile by the Altiance,
50. Official Payee arad Representatives(Noxne,AOdres-,i,ant],Telephone Numbers)
The narne,address, and telephone number of the representative ror Ow Alliance ror this conuacl k;
Max B, Kodiman,JD, LL.M. President and CEO
760 NW 10711 Ave, Suite 2[4
kfi,anil, fl lorida 13 l 72
(30.5) 670-6500, Ext.224
Page 15 of 66
KCV-2129
The narie,address,M)d tCJCt)h0V1C 11L,1111her Ofthe 11.0presentalive of the Confmctr,,)r responsible for administration ofthe
program under this mmract kt
Nfooroe County Board OfCOUNY Co I rill iss io'ners.
The Contractor name, as shown On page 1 of Social Servicesda-Homu Services
A dais, Qon tract, and mai I ing address oft
he offi,6di I 1100 Simonton Svcet. 2r noor
payee to whom the pavmem shall be niade is: Key West. VL 13040
305-292-4510
Sherri Gitaham
Munroe Counry Board ufCounty Cutninis siunersill
The rarne of ill-contact person Ofthe Social Services
B Coniractor and street adcJrcss mict,o fil,mliciEll
1100 Simonton Sireet, 2`1 I'loor
and administrative rocordk are maintained is,; Key West. F1, 33040
305-2,92-45 W
Shei-
yl Graliam
The name, address. and WICphOnC 11LU.,11nber of i'MO,111'OC COUnty 130al'd CC11lJU11,.,-,SNiO11C9-S,
the rcprcsmauve,ofthe Provider responsiblo Soci'al Sell, Servim
J6t,adtninistration of tl)e pr(.)gram to [his I I OG sin'lonlon street, 21,11, I'loor
caji 'act is., Kcy West, FL 3304C
305-292-45 10
A(Iiaitco for`Aging, hw.
The section and Imation within the AAA aYherc Fiscal Departrnent
rl Requos. s tsar Payment ,rid Recei[it,and 760 NW 107th AyerILW, Suite 214
Expenditwe farms arc to be mailed is: Miami, Rorida 33172-1155
305-670-6500
. ... ........
Contract Monitor
The nat'11Q, address, and telephone nuint-vr(it' Afliaiice for Aging, lnc.
the Cun(ract Manager friar Ow AAA I'(v this 7 60 N W 10 Ah,AVC11 Ue, Sti Ite 2 14
contract is: Miaa)i, Florida,33 172-3 155
3.05,-670-6500
Upon change afrepresentatives(names,addvesses, leYephone nunibcrs) by 6(her party, notlec ,hall be provided in
wri(iiig,to the other party and the 1:10fificatioll attached to the orkgimak of this Contract.
57.All Tormg n nd Conditiomis Indisded
Fhis contract and its ATTACTIMENTS 1, H, III, VI, VIL VIII, IX, X. 131 11 F, and G and tiny exhib[ts referenced in
said attachments, together with,ariy docurnents incorl-Kiraited by reference,contain al I the terms and civditions
qreed upon by the Panics. There are no pro-owns, terrils, coiidiLiou!�,.or obligations Od-,jer than thosc contained
herein- and this,contract shatt supersede all previous wir tnu mcat ions, representations or agreements, either written
or Verbtl hctweeo t1w flartics.
Page 16 of GG
KCV-Z129
By signing this eantract,the Panics agree that they have read and agree to the entire conww-
iN WITNESS THEREOF,the Parties hereto have caused this aoniraet,to be executed by their undersigned af'ficials
as duly authorized.
MONROE COUNTY BOARD OF COUNTY
COMMISSIONERS.
S RWIECIESI H V Fk5 ALLIANCE FOR AGING.INC,
• Au r
SIGNED BY:� __ SIGNED BY:
NAME:-,c GhaLP_ ! f] r� i C -�_ NAME: MAX B.ROTHMAN,A LLM.
TITLE: PRESIDENT AND CEO
May 3,2021
DATE:_ `� 2 E f- 02 , DATE: _
P l�iL�1DG---
ASMST, A77i]RNEY
Do% 3129121
--r
�'�, yv..�'�T�y':L'bt't tl'fAffz:(•ClrC7i: —d _
—4'
Page 17 of 56
KCV-2129
INDEXTO
ATTACHMENT ATrACI]Mr,,NI'DESCRill'I'](,YN PAGE
ATT�CHM,ENTI STATr-,mF.:NT OF WORK
ATTACIAMENT11 f"INANC[Al, CONIP[JANCh AUDITATTACITMENT
ATTACHMEN"I' ll AUDITREPLATlONSHIP DETERMINATION 3 4
EXHIBIT
ATTACHNIF,.T 1Tl It, rrmcRAL RESOURCES AWARDED PURSUANT'ro-rviis .36
EXHIBIT 2 AOREEMETNT
ATTA(.'HMF. I' ll] CERT[FICATIONSAND ASSURANCES, 37-.424
ATTACHIMENTV] ASSI.)R,,4.NCI' —NON-CO'NS,'I'IkLJCTION PROGRAMS 43-44
45
ATTACHMF,NrVfI CONTRACT131)OG ETSUM MARY BY
ATTACHNIENTV111 CONTKACTREPORT CA1+,NDAR 46
ATTA C I I M ENT I X RLQUFST FOR PAY?vlr-,Nl' 47
Ar I'A C Il M F NT X RECE'[PTAND UNIT COST RETORT 48
ATTACHMENT13 DEPARI'MENIT OFELDE'R AFFAIRS' CJVTL RIGHTS COMPLIANCE 49-54
C14ECKLIST AND INSTRUCTIONS
ATTACI-MVILNIT D BACKGROUND SCREENING—AFFIDAVIT OF C(I)WHANCE 5 5
A7"TACHMEN17F BUSINESS ASSOCIATE AGR ' -ML`;14 f 16-61
A]"I'AC H.M F.NT ADRC POtACY AND PROCEDURES FOR OUTSOURCED 62-66
FUNC11ONS
Page 18 of 66
KCV-2129
A-C'UACIEMENT I
ALL IANCE FOR AG ING, INC.
STATKNIENTOFWORK
Ctoronavirus Consoliduted Appropriations,Act
SECTION ESERVICES TO BE PROVIDED
1.1 Alliance for Aging, Inc. NIission Statenient
The Al5anec snksion is to promote and advocate tor the oplimal qWifity Of life f 1-01d0T,-,1JL1[t5 WId their families.
1.2 Program Specific T erras
Area Plan: A papaw developed by the area 461CITCY tMl QW1i"i",, a comprehewilve and w;nordinated wrvice
dCJiV0ry'SYS'XJ1n in its planning and service arca in accordartec,%vidii the Si:cwon 306(42 US�C. 3026)ot'the
Coronavirus.,('onsolidated Appropdmions Act (CCAA)arkd DOEA 6istruc6oris.
Arest Plan Updaw A revision io [he aria plan wheraIn the Alliance enters CCAAr Act specific chita in the
ChQw 1'riforillwirin and Ke-ktrzition'Fracking Sysrem(CIRTS), An tiptkac rnay also irwItide odier rvvisioris to
IM
the area plan as Instructed by the 1)0r,:&
CIM& An individual who is not more tivan 18 years ofage or an individiIal with disabiliLy
Disaster Reliel'Services: ACL considw, disaster rvflicf si rvtccs for older individuals w be arty illowvble
OAA sea-vices during the period covered by Florida's MDO that are provided to eligible older individuals or
fami 1),carcSivers as del i ned under the OAA.
Family Caregiver: An a61t Frollity momber, or anothcr individual, w1rit',i is an informal, provider of in-houle and
communk,y care to all older lndividual.
Frail. When wi older individual pS Unab[e to perforni,at least activitics of daily living(ADLs)%viihout,
C . �Supervision;or dv. �,o cognitive or
..ubstantial hurnan ass N tance, incl o&no verbal rertlinding. physical iteing car 1 .
Lytherrilerikal impairment, sul-)ervision becakise the individt& bchaves ina mannet,that poses
a serious licalth or saf ty, hazard to epic inctividual, or to another individual,
Grandparent: A grandparent of Sir'ep'-,grandparerit uf a child,stir a rclative ofa ohild 6y, blood, jilarriage or
adoption and who lives with the child; is the priniary caregiver ofthe child beCaLISC tile bl()1010rcal or adoptive
parews are Linable or Linwilling to wrve as th Prinuary CaTegiver of dl(�CNW: an'd lam a legal to the
Child, such as legal ctistody or guardiwiship,or is raising tile ciild informally.
Major Disaster Declaration (NI.DD). States rilay rcqjiest and receive an MDD by the President tinder the
Stafford Act.Florida's request has been approved, which permits the Department and Contractor to use any
portion ofthe funds rnade available Under sections of CCAA for disaster relief'fur-oWer individaals,'I'liese
r Contract
rd
flexibilities are only akWed daring the period of the KIDD. Tile ,C,to r N,%,M be notificd,via Notice of
histrLiction once the,MDD period has ended,at whicli wvie these flexibilities will be wapved and tile Conteactor
raust provide servk:es in core pliance with CCAA.
Page 19 of 66
9,CV-2129
13 General Eyes eription
The Pdlrafv PLA-POSC ofthe CCAA Prog0rarn is m to prcil.. PTCPW'V 60r,aural)'eSpQ C0 rId 10 r0na4irUS by
providing nuttition services to olldcr individuak and their aware fiver°�,
1,32 AwItority
All applicabic I'cderat lawS, I'VkM LI-OnSffli(IOLi. 131!011r�ufl rV%jew allides and
similar relalled to div 1,611o'kving:
a. C[UtILM-� Of PC&I'A Dc)mdst-ic Assistance No, 9',04-3 93 0,14 93,04% 93A�2-aml! 9 0.33:
h. 011del r+`vwc6can-,Act of" [96i, as wi-tended 2016:
C. ("OtIlididated Appropi iations Act wid U5,-Iliccl: surlcs odQ -1-1 kJ
c. RuIc :�8A-L F'IorUla Admiriiitralivc Code FAC ')
C, skxljon 33l9-it)1, F[(Wida statows, and
[ -vik , I landbook,x)F,e\ Pro grzioris and Sci :V-;
ot- PW
1,33 S cope or Service,
The Contractor is rc-Vonsible rur khe prqgrarnmaiic lkcal, arid operahonal management of(he CCAA
Program within its de.4ignated 11SA, The prograrn services shalf be provided in a mannervonskicilit with the
Contractor's;current Area Plan,as updated,and hereby incorporated by referenee, and the current DOEA
Pro-gyrams and Services Handbook.
LIA Major Program Goals
T'he in"Or goals orthe CCAA proguAll"i 4it"to lNevem,prepam for, and respond to corowtvirus by prov6ng
mitriflon servicoi to older iudiVidLIIVIi ,an
d their ciroulyers,
I.M, Leadership and AdVoCaCy
As a do,.iigoated Focal Point. a provider 6s encouraged to provide coordination of services for older
individuals, The Provider must also provide community oil aging issues and serve as Oic advocate
and CxM point for the elderly vOtlliu the CGITIMUnity in cooperation with agencies,orga ni 7a t ions amd
Advocacy should iticlude initiating positive
changes in Public or private policies and anitudes towards DIdQr perwns,takln adiun to improva, anodWy, or
Chirlinate situations willich adversely impact on lives ofolder per-soils, or expressing support fm,older pcir:5ons,
and their interests, Advocacy acfivities,miy be bruz4dlySUj.)P0rtiVe Of Clue general interests of older pei-sons or
may involve 9peci fic Faivities on behalf of individuarls,
L4 Clients to Be Served
(,,I,I General Desudo6on,
The CCAA Program gives Preference to older indMduals with greatest eCOn0uliC need and older iiidlviduals
W 61 greatest social need(with particWar attermon to low-income older individuals, including low-incoale
mirtority older indivIdtmk, cyder individuals with, 6initcd English prokiency,and older individuals residing in
Rkrill area,;).and clients xho are pnicticing social distancing dUp Loth COW)-19 puhlic
Page 20 of 66
KCV-2129
rt, C,CAA Program
Consuniersshall not be dUallY emVtcd1ntlw( CAA Act Program and Medicaid calpiumtd Long-Term
Care Program.
b °AA for NU16000 SCr-viceS 1111dCr Title III-C of'thc Okler Anivricans Act
Genem° factors that sfial!l be considered in estabiishing priority for(tic ruccipt 4 CHUidti0t)SerViCCS
include those older persons who:
L Cannot affiord to em xlequale'ly;
Ji, Lack thoskills or knowledge to select and prepare
iii, 1,hive limited mobility which, play inipairthch.Capacity,to sbo,p and cook for thernselves;
jLV. Have at disabling illness or physical condition requiring nutritional supporl,
v. Have becti scrwted 4(ZI high IIW6601141 rjska or
vi, (Surlable to obtain rultrition bwawse the individoal is prdaicirtg sociiAl diswacing due to[tic
mergency (unly dUTing the PefiOj oftho COVID-19 ptiblic hcalth enwrgency declared Lander
wction 319(IF& Pubile Health Service Ac;L �,42, U S,C. 247d)f
vii, III addition to I-nectillio the g,:negjj Iltttrilion SerVie'eS ejigjt)jjjt�r requirements li�tcd in Sectlot)
I.C.2.c. a.t.-mve, individuals eligible to receivo, nutrition servicei include the lbll:mving.
(1) Individuals age sixty(60)or oldcr,;
(2) Any spotise(regardless of'agc)who resides at hoine willi or attends the dining Center with
lfls�ther eligible spouse;
Vlersons wit'li as disab0ity, regardless Dfave, who reside in a hokisincili li,iL i i g ty ucclipied
primarily by older individuals -where congyegate nooition services are provided, or horr,,&
debveredmeals We defivercd�
(4) Disabled persoms who rr side at [joq1z wvjth iny,accampaoyan eligible person to the dining
center:
VolooleerS, re6yard[ess of age,who rc,,ide w liome wlfli or provde essendal services or.a
regular basis during,incal limirs;
(6) P01-s0115 al nUtritional risk who havc physical, ernotional, rIr bcliavic)ral comi4ions which
wc)uld prevew thcrn frog-11 014ining notrition; and
(7) Persoris at num-itiorial r1sk who are SoCially or c)trherwir,,e isolated and twable to obtain
nutrition
SECTION II:-MANNER OF SERVICEPROVISION'
2A Service Tasks
In order to achieve the goals ofthe CCAA prow alp, Liar Providet,sjjalj ellsotv flies fb0omving tasks:
LIT
(1) Client Lkgib4ity Deteraii1riatiorc 'rite Providershail en sure that applicant dwit is evaluated winually to
determine eligibility pl-lot,to rendering, services, rzligihility to become at client is based on meeting the
recloirerneirts described in this Contract.
(2) Targeting and Screening of service" Dvhvery flor Nuw Clients: The Provider shall develop and in-iplmnent
policies and procedures MISiStC111 Whfi CCAA targeting,and 5,creer6q,,,criteria,
(3) Prograrn Services:, The Provider shall,ertsAire the provislon of a continuum,ofservims that meets the diverse
needs ofelders arld their carculvers, AI"w Provider shall enstire the perf'ormance and report perforin,,InCe of
the Following services are, in accordance with the current DOEA Prograirris and Services t landhaok.
(4) Prooram F-11gibilky Requirements
a-
Page 21 of 66
KCV1129
(.IHAN imust ravet the 161kwJug to K.- c1igiLlIc for lwogn',Nill parficipmiow
L An agwric; thm has muNd a gnmi undo CCAA: and
Ji, A m,arition sci,vice jumider thaL nums meals and is unda the julisdinim, corlmd.
d#)d outlit authority of the Am Apenq on tying and the INK&
Npannuent or LWcr Al'birs
b, N-ovider's Noo-ition Servo ce Operations
The Comcm shall oqmr dre nmddom sovh:v ujimstions oTt1w pnwWcr mml Me mq0reninnis
arims CURIML as avil:B any, otherappHemb1c regtoamus and ImFeies prescribed L[WCUMCIA
001HA Programs anti Ski-vices liasKINK, the Departim-nit O'l lealth arhI Hiamm
US11A, 1)011 auid local health deparuncirt- , D14111k, ornry other�ng,cno to ilasqwcl
nwal qmQ, l-kn,the Sf,,ott,,. 'nw Commetor nium agme to nodf� the Alfiancet.yi kuarti soldiatioll
%pCWWV CqXCNHY LhWC chart i"cludu Idgh prknity QAWkWi ujrd t)f�lVjJC aj Ol'LhC NlIOIA
to Cie ANum Wdu 24 hmms. (71ustu os mum he reported innvwdimclv All f6od
service veWors om proOdc at NyrALOW CWTOCK C afthrn P120 to the Abarilimi %adw for may,
high priowly, or QlailAmm 6ndings on arriitantikwtr 4-iqxmm The corit;,t:6ve action roust Ise
appmcd by the Provider's RD and submAted to the Arhmice to vnsurc that deficrenctesan:
rom"HK
c, Prescribed Nutrificincall Requireri,retlts
The Contractor sluall ensure that each nical providcd under t[ik conUract rneetS the following
em"B:
L QmMics with the current Dietary Guidelines Or America ns. puNi0ted by LhC 8CCIMMOS Of'
the Depanment of With and I,Wnmn WNW nand the cipanmern or Agric0um,
ii, Provides a mirtinumi of 33 113 percalu of Me dietary refercricc irilakeshidequatu intakes For all
age 70+ feintile as emahrished by the Food and 140tion Board ofthe National Acadcffly(11'
Sciences,and
HL Is somed from ond approved Alliance nieno,
(5) NksQuAg Me peribmance oNts sulocomiructors ilnd/or w('mtlors
N) Cmnpy "Th die A liances?W166ol) policies and procedirim
21 Use of Subcommek"i mdhw Vendors
ilahl,emum w"ms we use ora andWr mdor. Own Ow 14mlOr WH m" del:y die
imphoutzubm of A mgmemarst %YRh Wo subcoomimf or vendor vircunislance occtws that in ay result
in a dekly fora pokW of ds,t60)Q s:onum Mc Walkm orke cir the performance
of be the llmovidor shall MQ, Me AUK"a (',orilracl N"Lluager ill ofsach delay',
The Provider sluill iml pemYr an nr perlorm ',O-Yiices rekm�d to 00s COVIV,10 wvithout
Wing v hilMing iAcmWa0m*mdm agreonent lic AllimlL:Q ,t�ill not be robl'o 1,61-
any old"Am or Wins rmishing from stmh Maw
111 COPiCS Of
Thim Provider WEI m1nih an copy of all subconuraLkb and/or veador5 io the All iance Ccintraet:Nianalger
%YiNin Aday(30) days of execution of each subcontract agrccrnern, 1-hroUghOUt the 0011traCt 11010d,
the Provider shall immedimely sArnH and changes ic subcontractors to the Alkame Contract
h4anager,
121 h4moWrog the ?e1jol,r11ance ol'S and)m Vendors
Tire Providei shall nionitor, at least once per year, each of its subcantrilctors. sub-recipients,
Yetidors,midior conmdWs pWd Amm flunds provided tinder this coramcl.
a SuNmQhms, - The NoWer shall perfortu 1-isca.1, udminklmlive and progmmmadc modmIg
to onme comaclual comphanue, fiscal accQrUnUbil ittr.pro granitnatic perkinnance and
compliance widi applicable maw and lideral laluVS An(j T-C,1QH[at ions.. The Provider shaH monitor to
ensure that time schedWcs mv mclh the budga and scope Of W01-k arC aCCOMPlished wkharr the
speciHod tinle period5, arld other perlimmaime gnals stated ill this contra ct are achieved,
Page 22 of 66
KCIQ2129
Vendors—The Provider0tall pm&wm now Amwive and Probirann-viatic monitoring W ensure
conimcnial cwvpLatice, programinotic parPorname an(] compliance wlth applicable sime and
Ndeml laws and regul[adws, The Provider shall monitor to emiure that time schedules arc met, and
the suope of work is amornpMd within We specified time periods, and other perforniance goals
smwd in this contrwa are achieval. The Provider shall perform a modified fiscal monitoring to
include billing invoicing procedures and reconciliation to,ensure fiscal necoantability and
SumakabUy,
223 I'he Provider shall ensure that all required client,chita for services provided by sobcontraclors and/or
vwdors am entemd in he CIRTS database per the Department's CIRTS Policy Guidcfine 'Fhe data
Hearst be entered inm the CIRTS datvbmw berore the Provider subinits the Request for Payment and
Expenditure Reports to he AM=I'lic PTOVider shali estab% time Game with AN subonlaWtors
and vendims to enmurc campliance with due dates for the Sneywas hv Payment and Expudilure
Reports to the A I I i an cz
23 Staffing Requirements
23A Vallng IxAs
'I'lic Provider shall ussigi its v"n admirubarake and iull"M AM, ummled to pedlorm The tasK
and UK undm this coninact and ensure that subetmiumcmrs anNor vcrakvs dcdknte
2,12 Prof�ssional Qualifications
I'lle ensure that the an>, v4diesvrAwlinos withinihh,
jj-j(�ajjojj' - -og 'vices I landbook.
0111raC[ havo 1he qirli in dic D()FA Pi. �iams ml,,d Svf
233 Service Tirncs
Ito Provider shall ensure the prmdyion of suWas hoed hi Ohs winUnvi diwAy ironnal business
holwi tudess other tinics U-C more ,inj)'J)1'0111-iate the mul the pcirformart'Ce ofdlis Contract,
on it shall 111onn(w its subcmumaom anWor%ewkws to cnswv they to provide services
Song hon�s respon'sivC to Client need,sand during thuw Onws 106cli hest nicet the no(,-ds of dw
relvvalli, Sci 6ce comnianuy,
114 Use of Volunteers to Expand dw Provid ant d MIA SerAces
The Provider shall We use of urines volunteers in providing direct serviccs delivered to,older indiVidlials
Wpossibb.the Provider shall work in coordination
v6th organ%Uons that have experience in provWAg urainin, pliturnent, artd stipends for volumeers or
panidpws(such as cmg,anizilluns carryIng ow Federal wrvice prograrns adrninistered by tAQ Corporation
for Mnional and Coimmurly Ser4ce), in Extrununity service sctungs.
2A Deliverables
Ile Wo"by seetkmi provides Me speciflo qu rail la,blC U1131S QCdCAMMUCS and SOUMV dOCUMCM000011
requAd to c%Wenn v the (A"the Laskl spccifivd in this covtract, 'I'lic "rovider niust submia all
requied docume"taAm in dw lime and niannerspecifled Gr ke mulmum pa%marwe Vvels to be nwt
L'ach deliverable rnus( t)e a,ccqitotj in %u6bg by the AHKiwe Comract Nlnlagcr based on [lie requireluents
Ax cub del"emble bdbm A %widevubmits ml invoice I'QclucsLing' pay mvnt-
TV Provider slmll ensure the proyawn ol's condnmir" ors"Nice; that nwe's the divcrsc needs oreklet's crud
UWK cmegivoy I he Vrovil']Qrshale cisure the performance and veporting oCilic Coil'cm iru" scry ce.' in
accordance "hh the current DOFA Progmum nnd ServA5 I lamclibook and IS contrao, Documnunion A,
sevvicc' delivery in"M hwhicle a aTort consisOng ol'the Ibllowijig; number of'c ients scrvol, JiuMbor ofservice'
tmits, pjavid, by suvo, amhmw pa sowke wAL "qh uAwk6un brat equal. the 1xHal invoice nrmnunl°
Page 23 of 66
KCV-2129
T'lie Provider shall provi&,the wrvi"s d'escrib,ed in the wiltract in accord,ance with the ctimcnit DOEA Program arld
P
Servid° FUindhook. Units of service wi H be paid pursuant to the rates emablished in ATTACHMENT VIL
Under the Stafford Act,and the State of Florida's Major l3isister Declaration, the Contractor is permitted to use any
portion of t1w funds in this ContrtjCt to prruyide disastcr relict'services to clig,ible older individuals or family
caregivcrs
IIIC SerVicO illchlk the 1-011MVill-
0 cuittry117
2 A,1 Nutrition Services(111C Program)
Narition,services arc desioned to rVdILICQ hUll."Cr and J'00(t ireckirily and to Promote sociaka(ion and the
health and well-kimg, of older individuals through access 10 11LItrition arid other disease prowentiork and
licalth prornotion services. Sery ces include the
(1) Congregate rneakr
(2) Gangregate incal.s screening;
(3) NLIt6fian education and nutrition cvunsefing�
(4) Flonic delilvered nicals,
(5) ScreeningjAssessrncntr
(6) Si-iollpilig Nisistance; and
(7) T6ephone
2.5 Reports
The Provider is I-CSPUTISible for responding in a flinch, fashion to additional routine ond)orspe6al reqtwsts for
information and reports required by the Alliance, The l"'rovider rnust esutbllsh due dates for any SLI bCU 111,NOOCIJ-5
anXor vendors that permit the Provider to meet the Alliance's reporting requirements,
2.5.1 Service Cost Reports
The Providei shall sttbnO Service Cost Reports to the A(haiwe annfoally, 110 later I'llan C)6(],iys after
the pro ider Fiscal year end, The Service Cost Repoits shall reflect ictual costs ol"providing cacti
service for the preceding Provider fiscal ycar. If ific Provider de,; to renegotiate its ivirnbursernent
rates, the Provider shall make a request in wrking to the Alliance in accordance with the Alliance's
approved Reirnbursement Rate Review po[icy,wilicli is incorporautd by reference.
2.. .2 Surplu.,O)eficit Report
The PTovidLx w tl respuad to the consolidated Surplus/Deficit report ill,a l`orni1,mTxmNed by the
Alliance(a the Alliance's CDntract martager, Surplus/Deficit reports must besubbitted with the
monthly reclucst for paynici report LS for all services provided in this agreenicnt incorporating
In this Contract between the I-Irovider and the Alliance,1-he reptit-t Will include the Nlowing:
(1) A list of all .9ervices and the ircurrorit StMUS regarding surplus or deficit,and %Yhy they differ front
its orIginal budget projections.
(2) A detailed plan oil how the surplus or deficit spending exceeding the 1%criondfly threshold will
be iesmlved, The glad 111LISt AlClude specific budget numbers to reflect how the Provider plans to
address the variarace,
(3) Number of clients curTentty on the waitHst(Al,"CL).
(4) Number of Undiiphcated Client served.
2.53 CIRTS
Page 24 of 66
KCV1129
(Ant InGmatIon and Rcgistrmioi 'fracking System,(CIRTS) Iteparts:
The Provider sl-tall input CC AA -WmHk dma lino CIRTS to ansorwe CIRTS dam acema, I&
Provider 5halt LISC CIRTS-gerw-Mled rep,DEIS WhiCh itICILKIC the ftfflMvh1g:
(1) Client llepons�
(3) Moritswing Reports,
(3) Scryiees Reporis, and
(4) (1000TTIC Measures 11eports.
(5) Fiscal J~t..eporls
2.5A Program WgIflights
The 1,1rovider shall submit Program. I 11hUghts reltrancing s"60c evews,that occorred under this
cowivict. The Provjdcr WH pro&de a nc,aw success sionn quote, WrionlL or human4MCwNt
vignone, The highlights shall be wri= I-or a general aL1diCnCC, NVi0i no acronyms Or beclrloira] terms",
For al I agencies or orgAnIzations that are Worenced in the hi2lilight,, the Provider sliaH provide a bridl'
deUption a(their mission or role, The activeaetpse sl,aall be consistently used in the highlight
narrative. in orclor Lo identify the specl&AdM&W or entiq that perfon"red(lie activity described A
Mc higldi& TheFrovider sliall re6vw and edit Pro&jrago Highlights f6rclarity,readability.
relevance, speci&Ry,hurnan iaterest,and granuinar,prior to subni4flrig,thcrn to the ATaflCe,
1.6 Records and Ducuntentudon
Ito J&Ddda agives to make avAbbb to A11mlee mWK Dqmrmjcni suifl',aitdw ao) parly ihe
Mae mWAw lkpatmoU call winnicl related records aod docinnemalJon. 11w Provider s1wil viswe the
co%dan arrd raaaaitttcrataaa e rot'Gall payrom ndawd WW"wHon orid Munwntadon on only inh symcill
designated b, the AlVance anWor We DepaMWAL NUnwance inckides MCI CXPC41S n"Ll haCkUPS Orall
dwa and yvew namr0n; to Ikpar9=0 QWMAY Dmh nirst be usWe and in at veahbW WrtnH, I, IN
Allianeo�m&oi,thc Department
16.1, CIRTS Data Maintenance
'Me PmAdcr mQ1 criswre thC,RCCUrate collection and mainwilance of cliew and set vita information oil
a nwndWy bah Rwn the CIRTS tw any such spiern dc5griated by the Allinec.Maintenance
ACILWO V-0fid eXpOrt-5 Mid back-ups of all dMa and symernsviccurding to Afliaricc and Do[-,,A
standards, The Provider num aMene w the Alliance CIRI S Data Integrity 130icies & PFUCCClUreS-,
incorporated by ret rcnce, m ordQr to crisure data accirrucy.
2.6.2 Data Integrity and Back-r.,Ep Procedure;
I he, Provider shaill inahnain "rkivn policks and procedures firr commIx0e; sy wo backup and
rucovery ;uxl shall havo flit UAW requ.h-emen; Lot its suNnimmsoN mmkv v OWOM lte:se
policies and proccdures shall tr)C jjjaj,&," aailaalrPa to the A llian,,:v opt,to reque's-1,
2.7 Performance Specifications
23A Outcomes and Outputs (ParAmnatwe Nkusw=Q—Ai as minhirrun,the PmAds naw
(1) Ensure he proWN of the sery ccs describe�1in this,contract are in aaa a trtrlaataa c with lhe curTent
DOHA Programs mid Semices Ondbook and in the Manner of Service Provision dewribed in
this contract.
(2) Tiane1y and accame"sArrit to,the Nhance all inforinallion described in this contract.
(3) Develop,cWtarment, am! Wow umulks 0 die Service Provider Application (SPA)to Suppoll
the Department's pertlormance outcome incamires in the f6 11 owing criteria!
Page ZS of 66
KCV-212,9
litantional status,
c) 65%of new service recipient,`~will nlaintuinor impmvc their ADL'Sassessrr)CIIXSCOM
c) 99%,of farrlRy and fantily-issisted carcgivers %vill they are very likely to provide czro,
2,72 Moiiitoring and EV81LIati011 Viet hOdO l0gy
"The Alliance will review and evaltla(c the Performance of the Provider order the terror,ofthis
contract. Monitoring Shall] be COI.IdUCtCCI thrOUgh direct COIA&Ct With(Ile Provider throqgh telephone, in
writing,and/Or all onr site visit.Tile Alliance's detennination of acceptable perfomiance shall be
conc lu,,ive.The Provider aVlrees t(.,,)cooperate with the Alhance]In nioniloriq Lhc progress of
cortipletion of the service [asks and d0iveraWc�, 'The Alliance may use.KII is not lirriitcd to, one or
laethOdS RH IlI011'tk)r'l1,g:
l) Desk reviews and analytical reviews,
(2) SchedUlcd, LIn,9ChCClUlLd, and J'()llCW--LlP ore-Site Vkltst'
(3) Client visitsi
(4), KeV CW of independent aoditor's reports;
(5), Revlew of'third-Marty dOCLIIIICIItS andler evaluation,
(6) RevO%v orpr'ogrcm reports,
(7) Rev ew DI'CLIStOrIler satisfactiull survu,M
(8) Avrec�l-opon procedUres, review by an external auditor orcon5uhanl;
(9), Uniited-5cope reviews, and
17.3 Re medic 4-Noricon formi ng Services
The Provider shall crisure Ihat all pardelpants served under thrs cagTwernent nre eligible R"v the
prograrn, and that all monthly arid/Or quarterly per1lon-narice rcpoi is and financial recoidsate
maintained for each reporting period and Rlbrililled as stipulated in 2.4,2.5,2.6,and 2,7,
Any nett Gonforming pro grain sery ces, repeats cir financial records riot nweling [lie
reqLdrernents of this Contract shall not be ctigib1c Cor reh unclear nboi:�errient ur this program. The costs
associated,Nvith hiring,trLiining,reporfin(g andlor mamaging the program Shall be borne solely by the
Prov der, The AlAance reqt1ires inirnediatQ notice of any significant andlor systernic inrractlon.s that
compromise the Provider's ability to provide participant services, to achieve programmadc
per Forniance or to provide sound finxicial of the prograrn',
2S Provider's Financial OtAtigatims
M. Consumer Contributions
Consunier contributions areto be used wider the rulluwing terms:
I') '111C PfOVidCl as liwes compliance with,Section 3 l 5,of the OAA as arnended in 2006, in i,egard to
consumer coritribwioni;
2) Voluatary contrlbufioils are riot to be used for cost sharing or inatclihig,
3) Accumulated voluntary contributions are to be used prior to i-equesfing federal reirn vnsement;and
4) Voluntary contributions are to be used only to expand serviccs.
233 Use orServ[ce Dollars
The Provider is expected to spend all redel-al.state and c1l,lier fiiii(js provided by than Alliance I'm, [he purpose
specified in the contraci. 'I'lic F'rovider inust manage the Wtvice dollans in such a manner so as to avoid
having, a wait list, at defic'Ll, or a surplus of funds at the end of the contract period, fov each program rnanaged
by the Provider, PrOgrCU11 SJUr-PIL13CS MUSI, be reported to the Alliance.
Page 26 of'66
KCV-2129
IS A AMC RecapWirc
In accordance with hs surOLOWC it 111t.1nagernent policies, in order to rnax5rize available fbndiqg and
rniAnnize the time dmt putenthd Was must %vait for servic% Me Alliame it) its solo discretion carl reducc
ANQ awuds ihhc ProAder is not VwOng auntmAing to monthly plansarld, is projectcd to inc Ur at Surpitis
at the end of the year,
1&5 Ile Plxidde"jwn to we Bids as detailed in the BmWa Swmmw-.Y, ATTACI IMENTVIL Any cl,tanges in
the arnounts of Ncral fitinds identified on the Budge Sunimmy by services MAhn mch Udc(Support
Services,Nutrition Services Caregiver Support Services)are allowed mdMout contract arnendment. Providers
must adtlevc LoAlliance's Modified Spending Policy, akwed undrihis cnntract,incorivrated by refcronce,
18.6 CCAA Funds
The Provider a,,,sirres compliance with Section 306 ofOAA, as anien,ded in 2020, that fund's, received
undQr CC AA will tint be used to pay any pan of at cost Oukxlirig,an administrative cost)inc orr d by the
CotAmom to nuintain at contractwil or cornmeskil rakdonMirip that is not carried cA to implemat We
CCAA services,
2.9 ALLIANCES K' SPONSIBILITIES.
2.9,1 Prograni Ouidanccand Tcchnica[Assistance
The Alliance%vill provide to the Flovider guidisnee and technical assistance as needed lo,ensure tl1C SLICce-Srvl
RAN11iment of the contmet by to PwAder, The Providers inust attend all required training,session and,
rnactings. The mVpwk ax lack thmM shall not Weve the Provicler fi-om full perlbil=nce of curarafA
SECTION 111, METHOD OF PAYMENT
3.1 General Statenterit(if Method of Payrnent
The Whod of Payment for this contract is fixed-fee/unit ratc, and advanced Payrneras,SLNI�ject 0,0 the av4ilabifity of
funds, "["tie Providusholl ensum include only those costs that are inaccordancc kvilh all applicabte state and
fi�dcra[ su.ttries and mgWatOns arid are based oil audind historical costs in instances whote an independentedit is
required, fhe Al hance wi 11 pay the Provider upon&at isfactory completion of Tasks/Dehymables as qmd Ecd in
Secdon IL 2.1, 2.and 2A and in amadlince %Vifl) other terltrS md cudWors of Mis co,mma.
3.2 Unit of Service
12.1 FQ(�/Unrt RoO,
Provider irust meet the nihinnum Q%cl ofporAniWr;CQ slatted in (11C Conlro'd to I'L:Ceivc jlaynlclv
11yrnevis 10, fixed FecWt Raps shill not execed anumms cMddWxd hi AWMW Wl
IN Provider agrees to riser hur kiiuk t,is dernikOl in dw Bud, liummary. 101 1 AC IVIED IF VIL 41
ih is coraraCL At* chm," in Ow UO I neat. mos ofille Imul's ik-wilied on,the Hrld'.!ct stqlnlllarw fol'111.
I CWOX a COMAU nmsdmew
1 3.3 Advance Payments
321 The PmAdu may requcst up to two months of'adv,-,1l1CCS At the SUM ofille contract period, ifavail,a.ble, to
coryerpi,ograt-ns,erviccQosts, [lie payment aray, advance will be contingent upon the sufficiency and
.1n)OL111tof Wds released ter the Alliance. Ttlepw idea'shall. provide tlicAlliaricedocuinentaiiori.itistlCNiiig
Page 27 of 66
KC�1_2129
the need for an advance and describing how Lhe funds will be distributed. Any Advance payinems must be
recouped no kuer thao the bi I I ijig subviifted to kho A I I ionce from %Ylli�Ch the MILTUt ftludiM'all0CaLiW1 i.i
33,2 interest Q4rm:,d on advances n1rist, lac; idel"ItiflitJ separawly by source offtardsi,suiate or federal. Providers, shall
niahitain,advance,,offedQral Raids for interest Nmring auxounts urdess othetivise exempted in accordance
with 45 ,FTC 74.22(k). Earned interest must be returried to UicAlhance at the cnd of each queIrlei.
3A Invoice Submittal and Requests for Payment
llaynicitt shall be I'lladC Upon the Providers presentation ofan invoice, follovwijig_, acceptance and approvai by the
afillaricc ofdclivorables shown on tile invoice., The Provider shall maintain docurnentatiQ11 to Support Payment
reqoosts That shall he available to the Alhanct!or authorized individuals.,such as the Departmont ofl'inancial
Services,upon request, Supporting documentation of services provided must be adequate to penril fis,=] and,
proorarrimatic evakiation and emure Internal manag
cnient-
The lbrin and substance of each illWiCe submitted by the Provider shall be as fbllows:
3.4.1 All requests for paymerit and eypenditurc reports subivilued to suppon requests for payrrem slual] be on
forms 106(ATTACHMENT IX), 105 (ATTACHMENIT X).
(1) Form 106
(2) Folol 105
.1,4.2 The Provider shall submit all payment recirrests based oil the suhrnissinrt o,f the Provider's actual momlily
expenditure reports beginning,with the first month of the contract as per ATTA0 IMFNT V111 to this
contract.
3.43 Arty paywent due by thie Alliance uriderihe terrris of this contract niay be v,viflhhdd pending the receipt and
approva.1 of all financial -and programmatic i eport, dac from tho,Provider and any adjUSIHICob"thereto,
"The Alliance will aufliorize payment only for allowable expendl t We%, wHch are in accordance with the
finlrtw spc6tjed in ATTA(,fAWNT W,
14.5 Monthly review cat the. Receipt and Expcjidlturc Report and 60 RCqUn't ffil- Payment Form by ihe Alliance
wW foc'Ll's on:
(t) Une item wniparkon of year-to-date expenditures with the budg,et to monitor rate ofexpcncliturcs,
(2) Allowable total reiniburscnient, on aserviec by service level,does not exceed budgeted/contractual
arnount (I No unilateral modified speltdint; A]11106ty.);
(3) Validation of service units rcl,9orted apinst CIRTS.
3*6 In order to properly irlanago 1"he prograi'll htld3, C'(, thy. P'r(Wid,tr 111LIS1 submit invoices for, paymem no later,
than 11he 61'b day tiollowing than 111ondl ill which the QxPellse was 1nCL1n,cd. ,nor W vNiceed three(3)mouths Ifter
the end of the rrionth,ire which the expense was incurred, except that invoices cannot besubinitted after
Close Out Report date. Invoices submitted IratC'MU require the approvalofthe Alliance's contTaCt manager.
Late invoices will not he Paid unle." ltmification is submiacd and approved in wriung by die contract
manager,
14.7 Date for Final Request for Payment,
The Provider shall si,ibmit the final request for payment to the Alliance by the chats, indicated on Attachment
Vill of this contrzact,
3*8 Payincats will be inade to the Provider based on a couiplete arid correct itivoice,invoices that are
incornplete or with incorrca total will not be processed and vvill be returned to,the Provider for correction.
Page 28 of 66
KCV-2129,
f7iscal slarl"wi I I, rint he able to corrector,make c I ianges to tire} invoiQes. Returning invoices for corrections
111ay 1'eSUIL ill fiailUrC to receivu payTircm Rx-that month. Invoiecs shall be submitted dillefly as per.
ATTACHMENI'Vill inaTcor to avoid in), payment
3,4,9 The Providcr must enter all required data,following DOEA's CIRTS Policy Guidelines for dents and
sLrviccs in the CIRTS database, Data intist be entered,, into CIRTS before the Providcrs submit their request
,for payment njid CXPMditL11-e rej)ONS,
14.10 The Provider shall run niontliiy CIRTS repons and vcrif� that client and service data in CIRTS is accurate.
This report M'Ust be submitted to tlic Alliance wii,th the inonthly request For payment and cxpend[tUre report
and must be reviewed by the Alliance before the Provider's request can be approved by the Alliance.
3,411 For Providers receivirig,funding fior Material Aid services, Nlworial Aid must lie provided ou[y whoa tho-c
is no available alrcniaGve,e, .another program fUnding Source or community resOUNC,that CaIj aCCOIripliSh
the,service or supply the goods, Prior writteii appro4 shall be o1binined in writing from the A11iaocc'5
cowrau tronagor Isar purcliuse of$590,00 or r1rorc. Written approval must be submitted wish the request
for payinent.
3.5.Reinedics for flu ntonforming Services
The Fruvidcr shall ensure that all.goods and/or services provided tondcr this contract acre delivered finicly.
C0111PICtOly ak1d C0111111011SUIrate r,Jlh required staWards 01"CIMIlit)', SUCK gOOCIS Urld/01-5QrViCCS Will Only be delivered
to eligiMe prograni participants,
If the Provider farts to meet the prescribcd,quahty standards,for services,such services M111 not be reinibursed udder
this contract, In addition, any nonconForming,goods(including hoole delivered meals)artd/or services riot ineeting
such staridards will not be reinibursed'Under this contract.. The Provider's signature on the request for payment form
CellifiCS WiMCMIFICC 01"SLIppOrting docLimentation and act nowledgernent that the Pr-ovider shall srrlelw bear the
cosis,assoriated w4h pnr paring or,providing nonconf6ri,ning go os analor services, Payni,ents may be Mtfilwid
C_
ajj(l,Jorr required to be reimbursed if stand.,xds arc riot upheld andior ifdoctinientation does I'lot support invoices
being processed or-already paid, The Alliance requirers imniediate notice of ari), significant an&or systemic
infractions,that ccirliprornise the quality_srmtrity, or contintuty ofservices to clients,
3.5.1, C01TWive Action Plan
1. cowmctor shall ensure 100% of the deliverable,, identified in KrTACHMENT 1, Scation tj (Marracr of
Service Prcrvisioru)of this contract,are performed pursuant to contract requirements.
2, 1 Fat any tinic the Contractor is ,testified by the AiFance that it has faiied to correcily. completely, or
adeqkta(ely perfoarri contract deliverables idenAied in A17ACHMENT 1, Sec. 11, the Cuntractor will have
10 businiess days to submit a Corrective Action Plan("CAP")to the Alliance Contract Manager that
addresses the dericiencies and states how flic deficiencies will be reniedied %kdtliln a time period approved
by the Alliance's Contract Manager, The Alkince Shrldl assess at Financial ConsequenceIsar Non-
Conliphance on the Contractor&s ref'orenced in ATTACHMENT 1, Sec 3AZ of this contract flor each
deficiency identified in the CAP'vvhic[i is not corrected pursuant to the CAI,`. The Alhanceshall also
assess as Financial (I I I onsequence for fztihire,to timely`submila CAP.
3. If the Contractor fails to correct an identified deficiency v,,Ithin the approved time period specified fil the
CAP, the Alliance shall deduct the perventage cstablislle,d in ATTACHMENT 1,Sec. 3.4,7, of this
contract, front the payment for the invoice of the fbilowing month,
4, If the Contractor fails to fijnclv submic a CAP, flu:Alliance shall deduct the percentage established in
ATTACHMENT], Section 3.4-2. of this contract for each day the CAP is ovcrdve, The deductiori wilt be
made front the payinent for the invoice ofthe following month.
Page 25 of 66
KCV-2129
3.5.2. FinaiicW Comequences of'Non-Perforrnince
The Alliance wil I withhold or l"CCILICe payrnent if the Contlictur finki to pe6orni the deliverable to the
satisfilctimi offlic Contract according to the rcquh�eoient) j-cI'crcnci:d in A,rTACI IMENT 1, Section I and
Section 11 of the contract,"I'he following financial conseqLiences will be imposed if Ow,dellverables stated do
not meet in part(it in whole the perrornimice criteria as okalined in ATTACHMENT I. Scetion I and Section 11
of this contract.
1, DeNvery ofservices to ehg;�ble clients as referenced in ATTACHMEIN r 1,Sectiao t,4 and,"Niection 11 (if
this,contract—Failure to compiy With esutblished assessment amd prioritization criteria as evidenced in
CIRTS reports will rcSUII in a 2%,reductiort of paymvint per business day. '111C re(ILW60111 0fj3aynIeflL Wil I
begin on the first business day following t'he Alliance's notification to the Provider that the Weatified
deficiency was not cured or satisfactorily addressed in accordiinct., with the Alliance approved CAV,
ref&cnced in ATTACI WENT 1, Sec.114,1.
2. Services and units of services as refemiced hi KrTACHMENT 1, Scctk:)ii I i ofthis contract—Failure to
provide services in accordance ATTACHMENT 1,Section 2A the current DO EA Prograrn.s and Services
l4andbook, the scr�4ces listed on ATTACHMEINTS VI I amd K. and SUbmi,,isimi of reqo{ rcd docunwrititiotl
AA-M result in as 2% reduction of pqmerit per business day. The reduclion of payment will begin the first
business day following the Alliance's notification to the ProMer that the identified deficiency was not
cmQd cirsatisfaccorily addressed in accordance willi the Mliance approved CAP, refcrcnced in
ATTACH M E'N'T 1, Sec. 3 A,1,
3, AtIrninistrative duties as relurenQed 41 A"ITACHMFNT 1,Section 11 of this conti-w—railur,to perforin
the performince specifications and oversight cal operations will ivsuft in a 2% MdLINiOn Ofr,-N Tleftt I)er
business day. The reduction,Of payMehl,witl begin the first business day following the Alliance"s
nod fication to the Provider 111EIL the id'entified dellciency was not cured or satisfacwrily addressed in
accordance with,the Alliance approved CAP,referenced in ATTACtIMENT 1, Scc.I-L 1.
4. Timely subrnission of a CAP—Failure to timely subinit a CAP ,wkhijt )()bLl$irICSS days atfter iiodf cation
ufthe duficiem:,y by t1w AlliaiwQ Contract Illariagerwill restitz in a 2% reduction,of'pnyment per business
clay thin;CAP is not received. The reduction o('payment wdl begin the first business day following the
Alliance's notification to (lie contractor that the identified dcfi6QtoQy was not cured or satisfactorily
addressed In uccordance with the AHlame approved CAP,refertneed in )VI'TACHNIENT 1, Sec, 3,4 1
S. Exceptions may be granted solely, in writing, by the Affiance.
Page 30 of 66
KCV-1212,9
�,kTTAOPYITNT III
ATTAC11NIENT 11
FINNISCIAL AND (A)MPLIANCE AVDIT
The adiviiiis I ra6url 131-rcs oil rces a w"Med by,the A I liance to the provider moy be sobjoci to,aLld its and/or num krin g by the
Allkv=tgwaor die Deparurerwt as&-scribed irl this set;tictv
1, MONITORINC
In "addition to reviews of aildilis Coisdimcd in accordalicc with 2 C F R paj°t ,Or) joj-j-lrej'jy OMB ('n-cv[a,rA-I33, is
rkivised), and &.clion 2 J5-97, F.$,,(scv "AU D11`5" bcloVe), 111DfljT47jrin4 procedures may i"(1tide, bilt nal be lini4cd, to, on-site
r 6NIB(1rcullat-A-03, as re%iscd, arl&ov
visits by the ,Alliance: andfor the Dei?artment.stalf, kmilud s opct
Offier PrI)Ced!.Ir4�$. By C-MCriM, r00 this 1-1gFCeMCflt, the C'Mitrao0( anprees to Comply and cltoperate whirl
procttilure0promses, devuled appropriate by the Allimco. III the LVCM the All'Auncc amVor itie Department determim- that a
litnited SCA.IPC audit or 110 Ccrilrowtim, is appropriat,�, thc COMTwor agrevs to comply %vith rfly aIddhijolial histruc6ons provided by
the A I I ean.ie a rdlo r the DeparuTIL31t j() Ole Contracior waavdin_g siy.,tj audit. The Controcior furOier ,i,grees t I o cumply
and, C001wraw widl any inspectimis, revivws; or akldits,i1v -flL by ccssaxy the A lliam c alld�01' the
Departincrit.
A U D ITS
PART' I.FL1VF,',RALLN0 V'UNDED
This part is ipplicable if the Provider ist,Stalei)" 10i°,al government ol—,j ujciri-pmfii organiza600 asdefined in OMB Circular A-
133, as reV ised,
1,n tfic event that the Providvo, e,.r.pc:jjds $750,000,00 or more in feltvral awards during it,; fi5,cal year.,the Pro)dder invo havi:a
single or progiarn-spccirlx akiifit conducted arl,acccwdijrjCc +,vjjjj the ptra)viskhris (if 2 C I-, R 11 1,4 r t 200, EXWIVE 2 to 1h Is
"Ign'Cmetil indicates f"Ckr3l J`C% MVIV&d through tiro.rMhanou by flii5 4-revinent, In deterr-momm the 1ederal, mvardli
-
re%
c\jimded in its fiscal Year, 11W 1`0 P v id e I shall consider YL'rs�'—u— Of f sIr rat ativarads, jaCILICHTIs� federal resources i-ecQ,ived
from tb,, A I I k"It c e 'file determination Of ZVOUntS of FedCrAl Awards expeaded shoold be in accordance %vilk the
Oui,delines c5iablishvil by 2 C FR part 200. An 1,kjrdjt cq the P rov ider conductod by 1he Auditor General era accordaIlec
with the provisions, of 2 C'P R Pa rt 2, 0 0, will meet the requireniums of this Plarl
h,CollnectiLl -r shall t'llifill the requirements relative to
.11 with th,,jiidit rcqLIjl`t1lwnt5 addirtssed in Part 1,paragralih 1,thic Provide
auditce responsiblMjcs as provided in 2 C F R I'at t 1 2 00.5()&.
lf(he Provk-k-r expends less tharI S750,000M in Fedcrut awards in its Fiscal year.ait audii conducted in,accordance with the
provisiorts or'-" C F R F,a r t 2 0 0, is riot required. In JIM CVC,nt 01i[(the Ptovj(1Q, expends Icss than S730,000M 41 federal
awards in i�s fi&cal year and elects to hive an authl,corldacted in accordance with lhQ PfD%r1jSio of2 C F R V a r t 2 0 0; the
cost oft1le audit must be paid froru narl-fedem-ai resovrcc� (k- the CC)Sl, Of SUCh audit IMIM by paid firoln Providcrresources
objaiijed rraill,otlier than federal critilles.)
An 3LIffit C011CILICtftl in ac rdatiet wiLh this pilri shall cover the 01tire 0e,jnjz.jtjcjj Crur the orgailization's, local year.
' . g
ClorrIpliance (indirik,!,,related to agrecinents with the Allimice shkjjh be based ol!i the at,rcement s reqairemenO, includin any
rues, N-eRUlF1i0nS,, CIT'Statutes rerfercriccd in the ai,,'leenient. "I'llic financial statej,4,unts shall disclo-se whether -neat the
matching requiromcnt Was Met for cach tipplicablu agrcement, All qnestloned costs and liabilities dut,to the Alliance and/0V
the Departmeni shall be WHY disclosed in the audit report ,vqlj rcfierencc to the Alliance agracl-rictii involved, If"not.
-Y
r of federal awards shall idmiti f
-)flltiw�se disclosed as requii d by 2 C F R p Il r t 2o 0,5 I 0 . the�icfiedute all
expelviditure5 by a,urcment number Im-each agreml.ment with the Alliance, ineffeet dt[fint' t1t0aUdit period, Financial
f 30,d,
reporting packages required tinder this part must he submitted �vijhjjj the ZvtVwt.Li_ days afUr receipt of the aUdit report or
9 monrh,,a ,after the end ofthc ProvidQr's fisi.,,al,year end.
Page 31 of 66
KCV-2129
PART It.STATE FL)N D ED
ibis part ifthc `rovi&r is anon-state entity aas defined try- 'SCCC01121-5,97(2),FS,
q,te rjq- of S750,000M 111
1at Itic o,ent that thu Pro%,idc r experWR I tuto[ amount Ol' oj�i°jj I,Ssist,jrt�c v,qkt,jI to (IT in
Pascal wear ref skich Prokidper (for fist as years vnthng Suptembo, 0. 2004 orlhereoflerl- the Pro idar muM hac e 11 kNte dng�e err
project-specific audit for such fis4il vvir in accordanix wOlh Section 215,97. applicable rules Df the l)epwinent I:if Financial
Services; and Chapters M5.50 (local govenimental entities) tar 10.6-50 (nonpwfit tind for-profit organizations), Rufus of, the Auditor
Ceiteral, EXHIDI'F2 to ibis agreenwrt htdicates state financial assistance a. %anWthrz)ugh dic pia liaac,. by lhas agruntem. In
determining the stall, financial assistance expeiided in its fiscal rU'ar. LN. Provider sballcmisider �flj�� rcc�sofstate firanvial
aysistance, inctudirm, state financial as,.dStajrtCC TCCCRved from the Alliance, other slate ageacks. and other non-wile, entilicq. RfttO
flmin6al assistancedcies not include Federal dim or pass-thr0LJgh awirds riled resources i-ecoh,cd bV �j entity for f-'edoral
program muctiing requiremQnts,
Iaaacrnnedtidwaa kwhh the aUdIt requireinctim addresscd M Fart it, FiLg,1graph 1.the Provider shall eftsuro that the audit oomp ias,NOth, the
recluiren,icnts of Section 215,97(8), F.S. 1'his naaludc �ubmksion of'a finami3l reporfkw g p-,,ckage as dcrined by 215,97(2),
and Chal-ger or [0.650(nompro(li and 1`o;-p4'ofiL organizat[m), Rules 4theAudimr Cencral.
Itthd l ratidt eslaaar is lee tla tra S750.000.00 II)SIaLermancial assisuarlou M Its ycikr{alrfa;ettl voaf;L!uLling Scpiember 30.2004,
or tt[3 tiLid it,condvQlcd ktzaccot-dance with the pmvisions of Secci,01)2 15,97, FS., is nol rvqi6red. In the event that(he
Provider exponds.less than S750,000,00 in Mate financial assiwtancc in its rISC&I YC0,3 and OCCIS IQ havc all"(fit C0116uctcd in
accordance with the provisions of Scojon 215,97, the cost Of'the audit must be paid froul the non-stite CMO's rVi(Mirces
(j.c,,jhe cost of suuh an audit tottg be paid front the Providcr regourccs obcained from than State,:notice,)..
An audit coMkIcted in accordance with this pan shall cover the omjje (irg!anization for the or-aniziition's fiscal Y-
I
Cornplintice findings related leagree I n e tits with the Alli,ancc 00 be based on the agNel"CnI's inc'ud'ngr any
41)pbcable rules, regulationi,or slattttes, The fma,neial I the roatchimg requirement was
sliall disclose whedier or not -N
Mer,Forcarl'i zl)plicaWe agreement, All questioned Costs vend fiabditics dOMIthe Allim&e-,hall,be ft[JIV kljSC)QSed in the 111(s't rcrort
with wfmmLe fm the Allimcc ugreet-norit involved. IF m)t otherwise disctosed as required by Kul,. 691-5..003,Fla,Admvin-Code,the
Schedule of expend4ures of state Financial mistance shall identify expeoditure's by aoreemem number for each agre'ernew with
the AI Hance in efrmi during the, audit period. Financird reportmV pavkages aclquircd LANIff this part mubt be sAmitted wi,thin
45 days after delivery ortho audit report,but-no later Ifian, I-t Inonths after the Provider's 65cuj! yoar =d fir local
government-al cntq ori ics� N -profit o F r or-prolla are reqwiired to be subriiiiied with ij, ,l5 days after deliver), ofthe
audit reporl,but.uU LIVT'et'tIj-;tn 1) iriontlis after the Provider's fiscal yeareml, Nooxi(lislandding the applicability 01,111is port ion, Lbe
Alliatice retains all right arclobligation toruuniior and oversee the perl'brnianGe rat This agrCeIlIcIlt as OLRHIACCI throu"hoUt this
dOCLIment and,PLINUalat tolave',
11. PART III; REPORT SUBMISSION
Copies ofn�porting pac�,ages and required by PART I orthis
I '- , f(jr au conducted In accordallce kvitfi, '2 ('FR Part 20 0, dirtgrbLlo ca li of the
Agrcentient sh,.M be submitted,when required by,? C F R P art 2 00,5 1, 2 by of on behalf'ofthe pjovideej� V 0
f`6 I lowi ng:
The aV,Ilimjce fit ckAch of ilio fioHowing addresses-
Allionce for Aging, Inc.
Attm Fi,�rul DOPAftfIrIc"t
760 NW 1071"Avenue
Sijite 214
Mifirni, FL 33172
ard em liar to thQ 1edcril Aiidit (1ea611-holvic dcsigm&A in CFR NO 16 at the t+.ill ra its„,',
Page 12 of 66
KCV-2129
Fenny! AndN (WribIghousc,
Ijul,call ol'the Ccasus 1291
Lam I W" sv"T
jeffel-sonvitte, IN 4?132
For thcal yvar 2014 ;xUI Im on punum" i a ? CFR §NW,p, Be mpmQy p,WWc and dwdata coUcokm QM aft M be
momkwd duvw0cally to the IT&W AW Clcarhnplwuscm
Ntrwa w 2 (TR §N(1 512.aH cmhcr Vcdcrid a�,:cocios' cWhos and oflnl.�'lnlercsted I)a rcronilt;"'
uad duackli"don, Ann mum OWN k b; w"%Ng On 10knd AmM (AwAgWLLW
'j"Ite �Jjajj WhIth a cW* of any m=Temou lowr Qud h; Ito athh1or. sjj dj,,� t�Jcrj njj
Aflnnr,aol Ile foflokN� aig ad(lross�
Affianco flu-;Agirl�, 13C.
AIM: F i s ca 1 1)e P A I't Fu 0 0 It
760 N%W 107" Amenue
Su Re 214
Womb H. 33172
AT114malln Copies repowhig imakapeg rcquhcd by INS cmin-WS 10wrabil(AmVphanK Nudh Mia0unle"r
parl 11 sIjjjH by or on hetwor-mv pm%jcr djay,to cach orlhe Wook,,:
Ibc FkwWn [Upwyncot uf Wder 10100,at the fbko%ving zukkoss:
AWkwe Nr AWn,hu.
Anna Fiscal Depa"ment
760 N%V 1071 Avenue
Suite 314
hNand,FL 33172
1 he Audkor mcm,nnke m me Nunn mkwi�
("F111(le Pepper ffilildillgo, Roorn
q74 HI k"Vest Miulbion -StITO
,my mqw nmmgcnhmt icuer or wher Wmalin rujukk iv be sAmawd w be DepmMem WTUM11 W us callmut
s"k bc submawd OnQ in auartwwl "kh 2 UFR W000, H" "W" Ond "Per" 10,50 (way uovornmay a 1
enwi.;or 14 6% (rungdo ary jonpok mianazattom n Ilid"twohe MWAM GdWML a UpIlicablk-,
evh'm stibrIduNg nrinchd Wp.bg P"Ujvs lothe DqwWww1a Am"," me in a"ammec&W 2 UFR W
200 orChaprers cathics)m 114650snonproOt—1 fo-iirutlt Rulk"snl the Auditor
Gencrak QwuW hilcate No duw to Ow mR"Qi, dch""ored ic h,,,,, Ilvo% Jor W vonvsp wrack n,:c ate cmnpnnjQg
IN: rcjroigiu'-
PAR Y iv: RE("'ORD RE'I'VNITION
'1 I,jk: retain sufnewn; reenak dommAmAg is carupdmice"it NQ lums of Mk comm. 1W a pawd ask,
0, yaws ton,I, Be dme Mc mW4 rurwo K imwl and AW NO" th, or 1t�. ('F() a,w Attditcn
Gener"'11 acccs's to iecords upin raqueSL "I he pwvrder sw am we to Wit "orkiag jwjvrs are made a%WhIc to
Me Alliame WNU Ow WmmwH Or deSii!nc:o, (:'1'0- or Whor (laical upon toquem Ru, a poyUnd of& 161 youc,
1),on, tile, cjrjtc tile 4ard4 mpwl ; kmw& vMvs emandW in wAhT by To DepmmouL.
Page 33 of 66
KCV-2129
A,r1,A(AtMENT 11
IqNANCIAL AND CONTPLIANCL AUDIT ATTACJIME�N"T
PART A.• (41 UR�'Art�2nd.5C10�
f6deral, t)r nviy not be StIbjQCtto the &I(lit ri,qktireni val-dadr� tef1rovidwi %1010 fetciVe state or ed to be recipiwits or subrecil)ieffls of'vederaiand/or Stvctioll sim, Pro v id e r 5 re delarill it) IUtCITMIL� �,ctforth ill part I ari ,lor
C'Ltl)%heatildit requiremelITS if the widit lltresho t 0 all(j it raquiv rrlmu,
Financial as,50Rn"511�-ty be qtlbjc S hIect to the,
ovExhibit 1 is,rmet. P r 0 v i d C Ntjo haw,lwen dleterwilled to be ve"lors al'-c"0 r, net,Providers w1to
� tile ao&t req ,,,e tile fit$11
Patt §2003N,altd/cir SectIg,11 21 1;97,r1a. Stat. alaward s ati'S of,% th ofrL F11`01 L��"Islat' mw�con"M Y Ns,itIt�,Ipplicable
deterry ined to be rcei*nls (a(S obrecipier,I CS Q,F rctief Ybe d' ! ui"Issis
I Ircmems.
termined to be�
Irtatact�rcit
i1j, 2 CI R Pat-[ §,-Qo and)oil Ride 69 1 5M15, YAC, Coll(facto r has Tema drat I I Ice ��v
t ,
Vendor not subject to2 CFR Part§20038 amUOr SectiOI12 5 97 P.S.
Scction 215,9,7� 1 .
aw,rds,
W 2 C1 CFR part§2,0() Scotion 215,97, rs, ror I collqgcs,dist6ci 5cholll
Exempt orgariz;ation (V)t subject to 2 '-4iM W111111ri
organizatim", ATc cNeMIA;fOr slalo rMancial assistance Jiro I Organization-, must comply
jects, pubk wiNtrs e(TIP
I cll�tlfflrt� EN
boards, bi-MChes Of'",late (Florida) government, and chartcr sallr`ols 4 re
With all colnp9itmcc reqktirtnlents S0 forth withill tile �xmlract Of award doculmollt�
ainvd to he a mcipierWSLibrecirvient offedoral ant! or Fj�atc financi,al a5sistarice 0114 11as b"n
NOTL� t f�A PR)vId1CT delel-r %Nith S C -5006, FAC 15MIC
V 411US1 COMPlY �t�ction 215,97�7), an,d 11til 091
approved by tllo A1,11311ce to s o bcon tract, tbe, al awar6l,
r1l )I T fcd or
finaricisl 1q, §100.,
istar1ccl and 2 CFR Pa -
PART It: FISCAL COMII,IAIINI(j: 116QUIREMENTS MERAL AWAROS FrOvid"s who recrivebe Fcderal
ft'DERAL --kWARM Oil STAT11', tvi,vro u m; ruNDS ON �)L
late fillt,dt, on FcdeT�a�ass,ards, and who arL deternlirletV tO a
terIA1Acct)f effort ftill(ts. or
fiscal haws, males an'd rcgalmiorls:
subrecipwril MUSt COM111Y s'Vitll the
STATES, LOCAL ('moVERNMEN,FS AND [NMANS TRIULS MUST IOLLOW�
2 CM Part §200.4 16- Cost Principles"
2 Cl,"R Part §200,201- we Roqu
2 CFI< part �200-500- Audit Reqt1ir0illents
,qide for Skate 1^AP01ditUrc",
oti,ler,fiscal wquircmenlq se.1 forth in,prari°,r`auat t,awas, I'LlICS nand regidatioits
NON-vRovrr ORC ANIZATIONS MUST FOL,fl-OW:
2CFR'Part§200,400,41 I-Co-S(PrinciPtes*
2 CFR Rart §200-100-Adrninuitrative Requii-P�Ilncllts
2 CFR Part §200.500-Atidit: Requirettlents Rcfcrcr,cuCju[dc! Jr)vStaw1�XpCJJdqtUTeS
()thcr I"Iscat reqk irenlerlts set FLIr,111 it l)r0&Traa1 I"%vs, rules and rcgultiom
E.D11CATIONAL INSTITUTIONS (EVEN If-' A I�AWf OF A STATE Oil LOCAL GOVERINIMENT) NIUS'I'
FOLLOW:
2 CFR Part §200A18-COSI PritWiPl0s*
2 CrR Part §200.100-Admin isLrafive lf(equirernents
2 CFR Part §'200.500 Audil Reference Guide fbf State Expenditures
Other fiscal rcquircrtwijls set 1`01,11 iv jjr,.rall, rtie,,sand rugWati,00151
Page 34 of 66
KCV-2129
*Some Fakral programs may be exempled fivril complimlec Ivith the Cost Mnciplcs Circv[ars as imtcd inthu 2('FR Nrt
§,200,400(5)(c).
For Nodia- passed throe Q.S, Health and I lummi Si�rviees. 45 CFR 92: for lhiridirig passed throql�i , Departmem
7 , U.SI
oHduca6ori, 34 CFR 80.
STATE' FINANCIAL AS,SIS'I'ANCE., Prov iders who rective state finwiciall assistance acid who ao dewrinhicd to be a
I'eC]piUnU'SUbrOCipieM MLIA COMply With the f0k0lVing fiWal IIAVS,rules arid BgUlaWlIS:
Section 2 15,97, Fla; Stat,
Chapwr 691-5, Ha, Admin. Code
St,aleProjezis CompljaucQ Supplemery Refareilce 0xvWx
f'or Staw Expenditures
Ocher fiscal requiremems set f6rith in progrim laws, rules and remulmms
The Remalridur of This Page Left lntentionaHy Wank
Page 35 of 66
KCO2n9
A'11"I'A(.:11MEN r 11
11NANCIAL, AND COMPLIANCL AUDIT ATTAC11MENT
EX111BIT 2-FUNDING SUMMARY
Nu �,'Title 2fflk ,200331. aisrovisld. anjS�:VtwnWl I'S."Welha Khmmbn now Font hvgmumw mme boats
inchdod hi ATTACHMENT 14 EON I bepraybded tit lcmW100L Wromil mi comaked is a pied k%o F 6undiag sources and
related arnounts based on the coalr,,wt 6a0get,
L FEDERAL RESOURCES AWARDED TO THE SUBRECWIENT PURSUANT 10 11411S CONTRACT CONSIST
017 TFIFT l'OLLOWING:
PROGRAM WFLE FUNDING SOURCE ,FI)A AMOUNT
Corcofla�17us Consolidated AFPropriations
A 0 Tot'N Wri I i all Sen,k es under T A le I H- LJ A I bad I and H v m an Sery Res 93b45 sm'm 135
Cr of t1w OWm Ammivam Auk
TO 7Al, FEDERAL A W4 RD S 71 A5135
('01AR1,.'ANCE REQUIREMENTS APPIACABLIE TO THE rrDERAL RESOURCES A WAKDEDOURSUANT TO
IATS CONTRACT ARE AS FOLLOWS:
WDERAL FQUQS:,,
2 CPR Pm` 3N-Udhnn AdraimstraLivL Requircinents, CusL F6nciplus, acid Aud4 Reqk6rements Gor Fedcralt Avvar& OMIB
CkmWr A133 —Awhe cif Slams,. Locat(lovernmenis, avid Non-pfl)rfit Orgmiza6cms
2. S TATE R FS(AIRCES A WA RDE D TO THE REM I&I E14T PU RS LJ ANT T01MIS CON-1 R-A CT CONS ISTOF
VIE FOLLOAPING:
0CES FOR Fll)[AkAl P RAMS
PROGIR !1111 Trn.[-,, FUNDING SOURCE LIJ A_ ANIMMUNT
101 A,L S IATE A W A,RE)
A 'E I"TNANCIAL ASSI FANCL SU
PP OGV SOURQ, CFDd AMOUNT
TOTAL A NWA RD
CO'AVIPLIANC , KLQUI Rl,-,M IH NIS APPLICABLE TO STATE RESOUIRCE,S AWARDED PURSUANI"
C(MTRACT ARE AS FOLLOW
A 1,.LN,S'�,.I A , L,F-
Secdon 21517.FS, Chapter 6943, FL Admin Wde, Refercocc Guide foo, S(ate Offim fiwal requircinents set foilk it
pmqmn Awq mles md mg&Aam.
Page 36 of 66
KCV0129
AITACHMENT Iff
ITFA wil I nm oward 06SCOOLI-OCI: olllc'i" the Provider conipleies dwsc CLR [I f'K,,'A I WNS ;'AND
ASS U R A NCT S in puRwramwe or A k c ammo. Ile Pmv Mer p rov ides the A I lom i ng col j nvad ons wid
Hssuranccs:
JIMMUon L29CFR Parl 9-5 oud Z'119!j 75)
_j,j, _
M QUIUCHWALFAIM99 IMM fZ94:ER Part 93 and 4-9 (01),Q121)
c. r4uncHserindngHou, & E,gual Qpjwt tinnity Assurance (29_CFR jl"lir( 37 al!!S1,45 CLR Part NO)
Certificafigil R'u"'ording. 1101fic Ef"Ifit), C'vipjcssac:okm 287J3-111
Rh° sock Hun 0 t-Colil gn L I!LN:
' -C�IEganizafiqns for Ruform.,M %v
Ass u ra tic I I-1�17
F. CertificsiGon Reanydiog Sci,tiliuked Cous, !g -clion 28.7J35. F.S,.
Lig�j�,L
C.. Cerfificuflull Regarcting Data Ct"114,1)141 nee for C.
U>aw f,nal
VC6,11calion of Ej11p10vT11C"1
R. Records and C)ocurtionlatimi
CelliAga[blol Reganling WsL)caiwi Rce,ords
A. CERTIFICATRIN 14104C.A.RDING 1JFRAWN1E'N& SUSPENSM, AND WHER
RESIMNSIOWTV MATTKRS . pRipomw covintKu rRANSACTMN.
11%, wulcrsigned 110vidur cart-till s u.) ihe he [ oCks kmmlalge and WE At H W A p6wjW.Sv
L Are not prcscody d6banew mmpoulK PvpMed Ru ddmvrvwro dechwCd or vcdw%lril)�
cxcludcd frorr; cmcrud wansacOmm by a Faleral Qwwivnt our agenc)
2. 1 hic mn "MAn a Arvej Qu pmod p,rccQding jbis Cbrarne; been com Wd(w hnd a W jidgmeni
rundoW aglnM WWI Wr cowdsion Maud or a crialhud of[61se in txjwv"r(ioj %%ilh UhUM&T,
unem[Aug to ubudo.ol po-Foliving, a 1rW4W ONWA Stare. Aar Mud) traosactiori or conkna oWer at
Public ulwsaoion: violal'ion of l,Qdcml or Sure aotknm smiums or comnikohn of umbeedemcoL INT.
l5govy, Avej. or dcosuvabn of mcmis. inaking AM iraienicnts, cat rc,-eiviny stolull,
105POW,
I Mc nW present, WOW or athcro&crwinnHy or 6%M; cbwVd by a Avmnwm cWy HOW11L
Swe or local) whii cnnindsOn of nin, or the Mimes entuncrowd hi paragraph AZ ol'Uiis
aluuCy,
4, liz1ve not within a Mejumu pe6od pwccOnq thk orle, or nlorc public
imnsact his (Mma L Sam w bcd HemAtowd Rx crr me oNkh uh,
Pagp 37 of 66
KC42129
I'lle I I ridersignedsha I I requirr, thal fainguge WhA cc tMaGoa iv inJuded 6 the doclunortils' far;III
swWMUMOS M all do, (mcwding SACortinlos" w ciikltws, sub-gymnis and commos tinder gmuts. hall and
rkvnu,�las)and th'it ulttalb recipic3it"',and contractors sIndl plo",lde (hl Cori it ical ioll
a"ardwQ,
CERTIFICAncm WEGAIII)ING L01114YINC - CERTWICA"I'lON FOR,C0NTRACTS,
GRANTS, LOANS, AND C*0,011E-RAJTv"F-
The undeii llrovldvp- ,�ertk-ws, to dw. bee k-,If,its "ll(mledge and bclicf° Ill'i
01,oli beh,11j"C41
appropriared fi,nwk have bun paid or "ill he pakL b)No Federal
l'or int1w2ficirl'o or to influnce an W11ur or empkIve oFCongres.or an eirlpJ5 cc ol'a
Menther orcongivss in connoXmi with be awarding ufan3 11doral colnuaci.Ow inaking cal any 11dW
grant, die vaking ornry Wkial loan. the wilw1h,AHU of Wq CU4,rpL:larvV og m rL;Q41wilat � id the
reek aw M. mocarlem or owini cal au3 1 oderal colitlacl., ""Tant. loall Ctr v!,00peraake
agrecr000ll.
if any Rinds inalwir limit W&W appipmiatird AHAs have becn paid gal All be Ndd vo, nay Pei Ali
or illW111paNg to innuowe a" Am tw empneu Any agonc) , it hIvnihor cUlUortgrew an
orlicer or of Clogress. tw empkqew urn manser orcongrc,l in corinve6on with a FC&Fal
C�,,nlriicl- -tnmu. loop""W Coopowive agvccrlienl the andcriguud "hidt olso d-oiralllioc Clod �,ohlniL Standacd
l'onn ,- ki.l., "l)isckNwQ Form to ReN, 1,ohQ in zl�;CordancQ kv ith ili in.�(rnk:[WN
t he brit vrsigiwd I rcqoire that kinpuMc ofthis vem l9icukn be WNW in Ou dompwri Ow vC
subcommas at all rins(li,dudkg m1conmeoz whTwou mid cWHOU9 Under,,,,,rar0u, lo,aas and wo1wrai vC
agweracnal and that all nob- i0pin, W cuormit'lis fliall w"d lJkcloso lecordiagly.
Tkis certil-teation k a nuWal rcpresewaHon of W upot which rohance%vas placed %i hen blis(,onlract was
Inadio tor cnwrcd Kim. SAWkwit or this cen!Won k a pmraquisite IN making or ciaelring inau tk,
UnUrav imposed by 31 USE 1352. An) peNon W1 Nih 10 filc`the, [�,LJLJiI-Cd d)all be
QV0 to a 60 te�,s thma S 11000 oind mi mom Owin $1001100 Mr nwh swh hiluw
C, I N00DISCRINIINA"J"110h; hk EQUAL 0111CIRTUNIFIN ASSURAN(,-f' (21) CFR 1"ART 37AN't) 45
CPIZ 11AIt1 SO). -As a condidoo of1ho COMM Pno idQr assures IhM it "M C01Mpt' AQ =1 Lhe
and equal o1juirnHAy towiskins 4the Milo"Ung It vA�
i secoon isH orAhe Wwtihme linvesitluen; ni or IY98 MAJ.(NO. L."502M . o hich tombbb.',
chwrhn Wdon nph"i roll NO,Walk in 0: Wwd Simcs on the balms currace. color. 1C 1fon sox noticoml
011ght. ago. d4abillity. 1=11dwil Wiadow or hoW and apks( bencriciaries on the hasis of
AWymmus as a Viony rmbnhwd hiluriVin WOW ro "oM in Me Urdwd Ws o"unklmion
in a, WIA TW ldhawbily an6wd prograrn (w aakk,
2A'ittic Vi ofthe C'ivil Rig!as Act or 1964 (Puh L 88-352). as arnerided. mKI all roquirements Wiposcd in,
or P"Nuana LU We lkv-
,"Llilailion of the DeInwinw, oC I Walk and I Man Seri Not N 5 CFR PW 1 80, to the
caid that 0 nucordenwe wAh I Wc V1 of dw; Awl mid Ow Kcpdmwn. no immmi 1k1 the UNWd Sows shall,
W the y1tround orvat:Q,con or Wowd Woo . ht culuded Amn pwh6piion us he denied it bcm:fils
oil or he odwrwise suljoctal to WwWWOma undim al pygmrn to a0Q, An awl ich 10 Qp1dwon
receives WWI nmaiwial nsvivarloce Front the Dcpamnvm
Page 38 of 66
KCV-2129
I scown 504 ortho Rollabifitatioa KI ;W 1973 Wh L Wd 12) ns anionduh and all mqukeracrib imfmied
lay of pumaW to the RugulaiRm ordw Wporlincill oft 1volih and I Imnan Swim 115 014 Pan 84, W
ML-eml that, in accordrowu xvkh "yet; on 504 of&W WAmd Ow ResdAm no onherm ise timlidimi
QN&Wped imlividual in We LOW IN% A= scrawl; by reason of-laic handicap. iv excluded fi-om
1=66ppbon A he tit,-,octi tire twnems W or be suppmd to di Win ii'lat ion under wiy progrtnml or activity
Rw i5kh Tv Appliant ruceives Rdeml l'unnicial a'.'si'surnce 11oni 1110 0coal-tv)Q111-
?11% Age D&Hninalkmi Act of 1975 UK 1. 94-f 35 L w rummW and al I wqWwnmmx kqmmd by or
pimant to the Rcguladoirl oF the Depriament L4 I 10h and I Kum tine n ims (45 CIAT Pon 911 to the oul
that. hi accordance vkh dw W and 1he McgWadow no peNon in the Uilited StalesslialL on On: hasis of
qgc. hL: denwd the bmefiN or be excluded Toni pw0cipation hk or be sulfcaud to d3c6mbiw6un undo-
all' prog'rol'-n or avWly Rn %Akh the A[,'Y[Ykorlt wct�k o", Ft:&['d tlmanOal assistance the
Depamnent,
x r4w ix vf Ne Edwifion Amendinvals of 1972(Pub, L. 92-33 1 K'J.as aua cilded. and all, requ�realer its
imposed b) 01'PLU'Suant u) the Regillwhon Wic Deparlinellt 4,11,l lealth and 1 (-15 CTR Part
86), lo the cad that, in acoordance xvith life IN and than R upAOW ilo persoin era 1he I !ndcd ")-naes
on the bads cirsm. t,)c ewiude(i I'mn, Immikipailn in. he donfed the boiellws n'[" or bQ
tea al III ivoGo'll I"Ider UID oducad on lawgram or for v�'I]ich 11lv Ap't)I icm It I uOdora I
fin,incial assistance 11°om the Department.
6.1 he Arnerican whh INsabohils Act af I 9on (Pub, 1. 10 1-336), xy9u0h pmhth diwllmhUhm i" alt
emplo3wient pmedum hwh0Q,P)h xiiMilicatkyn pnwedure& Wng. lWaag.advancomm nompmWon.
jilin djrjd (:)tljejL j�:rfl v, 4:umclifioll", in"I PI id Qvs m-em Ida,mum
Ifoudderm alai mumilrat it %Wl comply Qh 2U(TR =37 aaty crank WwrwpWWwns fruphowmAg dw
iawq MIA 1410 1 - OnwhAvassisted
pro pvarn orauhip. and wall coranwis, Provider makesnowwryrota We AIA
prog;mrnor;wtivkj Provider DOVAuld the Unrtcd sulie" havc the rig'!hL klseckjwlicial
assural%:e,
The lindersigned ;"hill! I-equirc, lhal Imquoge WKS J',,llrance 110 ilickalod in tile
sOwmimets at WJ der,Q&ahn,g, Alhcootracls', v;ndon- sob-grants mid conl"I-'Id". under nild
c0q)VI-adve agvi:'ellleflts) and that, all nh mcjkms ancl conurawtors slud! provide Tis assurunce
aumAwo' .
0 C'ERIAW'ATION REGNRI)ING IlUBLIC 287.133, VS.
I'l-0Vi&V 110T,6) CQftil'ieS titan ne it I rzir it. not,anry, person or anvime or Pmwkkx. has bQQ'in conv I tQd ora PI Lblk�
1160 Cdow as detflu%d in -',ccr ion, 287,133, V.S. to phad on W cot" Owd x wWor Hsl.
P1`0A idef`klt')dQ1"StUl1d-,i 10 that it is recite al to Wmw WI&I Rnmadtach Upon Un' C111112C (W
Crf-CUIIISILIIICCzi regqvdiw2 this
F! ASSOC LATION OF CONINIUNITY 01IGNINIZATIONS' FOR Rri,'0101 NOW(ACORN) FUNDING
RKSTRICTIONS AS St..-RANCE (11"t It, L, I I]-1 17),
As as emWhkn of dw (IM11101, Frox ider assures that it "dt cwnply RM) "all the Wral fundin",
1510111%W P10"aulul,11(UACORIN' and its suhsidhirles ps 15(Ampolidatud Appmprimions A cl.201 M
)')i6';4111 l"-scclion 51 1 (look 1. 11 W 117 L 11w Cominuing Appophations ACL 2U1 1. WAS 101 Und 103
(Put 1. H 104 2 Y ImoUbs Inv a ppropr ial i till'. jundo ander Pub I.. I I 1-117 arc m aflahl", koiLlel-the
couditions provided by PuK I-. It 1 -1 17,
Page 39 of 66,
KCV0129
Ile londwAgned AW rcquirc that lurigunge oF;kkViSlJV1lnCC [IC inCIMIC(I in 1110 (11,M)OWflis Cor all
sukanhmcts at -ill ficr's M"Mnly, %eahms. s(th-pimnii UIW omtow 1"Wer pmn". limns anti
and Ito aH mh raoiems and uumumuns shall pawkle Lhis aisurance wardingO
FS
in o win iw alit.? e, in i th dle req il i rernell Is c)C S.Ct ion
M 135. FS. Pnivider hereby cenifies that it k nol, pWIkjNAlAg in a Qwt orlwad k newt Jklod orr
chhoAhc Scrtnitind Compiwks "kh AM ilie, in So&m liki, or to Sawittized CbmNmks "hh Anklks
in he Imn I'Mewn FrIoly SmkM ILL and dwt 4 Ins nw have huxinew qwnVhn6 in Aba ur SyHa.
000, HAS WV SCA:000 7 15,471, li' S
ProvI der uJI&JStands that In"sulant to Sudicai 287J 31 ins, the umussim, oral We cai%Won nvl�
subjuct Piwilder w civil pcnake& aluirnwIPs Gus, and/or coww',
anV ofilic Protider shall .111'a4:h all
exlyarladmi to this (Awnsact,
G CERTIVICATUM REGART)04; DA'TA INTECRUY WAMIJANCE FOR WNTRACTS',
AGREENII&NIN. WANIT. L(INNS AND RF1a,1VlF,1N'TS
1. The urakrok ww"act havc, 5owciol alianag-Colent
symems mMaNu oFproWdiHP MUM 00111WOR including: 11)mewan omnow wd smWK(e
disclo.�an%: ol'tho lbancid Wix of,wh powNirldcd Imiject or pmgram in amokatwe nklit die
ple-scl R)Cd reportiogy d2')'Ific sotnrcv and apl,)Fco0ol) of, ,nrld's jor alt coluraucl supporled
acdvidcs nnd 01 the civralmrimm tWoudays m4h buheted awooro.,, for eackatWtkrd Yke nurRiq tai
prxess inami"adw All ancordame to M We requKimmums could mml in as wnvn 4 gram Ws Tal
have alcn bimn accoinrltad fol, propo0,
2. Management hif'onmation tjSCCI I-Yy (IIC 'uj1o(jntl-aCL0l""' 't c'Vldor"' Or ally olositle,ontky
salt "hich A vrovkler A dMemkin Or dMa dwr k to ho wMwwd iramniNted cw wkvkRaL have bco'l
assessed and ve4°i5ed to be capWgc of lanxeshng dam occummQ. WhONgyu-dwe dqwWcm dam
l,"or fho,;c sswrrin hienolied to W lWWWUP41,01. Provider to 01 iske imunKme aelikin to ussurc WIn
hucyll",
3. If this contew includw the linwision 01,11ard"kire- sofl�Narc. ilmno,tw v� jinicl-cicodc or ijifl%�dded cliff)
whinniogy, the i"Werwigned m amnus 101 those products are etipM of tinnesing yom-W
de,pendert datla .,%u e,vi-sliorm orthow; pwdow tiff fed h3 IN., 11roo,it. (rclwes'erovd I-i) Cie
undoWignal)and purchowd I, be mme "ill he wrifind for accurnly and Atugh; of chla lWor to
tonson
-4. hi, the o,vent of fall;' decrease in llwrrliunahl� rcklted to 6111:und (kuC IVIMCLI QO&S Fund irtOTWIl
"tili'll'oulilles dial initpedQ thQ hardvary ur soWre progranns from o[jerrafing
properly, die Provitier
agrees to WwWacor ritake mcpdred couedions W sol"tware pro 'zrnl�" ni the`
sollic lCvk:l of RillaimaH, ws hcrcny at no chatio to dic iww. arld "Wrl ka-wPiUm 11,
the otnmlina buskess orthe Mato Lane tWhIg OC We VASeElCe.
5. Ile ProvkIer and any sub"wimcurrs ondor widors, under this t',owracl �oarlrnnil their
liolikJe' "alf"t raocodurres include a dimmer Pon to pno"Wo frfr S4�1.64:Q to t:onllakw far co"'v cif
an emeNowy hwWdkg an"pancies UAL,6"111 &Aa ijoc rliy conilpliancV k"riue'
Page 40 of 66
KC VA 129
1 L V K R I FI(-,'A'FI 0 IN 0 F E N1 P L 0 Y"E,N"F STATU'S CY,RTI FI C ATI ON
As u cmrdh6vt or emUrad 6, "kh the 11 orida DaImiucal ail Fldcr A I'li6rs. I Irov idc r ccj-611vs dic wiQ r-W
d vc U.S. DCPU"ricill (I f I I,ol nelad Smu A YW F-vvrl I) to vvvi f the cill pki,~1twil I C I ig,i'll i I it,) al,a I I
neNN vinpkt)ees himd hy Wc PRwWcr dwhy 0w cowract term to perforin (IL16C.S f)UNUaRt t0
dik canwwt and thin any sttbeonwo inchide an expe ass repiwinent Hut subaranwous andIr vudw,
paArtnNg "ork or pmvWbg services pursuant to this f1muiAct talke the P-werily morn iv vK11 the
urvoyrnow asph),oraii We" crapkices hhvd by the suhwmrwvw ampa NvAn wwwoweAke
COMM lurn,
The Provivir MwIll WqWw Iho dw Ingwye MICK uwKwArn be WARd in all sub-agrecrtions. sub-
gnat, md oHwf agmernmukuntmets; and M mh sAmmumnow andAr %onANY WWI eonHy complinco-.-
0"Ordwgly,.
I his, Cvr66wa6n1 i s ar lnlaLcrial r�11,rescvtativfn offnct Iqwn %w 16ch reharwc t%vrs phud "hoi ON hannakii
inns maWw allewd MY Wvnkshmi cX ihi, ification i,;l 1'1)f 1)l 0e1r iL;n,
hvipo.,;,Cd1 by ClwWws AVI02 and 2 CFR F%n 201L and 215 (Wrivrorl); W,%1B C,4vular A-1 10),
L RECORDS AND DOCAiNIENTA110N
'JIM PI LWider ujuves w nwke avAhAW too- DOPMPICUL Mundwor any pit my tkAgnmed by the Dopmhaera
any and aril t:ontirica vclatcd r t:cord,,Und dmumentm5n, nw ism kor Awi omwe dw emwan A
maintenmwe nfall proflrrof vani rdmvd inkrnraviov and dwMPOMMM no M, snfl Il �`;1%loni dcsii,-�?Iwwd by die
Wpummm. Makumance Kludes Wd expons and bacmqs of,itll data intid iy-slears nccordjw-� to
DeponNuent standnG,
,J, CEwriFICATION RECARIMNG INSPECCION OF' PUBLIC RF,('0RDS
1. In uddition w die uqui5vinunu M'swimm W. 1M2oCWcSmmWWnv;t0.and 11107010and (4)
KS. and any udwrupplicablc il'ackil action kcownnenced ancornornpiwed by 506on 11107010).
F.S. invi the Depament is ownwd in WuNd aokm,
Dcpmmou 1511- 311)' C(-,.,&`, 10eL11,TCd III be Depamnoll- and nny Wonwy-,' recs assossed ovmarded
the Wepanniern Kim a Flbhc RecuWs Rctpwi nimle purmoni w Chopwr. I IQ. US. omwend"g dik
conti ic,I ri,r sicrvievs perforraedi Ilherenindvi-,
& Nobt ithstaildiag Sco Wn 1 IWO 1. Ks. or adwr Florida I'm, 1h1s wction k 1101 nppl icahlo lo
coomw evouted hm"ccar Ne DqwNmeiv W staic orsobd N Wn dk0wd W
Section 768,28(2L F.S,
2. Secilwi I 1001(3t UK. states il"III&Irc ftnni,.k are expknided b an aogenk:� in paPe rncra ordocs or
qw nM jw""t cwpotyl4w. Rnindalion. il tto. nswochuki. proup. tw wher
wpitNAWL all We Awncial,Whiew and ;nwnhefsQ rewords ul-snidi wn My whielt lwrUdn fu 102
PMIdw agcncy(Florida Depar-taient of Elder AfEdrs) are pbk records. Secdow; 1 1407. KS.mines Wat
cvei-
. person �%ho Imscustody of SUM public rewid skall pen"it the rt%,old to hk,. and cupied b ,
any per;s on a)do so trial r rcasov�ahk,
Page 41 ol 66
KCV-209
Vpro wide Ar huth ode nal amburk ps,
Now0dal 590HIM 1100" MIUSS Mat fcccrds P"a"19 to the duestx-mevuborshij,applicatim lbd, the
AlIdnec and the Dcpmmmu are available for hispection as stated al,'Ow`c
My execwkn aft his cowraWt. NVOJ,41-111LUA inckde these pra&sians in A reWled s0cmifut
icable),
By cnaudon of 00 cuutracL-Vrovid'23'IjjkiS$iVJ'Ltdc tl'ws,L�provi-sio0',',(A-J) 01 Oil
aggrecovnts(if applicab1c),
By Mgnhg b0ow. Provider ccrti%Be mpmWcalbas OwlWed I � j ,,jjit)vc. gre krttiu and
Wo 0—r
Street Address
Munroe County Hard of County Coin missioners, IK e W - L 33040
IC10,11c,—
ip
—tc—i YY—, %I W—S t�3 -,Z�� d
WdW Name oat
NA ESOU NTY ATTOiINV
A 11110W 0, FORM
ASWT�,N INTY AATTORNEY
Dalq� 3129121
PAge 42 ul 66
KCV-2129
ATT ACAIME.N'T V1
ASStJRANCE,l�--NON-(*ONSTRUCT'ION PROGRAMS
PUblic relvoiog harden floc this,collectitin of inforination is.estimated to amage 45 minvws per response,kidu'ding
time foi-reviewing instructions, searching existing dU10 WLH-ces, gathering aricl maintaining (lie data needled and
v.ompleling and reviewing the collection of infivniafion. Sand regarding the htirdcit eslimkjteorany other
aspect of this collection of information, including suggotiow�for reducing this brj, 'den to the Office ofManagennent
and Bud tt, Paperwork Reduction Ptoject(,0349-0043), Waskingtan,DC 20503,
PL,HASC DO NNOT RETURN YOUR CM1PLETED FORM TO THE OFFICE.,OF MANAGEMENT AND
B U DO ET,
SEND ITTOTHE ADDRESS VKOVlDf,.D BY THE SPONSORlNG A6ENCY.
Note: C`.crl,ain ol'thow asslimuces weary not bcapplic�,ible to your prolim or,pro&,vj,m,, 11"YOU hUVC qUe'Sti,011S, rlleaSe
contact,the awarding M - 1`CAl,LJirC applicants to certify to
mtency� l7tri-iber, cct-Wn Federa� awarding vgowics ma,�
additional assurancm If Such i� the Case, yr."lluwill be vrodfietL
l Has the le gal audlotily to apply Isar Federal assistance, and the institutional,Ina rragcrial mid flaillicial copab llty
(including funds suffir6mit to pay the ncm-Fcdcrat share ofprxnpect cost) to ensure proper plarming, management,
and complefion or the project,described in this application.
dill L7
give the awarding,ago ley, the com twller General of the Likiited States. and irappropriaw, tliv Slate,
through any auffiorizcd tvpreqclitative,access to and the right to exarnine all records,books, papers, a,r
docurnents related to the amardq and will estiblish a proper accounting sys(,em in accordanco. a01-qpnzirllly
acceptcd accounting standa,rdb,or zqgemcy dli(;djve-q,
1 Will establish safi-,guards to prohlb[t Cn1p10VCCS CrUln LI'Sin"their pusihons fni-<i purpose that coosti4tites or
prescrits the appear-aric,�ofj)er,,,,onM or orgagiizational conflict of interest,or persona[
,4. Will 'Minate and cc)mplete the work within the applicable 6nie frame after receipt of approval of dic wkarding
agerwy,
5, Will cramply widi the)rRergovervullmtal Pcr�,urinel Ae� of 1070142 1,J,S,,C.472847630)relating to presv.fibcd
sumrdards fcrr n-terit qstcrns for programs runded under one or oic 19 s[ztutes or regulatioms speci f1ed in
Apptndix A,caf OPM's Stind4,,irds for a Merh System of Penqortncl Administration (5 C-PJt 900, Subpart
Will comply with all Federal slatuics relating to,nondiscrilPination,These irictude bla are not liraaptetf to: (a.)Title
V1 of'the C44 Rights AcC!of 11464(P.L -,3i2)yxllich prnliibitt discrimination,or) the basis ofrace,cator or-
national origim (b) 'ritie ix orolp Cdxwion Amendments of 1971 as amended(20 U,S.C, 168 1-1683,dfld
1685-1686), which prohibits discrimination Lin (lie basis,of se\; (u)Seerion 504 of the Rehab![416on Act of
1973, as amended(29 US�C 794, ),which pruhib;%,discrin-lination on [lie basis(if handicaps; (d)the Age
Discriminmion Act of`l 975,e6 amended(42 U.S,C.6101 -61 07y wkidi prohibits discri rill nation on tyre basis of
age; (e)the Dn.tg AbU5e OffiCe �3rld '1),ealnlent Act of 1972 (P,1—92-25 5),as amended, relating to
nondiscrimination on the basis of"drug abuse� the C0171pre1'lellSiVe Alcohol Abuse and Alc(,,)hoksnl prevention,
Treatinew and Rehabililitinm Act of"1970(V,L 91-6 l 6), asamendod,relating to norujiscriminaiinn oft the basis
of alcohol abroj.w aralcoholism; (V,)523 and -527 or the Public Health Service Act of 1912�42 U,S,C,290 dd-3
and 290 cc 3),as anicrided, rclating to confident4flity of alcohol and dlmg abuse Patierltr re`Ordi;(11)Title Vill Of
(lie Civil Rights Art of 1968(41 1 L&C, 3601' et,seq.),as amended,relating to in 010 Sale,
rental fimarci'ng of housing,(l)any rather nctnttiscrirttiaaamttcarr pruv sions in the specific statute(s) under which
apphcmion ftx- Federal assisitanctis beirig madel- and(J) ihm of any other notidiscriminatioil
stattite(s) which, may apply to the ay),plication,
7, Wili comply,or has already complied, wiih the requireatents of Tides H and fit of(lie twirorlil Retutudon
Assiman,ce and Real Property Acquisition Policies Act of 1970(P,I,,, 91-646) which provide flor fair and
equitably treatment of persons displaced or whose propert.,v is acquived, as as rcsul( rX Federal or fiederally assisted
These i progragns. -equiremerits apply to'all interests in reiii property acquired for pro ect purposes, rcuardle—ss of
F'edcial p,,rwicipaitiori in porchascs-
Page 43 of 66
I<CV-2129
& Will comply,as applicable, withithe provisioniofthe Hatch Act(5 U,S,C', 501-1509areal 7314-7328),which
limit the political aelivities of employees whose privcipa1 CMPIDY1nCnt activities are funded in whole-or in pan
with Fcdcral'funds.
9. Will comply,as applicable, with the I)Mvislons of the Davis-Bacon Act(40 US,C,276a to 2'76o-7), the
Copeland Act,(40 U.SC.276c and 18 U &C. 874)and the Contract Work HOUrs and Safety Standards Act
(40 L,J,S.C, 3 7-333),regarding labor standards fear f" dcrgWy assisred construction sub agreements,
10, Will comply, if-applicable,with flood insumnce,purchase requirements ofScQtion i 02(a),ofthe Flood Nais,,tcr
Protection Act of 1973(P'J_93-234) which requires,recipients in a special flood hazard area to pulicipate in the
piogs-arn arid to purchase flood lasUlAnCe, irthe total cost of insurable construction and acquisition is $1 0,000AO
or Inl0re,
I. Will comply with environmental standards which may be prescribed pursuant,to 6iw fbllowing (a)Institution of
environritental quality control measures under whe Nationa.11 Eirwiton,mental Policy, Act,of 1969(P,L�91.190)arid
EXCUitive Order(EQ) 1 15 11,,(b)notification of vioLating facilities purstiont to EO 11738!;(C)protecLion,or
wetlands pursuant to 130 119,90;(d)evaltAtion uf flood hazards in noctiplains in accordance%i,,ith 50 [1988,(e)
assurance of project con istency with the appi,oved State manavement prograro develol-lud under thr Coastal
Zone,Management Act,of 1977(16 U.S,C. 1451 at seq.)l,(f)co`n�fbrmity or recteral actions to State(Clear Air)
Iniplernentation Plans under Swion 176(c)of the Clear A4 AcL ot'1955,as arnended(42 U,S.C, 7401 et scq'),
(9)prolec6on of underground sources of drinking water,urider the Safe Drinking Water Act of 1974,as,
amended,(P.L. 93-523),,and (it)protection of endarigered species under the Endangered Species Act a f 1073%
as amended,(P,L, 9J205).
127 Will cotnply with the Mki and Scenic Rivers Act of 1908(16 (IS.C, 1,721 ei surf,)related to protecting
components or potential components of the nationai wild and scenic rivers,system.
13, Will assist the awarding agency in assuring compliance w+fli,Section, 106 of the Naticiral Historic Preservation
Act of 1 ,azi araended(16 USE, 470), F0 1 1593(identification and protection orhistoric properties), and
the Archaeologicai and Historic preservation Act of 1,974 (16 LJS-C, 169,9-1 et 6eq.).
14. Will comply with P.L.93-3148 rcgardng the protection of iluman subjects involved iti rcscarak,devitlopmeni,
and related activities suppweii by this avard,of assistance.
15, Will come ply with the:Laboraton, Animal Welfare Act of 1966(P,L 9-5,44,as arntended, 7 LkS.C.2131 et sjq.)
pertaring to the cam, handling,and treatment orvw,anr, blooded animais field Ibr rcs,carch, leaching,or other
activities:supported by this award of assistance.
16, WN comply%vith the Lead-Basied Paint Paisoninig Preve4on,Act (42 U&C, 4801 et seq.),which prohibits the
use of l&ad- based paint.in construction oir rehabilitation of msidcncc structures,
t'7, Will cause to be performed the "Ltire.d Fjoaricial and complimee audits in accordance with the Single Audit Act
Amendments of)996 and 0,MR Circiflar No, A-133,ALdits of States, Local lGoNvninialt(s, and great-Profit
orgAnizations,
IS. Will comply with all app6cable rcquiremems of all ather Federal IaWs,,executive ordcm, regulations and policies
governing this Program,
SIGNAT TITI-1,URE Or
7)
JOL, AA_/
APPLICANT ORGANIZA"rIoN D A T E S k J,A M,J1 I ED
MONROE COLN-ry BOARD OF COUN"I'Y CONIMISSIONERS',
SOCIAL SERVICEYIN-HOME SERVICES 42 q'1e_;'A?,
...........
IME COtt YATTOPINEV
Af!PAQVEL1x 'I J T FICIFOA
Page 44 of 66
PE040
ASSIST rMAW ATTORN,EY
3/29/21
KCV-2129
ATTACKMENT VII
CONTRACTRUDGETSUMMARY HY SERVICE AND TITLE
CIRTS SUMMARY FOR THE AGENCY
Service Unit
Services to be Proved id Utlits of Maxillimill Dollars
Rate Service
-Lmlarelvale Wals 9.00
Coca greple Meak i I,T y 9.0D
Mcal s Guest
Volunleer M)o
Emen,ency C'migrematc Mcals 9,00 1 Is 9.rx)
c eg Meals Screeniry S 20,00 -00 20
Nvoifion Coq ch S 7 0.56 1 70,56
Nutrition EdLICati011 ii 00
------------— ---—
Home Delivered Meals 14, 0 70,850.77
bnwr,ppia,Sale!I'lionic DcfiverTd Neleak 6-5" �
—L).53 -, I 6,53
_.Lkreenint4 an4 A�sessment 2 6,22 1 S 2(5M
Shoppitug Assimance CV X90 I 30,90
Feleph011e [WISSUrance CV r, 7 1 $ 27,37
TOTAL 71,051.35
Page 45 of 66
KOV-2129
ATTACH M EN"I' V111
CCAA CONTRACT REPORT CALYNDAR'
ADVNNCE BASIS CONTP.,kCT
Report Number Brised Oil Submit to Alliance
orl This Date
I February .Advancc,* VCbtU,ary 61,202
2 March Advance* Pcbftfary 6,12021
3 rcbruiwy Rqxsll. March 6,2021
March Expericliture Report A Imi 16. 2021
AprH Expenditure F�eporf Kay(), 2021
6 May E.xpunditUre 1�cpxm Arm-6 2021
7 R;me E,xpenditore Report July 6, 2021
8, JWy ExpendilLWO Report ALIgu5t 6,20-71
9 August D(penditure Report Septewher 6, 1-0�I
10 Septeoiber Expundia:trc. Rcport Omber ,2021
11 (,)ctt)bc,r Fxp,=Witure Report Noven*er 6. 2021
12 November i~xpendittire Report Deccm cr 6, 2U2 1�
December Expertclitum Report Janflar'v, 6. 2022
Jan-ocir), L"Xpenditurc Report Pcbruary 6, 2022
151 February F--x9endituve Report March 6,2022
16 Marai Expenditure Repoti April 6,2022
17 April Fxpendiwrv� Rep Drt May 6.2022
18 May Expenditure Report Ju ne 6,2022
19, Jane Fxrw.ndiwre R.eporl July 6, 2012
July ENVendkore Report Augmsi 6,2022
August Expenditure Repo.s,t Septtrnber 6,2,022
22 September CxponcWure, Report October 6, 202'
21) Hna[ Expend4ure and Uose Out Ruptio Omabeyr 15. 2022
Legerld * Advatrce based on projected cash need.
Note is I Report 01 for Advamc paws Agreeniwits cb'mnot be submittod 90 the Dcpm-trnent of
Firmn,6'al Services(DrS)prior to Februat), 1, or unfil the agreement Avflth the Alliance his
Wen"e-cuWd and a copy sent to DFS. Actual submission of the vouchers to DFS is
dep')elldCAI On the-ACCUracy of the cxpenditure re,port.,
Note ti T Repcyrt nunibers 5(hrotilah 22 shall reflect an aq�ustrnem of enough fund.'s to repay adviinces
M.
issued the first two montlis of the agreemea The a4justalem shIM be recorded im the
properniva refute billing forms.
1" ote,03� Submission of e,xperidiwrc reports may or may not,gerwate a payment request. Iffinal
expenditure report neflecLs funds due back to the Ailiance paymenr is to accomjmn�,the
report
Page 46 of 66
KCV-2129
ATTACHMENT IX
REQUEST FOR PAYMENT
FORM 10,6
Coronavirus Consolidated Appropriaflons Act
Nutrition Services
'riPE OF REP DR7,
PAWDER NAIVE,ADDRESS,PHONE&FED 10 NUMBER
Pro',Jdarr Na me: convau P0600:
provoer ditss
.. ............... ..........
R el rnbur eM -q Roporl Period
pfoydw Telephone:
C RIIRCAYQN: I hwebycewtifylu Ifie bQ5 lormyknuwladge thUrldliG IeqU'Vfl conforms wibi thu turms and Itle puTposes
uel,Wh in Pha abovt canlfarL
pmpardd Owe
Aq pro Ved By___
BUDGET StAJAARY TOTAL
CaMraetAmawffl
2.Premaos Faradn
A,6.r-E I vt'0
3.Ptavious Funds
REQUESTED and
Not RecOved.
---------- —---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------
'4 Contract Balance
Net Expend ku res
Foie Wiih
PSA#I I CCAA 136 Fqw,Frib 202
Page 47 of 66
KCV-2129
oronavkus Consaildated AppropriatIo ns Apt.
Wwu4��k��ri er+Jt,�Q,
pM^;dS;lINGAOURC kil i9 P��i P BSSS~ .
$4
'Pimp aped tvw---
d Cs!Mrpc4 SsprWtt'�,
Cmndrac9�. Sl
�iRt9
'u � � �1 WaoA M�4 i>'a�a�9 WE mN l�A^Y3'hd bd0a'�n�.�Wi+6dT 9w G'M6 raWpIAf9N A�a��7BSaLN as�C$,tA w vlaPnlf Xu6 N41�Ny9;ib Mnah�&of a pn jr•`rrtSeWW�k b tlU kltlC�'la
dWw rrSrMlp uaA SYmnSa at,B na i5�i HnaW anm a�xuied rvnaia2'.3y aYtid`w�ii.Y aaniaea ua+7M'�aeW+,rwMe Marl Nw@e nAa`nnle�at Yw canracw.
wt+IC47 MiS 3&:R. F+'6'fi A A d -T .� .w-
— � Tawrd�14wInU w� ��.of mpCw'a�✓ga
xou to Gash raingas PM pr Mg 94COIpss J9F
t,podctal M`+t+s�dk ¢ S 9 #GpiXf
P> �wdeca� e�r,a mar n�
Aarr��s are ade
�:7t��A� s a SN�h1lal
"NV big Wrm cunt P.opom UnAmpliialod CIi R%Ur"4
N M (r) A CE 1 Pa lib A N?
nmauN Wits "I"h s peflad &,wwaa=lr bib bct Lind#Or"Is Jrwvp;ji4,qts
�.
VO04ai Ml+neptv&+n.d+r8"mar°PY�w1
S
F7£JGY.if S '
hFUrFp S d
S '3
EHDMt i S
PAS F91 eGLP y lei Xul
Pape 48 of 66
KCV-2129
ATTACHMENT B
STATE OF FLORIDA DEPARTMENT OF ELDER AFFAIRS
CIVIL RIGHTS
CQMPUANCE
CHECKLIST
ProgramlFac0ity Names Monroe County Board of County
Commissioners, Social ServicesIln-Home Services County:, 11110voe.,'
Address; I[006JftN-QWC0t-r -"rr 6kxi+t)' TM ompleted By: K;r�, 6YUKem
C ve4pv-
Telephone:City„ State, Zip Vks4� R- o 14 0 Date: 11=qzo?j
PART'l,
READ THE ATTACHED INSTRUCTIONS FOR ILLUSTRATIVE INFORMATION WHICH
WILL HELPYOU IN THE COMPLETION OF THIS FORM.
I. Driefly describe the geographic area served by the prograrrilfaicilRy and,the type of service provided Tke 'ehRrr---1 Rvw4
V-4-kV L
2. POPULATION OF AREA SERVED. Source of data
% %
ki?nt-1 !& %
3 �,STAFF CURRENTLY EMPLOYED, Effective date: 7aw
-�isip`- T d2j
Black, 0/. arlic ile7 11/g,D�sqble
4, CLIENTS CURRENTLY ENROLLED OR REGI STE REO Effective date:
%Slack %Hfparjc er 0
% otf
6, ADVISORY OR GOVERNING 90ARD, IF APPLICABLE.
%White too %Black %Kspar,�c %Femal+wl %Disabed
L2��L -,L—J—%�Ot,"r—0mer I
PART IL USE A SEPARATE SHEET OF PAPER FOR ANY EXPLANATIONS REQUIRING MORE SPACE.
C. Is an Assurance of Corriptiance on file with DOEA? If NA or NO, explain, NA YFS NO
7, Compare the staff compovilon to the population is staff representative of the population?
lif NA or NO, explain, NA YES NO
8, Are elig�hflily reqUiFements for serv�res applied to clients and applicants without regard to race, NA YFS N0
color, national origin, sex, age, religion or disabililly?It NA or NO, explain, Ll
Pagp 49 nf 66
KCV-2129
9, Are all benefits, services and facilities availaUa to applicants and participants in 2n equally effective manner
regar(fteSS Of rare, sex, color,age, national origin, religion or disability NA,, YFS- O—It NA or NO,ekplapn,
'i For' In trade services, are room assignments ade without regard to race,color, national origin or disablRy?
NAYES_ NO— If NA or,No, explain,
1 Is the PrOgrBrIn/factillY accessible to non-English speaking clients?It NA or NO, explain.
...........
12, Are employees, appficarils-and,participants infortned of :)ear protection against 6SWimination?
if yes, how? Verbal Written Poster %A or NO, explain,
13, Give the number and cauen't' status of any discrimination Complaints regarding services or
employment filed against the pfograrn1facility.
14. Is the, progra 'ffaciPty physically accessible to rnolbikty, hearing, and sight-impa[red individuals?
NA_Y E 5 11 NA or NO,explain.
P'ART Ill. THE FOLLOWING CIUCSTIONS APPLY TO PROGRAMS AND rACUTlE5 WITH 16 OR MORE EMPLOYEES
15,, Has a self-evaluation been conducted to identity any barriers to serving disabled individuals, and to
rrakle any necessary modifications? If NO, explain,
16. Is there and establish grievance procedure that inrlorporates due process „n the resokition
of complaints? NO If NO, explain.
..............................
Rage 50 of 66
KCV-2,129
17, Has a person been designated to coordinate Soration 504 CoMpliance activii4es? YES,/NO._ If NO, explain,
18. Do recruitment and notification, materials advise. applicants, employees and participants of
on the basis of disability? If NO, explain,
19, Are auxiliary aids a flable to assure accessibility of services to hearing and sight impaired
individuals, X1,
NO— 11'NO, explain,
PART IV
FOR PROGRAMS OR FACILITIES WITH 50 OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF
$50,000 OR MORE.
210. Do you have a written affirrnafive action plan? YFS 440_ tif NO,explain.
Page 51 of 66
KCV-2129
Alliance USE ONLY
Reviewed By In CompHance, YF-S NO*a
Program Office *NolIce of Corrects e Aotadra Sent —r t
Telephone Response Due
cote
Cn.&te Cl desk Rova w 0 Response tieceaved
INSTRUCTIONS RUCTIONS IUR THE `IV'IL RIGH'I*S COP4r PI.J NCE'r CHECKLIST
I: l tmdbe ilie geographic service area m ch aas as district, county, city cat°other locality. If the
frrc°r r°arraafi ilitiy serve,°s pa staeaa• l)w,var eyt laa�faidwion such ra:; aadolesc+ams. describe tile'taarl
popultati(waa. . .w.define the type or w-vi e provided.
2. Enter*dw percent Of the POPLIfatr n served by race and sex '11c, polattldation served includes persons
in tlae cogrtapfii"lI arc a for which services,are provided such as a city, coa.nTy or other mgional'.
aarc:.a. Population statistics c:ata be obtaaiivd from Iran:<al ch ainbers, rafconarn rce, libraries, or any
publicallon from than 1991)Census comaining Florida fit'pula6cm stalistlei. Include flee source of
your population,statistics. ("Other"races includeAsian/Pacific Islanders and American
IndiaalvAlaa.skaan islaativcs,)
3, Enter; the total number of full-tin-je staff and their percem by race. sex aml clisabiHty, Include the
c ff�ctivc elate of e 4atar s,urnrnz ry,
4� Eater the lrataal rmuml�er of'clierat" W1"o<ar`e eaaa alleLi, rep'stuarcl cn can't ntly .served by llae l raaeaaara car'
facility, and list their percent by race, sex and disability, Include the date that a rraa-,Vallitient was
cemented,
5. Gnier the total taaaniber a f advisor'y lota:.tad members rs and thelir pera:era by aacce,so.N,and disability If'
there is no ncivi spry or governing board, leave this sec°tion blank-
fi. Eaac]-c recipient tal`federa] f naanua aal oss.istaance must have on. Isla~ an aa-miraaac:e thee( 0w pwgttaiga -"v 11 Its
conducted in cc mpkan e wide all a tondisc:rimiraaatory provisions as required in 45 CFR 80, This is
asualty a standard part of the ccarata°ac:t laaragaiage liege`DOEA recip e1's and thoir:sub-grasaaaces, 445 CFR,
414 ( ,)..
7. Is the race,sex, and national origin ref"the staff reflective ral„[he gee raaI poptclation? For marraple, if
10%of the; ptapulatinn is Hispanic.,, is thkcare a comlaa,ralAe percentage of Hiss ark staff,"'a
Whet e there is as significant vmiaation between the race,sera or ethnic composition of the c4ents and theia°
availability in the ptapt4lat"Ceara, the prragr�tmlfcacdiry li as the rresfi°onsibUily°to det�,raa°aine the re a�rraas fr,a°
scacla varrialion and tame whatever,action may be necessary"to correct ain), discriaaaination. Some
Ira"gitiraaaat:e disparities may e<xist when programs are saawiaoned 4o serve target population's saich as
eldcrly°or disatbl.ed persons,45 Cl"`R
0.3(b)(CS),
paf r^52 of 65
KCV-2229
Do eligibHity reclGiremems unla%vlluliv eKCILI& PeNiOrs in protected groups 1rom the provision of
services or omployment'? Fvidence of suck may Lie indicated 1wiWiTand cHent representation
(Quesitions 3 and 4 1 arid,also UITUU,�'h cart-site record analysis cal-persons wko api")lied but wvere denied
services oI. Crop'[0yj'141 crit,45 CFR 803 (a)and 45 CFR K I (b)(2),
10, Parkipants or clieras must be prOV led Sel'ViCeg iUdl as medical.nursing and dental,carc, htborato iv
tervi".LL" Physical and recrealiorlat theMPles' c-oullsefing and soc;al services without rc.L,',arLl to race.
sex, color, national origin, religion, age or disability, Courtesy titles, appommient scheduling and
accurtricy of record keeping MUS1 be applied unifurnily and w4how rugard,it)race, SCX, Cjjjorr' jjatj()jjaji
cnigin, reli-ion,a-e or disability, [IlLraoces, malling rooms,reCe pticil-7i"ll-Cas, restrooms and other
C, I"
ft-licilifies,must a[b'o be equally ;Availabte to all clients, 45 CFR
80.3 (b).
11, For in-patient scrvices, residcnts must brr as,sigricd tio rouins, v,,ard , etc- withokit reg�ird to race,
color, national odgia cia' disability, Also- residents most not be asked whether th,ey are willing to
share w0111 persom,oki.differeat race.color,national origin, 45,CFR
12, Tho progiam/ricility and all ,�Crvicv's Rllu""l be alcca ssil,le to paiii4;ipants and applivarits, inektdlng
those persons Who may not spcak [In lids, In gcographic arca,,; kvlicrc a srgril ricant popraWion vC
non�Engfish speaking people live, program accessibility may,include the ea p oylilerit ofbiling"rua'
staff. fn Wlwr areas, it is tad4f icnt to havv as policy or plan for service. WCJI as as CUrrer4t list OrIVIUCS
Zind (U[C[.)hUYIC numbers of bi liTI'l-WIl Individuals who will assU.,i,[it th-. pirowisiofi orservices,45 0"R
803 (a),
must make information regarding the nondiscrimi'llatory Imwisions of'IA[e V11
avail,ible to their participants, benefliciarios or an other 'ra.crestcd panies, This Nh,vuld inkdkide
Information Lill their right to isle as complaint of'disci irninm[ori wWi either the F 106da.Department(if'
Elder Affiairs or the US. Department of HHS The inforniatioll, may Nye supplied verbally or in
writing to every individual,or may be supplied thrOLigh 1110 LISQ Of all equal opportVC11(y potic), poster
displayed "M as ptiblic area of the facility, 45 CFR 80,6((J)=
11 4. Repon 11LIMbOr OftliSrrinninarinn complaims filed agairist the progrart'iffacilky. Indicate the basiis e.bj-
raca,color, creed, sex, age,nadonal origin,disability. rctaliafion.the issues involved,e.g.„ c�ca
r
C
cniployrnent,placement,rermination,etc, Indicate the civil righta law or policy alleged to have tx-,cri,
%r kilated aalorig with die il"It'ne"HI'd ai.Jdress (l'F the loc.,,11, sl me or Federal agency %6 th whom 111c,
cornralaiint has hPoen filed. Indicate 6e CLn'F"ent SMIUS,e.g., sealed, no reasonable caU.W I'DUnd, faiture
Lo conci I late, failure to cocaperate, tinder TevieW7 etc"
15, '111W prograo'l/faOility lnt'rS( be Physically accessible to disabled iridividtmls. Physical accessibility
irlCkldes ciciignated park-ing areas,carb cuts or level approac lies, inirnp and adeqtiatc o'idths to
ciArances, The lobby,public telephone, restivom faciiktics, water fountains, information and
admissions,oMces ShOUld be accessible. Door vvidills and traffic areas of administrative nMceh7
cm,fictcrias, restroom5, recreatioll areAs' cownters and serving lines should be ob5 Lava tc] for
iccessiWity, Elevators should, be obsefvcd for door width, and Braille or raised numbers,
Swiiclie5 and controls for light, heat, venWation, fire ralaarraas,aad other essentials should lx-
installed at art appriopriate her lit mobility lixpaired Mdivjdtla' ls,
16, Section 504 Q,f the Rohabi[46on Act of 1973, rquires thia a recipiew o reder,'Al financial assistance
condoci as set f-eval unt ion to nny accessibility harrivri,. Self-evaluafion is as four -step
Paige 53 of 66
KCV-2129
proce.qs:
0 With the a.55istancecif`a disabled individvaklorganizition., evaluate curront practices and policies
which do not comply with Section 504.
Cj Modify pokies and practices duct do not mcet Section iO4 retjuireniartts�
D Take,remedial steps to eliminate any discrimination that has been identified.
ay has used to satisfy this requiiernet i '. e 1'-,1 Mainiain W]l'QValUR(JQf)W IHQ,(This chcAlist m, it I fl) Ss'
four steps have been foHo%%-ed ), 45 CFK 84,6
17. Programs or facilities that ernploy 155 or rnore persons must adopt i grievance procedurcs that
incorporate appropriate due process swndai°-ds and prtwide for the prompt and equitable reSOILIIi011 Of
coniplaints alle6im,any action probibiw.d,by Section 504A-5 CFR 84.7(b).
0
18. Programs or facilities that employ 15 or inure persons MUst, designale, at Ica.qt one person to
coardinate efforts to,comply with Section -504,45 CFR 84.7 (a).
19, Continuing steps must be taken to notify employees and the public oC the program1facility's policy
of Tion(Lscrimination, on the basis ofdisabi ity, This includes recru&nent material,notice.", ror
hearings, newspaper ads,and othorappropriate written communication, 4i CFI 84.9 (a).
M Prograrnsllacffities that employ 15 or more persons must provWe appropriate auxiliary aids to
personsvvith impaired sensory,itianual or speaking skilk where iiecessary. Aoxililry aids may
Include,but are no( knilled to, inter-pre(ers f6j"l'jL'j'j-ijjU H-oPEjjj1o(I M(IIVIC[Uak, uAped or BrallIc
rnmQrials,or any alternative resources [hart can be used to f)MVide equally c tli~cd vc services,('15
C F R 8.4.-5 2 (d).
21 Progranis/faciliries With 50 or more empdoyees and $50,001, in federal cowracts must develop,
miplement and maintain a written affirmative action compliance prograRl in accordance with
Executive Order I V 246, 41 CrR 60 and TiLle VI Drthe Civil Rgbts Act or 1964, Lis ai=nded.
Page 54 of 66
KCV-2129
ATTACHMENT 0
BACKGROUND SCREENING
IIJ 0 F R A Ir,VA I R Affidavit of Compliance - Employer
AUTHOPIM This fora,is "Uiir*—dMnll&0Y Of ag",ployer,to ttttpdywrtt "ittastation
oquirimnents Pat forth in ract;on 436,0415(31,Flocida Seattat
rx- toltm upip"er, Maaw a porsori of onivri r"pows by faw w conduct lb t,' trti„wd 'scrwlirrg'
anti sorws eo PWAdeXs thlP 6ep4sr"'*nt Of 5dDr&V2ifs(COrAlf,aall
anv OwT person Ot antitY whkh kh"re,-amploytenr hZZ vMunt"K nj4et th*delrWmn
of,a dirt genke piqVdW 435,02,430,,WZ,Edgy, tat;
4"
s, A d rOtl SefVkff PrIP604f 4 ')PM E011 10 VeDr5 Of 80 Or dl'dPt'Wh'a, pu sire to a progra"I to pTVUd(i
"'erri[fit to tj*, *k$rrOy,has drecs,facet-to-taco contact wih;p 0i"t WN4,pravizEr's,swv ces,to TA&46ril
and has aa:az%a the tfierrV 11hewag ou,ea, "Unds'P&WAMI pluperve,04 pemonad Ida naafi"6104
as d'ofinV4 in 3,317 563,The,TwM wrludii;c"rdinwors,marnagers,mvJ VjpW'AWr3 Of
artrivaluntrars,' 4,%m=2ii)i1n),Fla-SM.
&UMMMI
As tht duly 4utliw,zed f*Vra,4fitatrVe of-- Muk'rc"e'
ef"XIM,
ia-awd
SIAV Or,AMMI cxjr attr 'Vp e add
o fm reby 614'yffii uj%der peia rrj a pQrj,ury
,,hat the,4bowo nannod ernp!oyer rr, in e %0akh ZKQ prow-',r_rjn uf Cj-�.apler 4, 5 and 5*M. an
_70 1 a e5l reca 43 jp`Oe,� st m , rd-m,..wvwz,!bacvcroundg,rteniriv,
Ive
STATE OF F-LORMA,COUNTY Or,
Sworn to jor affktned)and SULMU&-4 WON We U11%& day,of 20
�_(ftrtvie of Who
to nit or pe 00'u pr u-W of Weriffkatrom
LONOSEY BALLARD
MY CIONVA&SION#GG 970OW
FXPIRES:JUjY 6,2W4
roEA PM—zzs'Amww�;k ar zj"7DI9, qrr 'IVA,Alai Pubda UM
NFIOE copury AmnNEY
A" OVEQA FORM
MR,M01 MIMICA
A UNTY ATTORNeY Page 55 of 66
Date-
KCV-2129
ATTACHMC-NT F
?4*111211ee for Aging,[sic.
Dau P rivacy an di,Seem rity 10tisitiess Associate A(greement
This Ausiness Associate Agreement (13A Agreement")is chrocd by thq? Allijece ror Aging. Inc.
and NIGnme CoutttN Roard of Fortify (,'01nmiAssic,I
Mi-Rome Soirvices, ("Business
A,ssaciatc"),a not-for-prorit Florida mporation,
1-0 Backg roue 4j.
1.I The Allimia has enlered info one or,more contracts or auul^oettaetats wigl,a BLjsjjjC.,; ('I'erviice Argmement")
th,M involves the mv oif Pi(,Aecied Health t6ormafloo 0,111).
2 ThQ Alliarxe, rccogniz", the requitenien(% of the FIcOth [tisonince Portability and Accouniabilky Act of 109,6
(T U.PAA)taid has indicated its intelit to CoMptY in,flrt:County's Pohicies aud Procedures.
1 3 State and federal laws and regulations mity esubllsh spier:i fic covididons Do when.and how covered entitics may share
intbrmation with contracti-,irs who lim,form functions for the AINanec and how Ow 446rination niom he kcp[privalo
and secure, and lic)w individuals must be +tvetl act *s to their ilttkmnadoo, Such laws mW riles, to the u%'tcnt
applicahle to the Service Agreement, will he referred to in this BA Agreemew to the C waitl cleaaticality Laws,
14 The par6 s wisli to enshirc flutt all individually ideatitiable health infcawaliun cm otkur pei'souLi!I dmo ttsvel, wod
dk erased pursuarit to the 5iervicc Agreement is kept sc(;vre and use and disiclowd etinly as permitl dby the
ColirldLmhatily The Health Insurame Portability mid Accouniability Act of 1996 and its implementiag
regulations("URPAA")and the Health Inl6rmnlion Teclinotog Rr Pcowinic And Choical 11a:a4t AM2009)and its
�y
implementing reguladom,fecluirc business asst.)Jaws of covered endtics to comply with the 11117AA Securky RuIc,
as set l6rth in,but vok limited to 45 C�KR,§§ 164-30K t 64-3 M i64.31t,2,and I 64,3"16(NOQ�and such seclinlis 911-all
1313ply 10 R bLtSiffi^s.S. I$S0Cj4IC ofa Covered entity in rho san'te tn"Iniler Ota"I "..110 sutioni apply to the onvered m6ly.
Ntwfier Alliance nor Business Asso,-iuw admrtt Iflat dicy are subject to,these Im tnw werthelwss Intend btat
PHI:, its defined below, will be HSLd by Utisiness Associate only as cantepiphated �y HIPAA and the I FITCH Act
and as permitted by the Confidentiality Lm-s,
The parties lhcrefbre aitrec as 1�41ows,
41
2 A Deri ritions. For purpows of this 8 A Ay rcemeiml he fbl towing defii n itions apply in addifiesi to defini lions elsew sere
in the Agreemear
2A Acces,,4, The ability or the oteans necessat), to read, kynte., to , w,conimonicatc data/information orotherwise
u,se atty S Srorn
2.2' Ntlniinistrrifivr Sateptards, The adminjsra6ve umons, and prilicies ava proczdurcs. to rinzinagc the sulec6on.
development, implern Coll al ion, and maintenancc of security
10 prolect ckcts-06,c Protected Health
Information (ePIR) and to manage the conduct of the entity's workfomc in relation to, the prweciiort of bat
k4orniatiorli.
2-3 Authentiention. 'rhe wr-rohoration deal i p rson Is(lie One clamicid-
14 Thk property that data or, infuniation is accessible and us bile upoia demand by 311 4IL0thcsHYtd prson.
215 Dr-each, The unairthorizcd ai;,qalsition accessit wlmh compironsisci the serurky arprivacy
Of SUCIIr informat4art,
6 Cmifide,nOinlify� The property that dava 4"br infonnatiop is J101 made ivadable or disclosed to unauthorized porsoo5
or princesses,
Page'56 of 66
KCV-2129
17 Infornmfion System, An intetCOMIUded Set of information mourcus under the same direct inamigenwit controf
that shares coninum functionality, A symem normally, includes hirdware, software, informatiun, dati.appfications,
commu,nic,itions,and Beep! e.
18 Integrity. The property that data or isirornurrion have nor been altered or destroyed in an unatrThorized manner,
Z. 3111ficions softwrire. U Z Vifu5,&Sj FUf�l s M.
_�TWd 10�41110,gC(11'65, s a syme
2.10 Passmorct Conriduntill authentication information comilosed ofa sl6rigol-characters,
111 Physical Safeguards, The physical measures,poEcies,and procedures to protect an entity's electronic information
syslenn-i,as%yell,as its buildings and equipment,from natural and cnvironmvnml I'uvards,and unauthorizM intrusion,
2,12 Privacy Rule, TkQ Siamjard; f6r Priva,uy of IndiviJuatly ldcudfiablo f1talfli Information at 45 CFR NO 160 and
Part l04,Subparts A tend V-
10 Protected Information. (Pill) Personal facts aboLfl individuals, inclucS Jtg
defined in 45 C17R l60,103, rmfical records sobject to Swkm 456,057, Florida Smwtn, hospital records subjccl
to -195.3025, Florida Stalutes,custonler records and personal Informatic)ri proteeied under Section 5011.171 Florida
Statutes,alld whirr personal dam,whother in p,,p r or Orctronic form,5vbjeci tostatc at fadt:rM laws or tcgulaOns
jrniiiagg uw or dis-lo-sure,tar subject to comr-3CIUM ohlig-aiiions ol"confidefltiaiity, limirt,(l to dit: infarmation created
or rcccvcd by Bwnness Associate from or on behaffol'Alkauce,.
2.14 Required by Um Has the same meaning as the term,"required by WO in 45 CFR§ 164,103.,
2,15 Secuttary I'lle Seo]Ctajjry of to CkIpartment of H ealdt and Human Sei'vices or his or her designee,
216 Secu H,ty incident, The attempted or,successful unauthorized access,Use, disclustirc., modificatIon, or destruction of
i.tifonitation or iruerl4renc;e with system operations in an Mforolation system,
2. 7 security Or Security Inemures, All of'the admitustrative, physicil, ,wxf iecl,mwaf safe,guards ire an irrlbrrnation
syslem,
2 l 8 Security Rule,The Security to 16- the protection of E`lectrona Protected Health lrifotmadom at 45 CF'Rparr
164. subpart C,and anicadments thereto.
2 19 1'ecliftical Sofeguards. 'I fic technology and vie pohcv and procedures fur its use that pmtect cicclronic protected
11CRIgh information and control across to i I[,
2,20 Unsectired PHI Protected bealth information that is not sccurcd thVOLH414 tho use of tech Iolo gty or imethodology
specified by the Secretary trt,guidance issued under 42 U S.C.section I 7932(h)(2),
121 All other terms used,bat nut otkerwise defined, in this KA Agreemont shall have the simme ineaning as those reruns
in the Privacy Ruk.
10, Obligations and Activities of Business Associate.
31 lousiness Associate agrees to nQt use or disclose H-111,other than as permitted or reqivared by 66 BA A-4vonent,the
Service Agreement,or as Required by Law.
'i") Business Associate agrees tea:
(a) hi:iplm-nent pli6cs and procedures to prcvcnL detect,cortain and correct Security violatim it%accordance with
the Swmiy Rule"
(b) Prevtmt use or diMoiure nflhe PHI other dian wi proNeided for by this BA Agreerrtcnt or ws 2'equiied by ktwc
Page 57 of 66
KCV 2129
(c) Reasotuibly, and apprqpriatvly protect ffie ounilideritiality, imqrity,,and availaNfity ofthe TIF11 that the HILSIAOSS
A socimc crcatcs,receives,,maintains,or transrnits rails behilf of thc Alliancc and
(d) Comply with the Security Rule req,airements including the Administrative Saf'uguards. Physical Safeguirds,
Techrliioal Safeguards, and policies and procedures, aiid doctialctitatimi rquircmentq set fi)rth in 45 CFA
164,308, 164.3 10', 164.3 12,and to,431 6
3.1 Biusivess Associattt agrees to rnifig',ate, to ibe extent pir;w-ticable any Narnifid cffi.,ct dum is kriown it) RLIShILS.'S
Associate Of a1 LISU(IL).diACIOSIArt.'Of PHI It),, ROS610,s Assouiaw in violation ofdw.equiremeok ofthis BA Algyeeiment.
3A Business Associatc a0rces to promptly (within 48 hours) report to M1,mrice any une or dkclosure of the 1IF11 not
t,
provided for by this BA Agreement of w1flch it b,ccomes aware, This iil'ZlUdes any mJAMUS fbr inspection. copy,uig
or ainerldrionit of such inf6rination and inchidiing any security incident Involving 11141.
35 business A~so,ciatc agrus to notify Mfiance%kilhow mircasonable dclay of breach pertainim,
I g to:
a) Identiricatic)n of' any individual whose unsecurod RIII has becri, k", is reiisortably [r)cil,eved i.,y the nkisiness,
Associate to have been. acccswd, acquired,or disclosed during mich securky brench,and
(b) All information required for notices rquired by Section 501.171, Florida Statutes,as well as the Privacy Rule
,and ,nd S, ccurity Rule, it SLICII other iiiffirittatiort requested by the Alliinee.
Business Assovi me a-r"s to ensure lb al oriv a, erit, incl Liding, as subcontractor,To whitn't it provides 13111 rcocived
from, or creawd or receiver] by RIAsivess Associate na behalf of the Alfiance, agrecF, to the sarne and
Corlditims that apply tkrough this BA Agreement and the Service Agreenlent to Business Associivte %vilh:respect to
Stich irlrofmatioll.
17
(a) Business rkssriciatc m,revb to ptuvide aLUCSS,id the request of Ific Alfianc(:clewing regalm business hovr&,to PHI
to the Alliance or,as diiectmi by Alliancu, to tarn individual in orJer in meet the requirements the(OnfidCrfli�,flit.y
Laws,ancl
b) Business AssociAm nrus to make imy to PHI :Isar the Allifince dirws or agmes w at t1w reqocsz
of the Allimicc within 10 business day5 of recciyi,ng the request,
3,8 RuMaess Associate anree5 to make imernal practices,books,and records,inclukhrig polwies wid prrraar e§rluae and PHI,
7 reltatirt
to the use and disc osurc of PHI received Crow.or created or,recrived by Busincss Associateori behalf of the
Alliance,avadable to the Alliance or to relrvaat regiflalory authorAies,which vilay include the Secretary,upon rctlijest
of the Alliaricc or the Sef�retwj,for PUTP0543 of dzicri-nining compharwe wiai apphizabk Confidenthalii,}, Laws,
39 to docurnew such disclosures ofPF[I and inforinati(m related to qLwh disclosm,L%as%vi)W
be required lor the Alliance to respond i(r as raluesi by an mdwtdual, ror an accounting of drsJo5ures, of I'M in
accordance with the,Confid.on6ality Laws.
3,10 Business Associate agroes to provide to the A Iiaxicc,upon reqjUeSt, h1f6rinitti011 C011tCW(l 10 pet'ri'lit the ARiance 10
respond w as rcquest by all Individi,ml for an accounting of disclosures of P141 in accordance vvith the Confi&mtiallly
i"aw Tj"
3.11 Busiitu.ss Associate SpCCir1Qa1,1y agrecs to use security incisums that reasonably and arptupTrately protect the
confidentiality;integrity,and av,iilaibility ofP111 in clectronicoranyoffier nutfim',iins,
ortrarismitscri behalf uEtheAlliance,
112 Business Associ,ate agrees,to implement security mca5urcs to secure passwords Lised to access PI-11 than it accesses,
maintains, or transmi�ts as part oftiiis BA Agreement froon iralicious softwarc and other man-made ard aat Lira
vulnerabili ties to assure Ome availability, imegrity, and confiklcmlapity of such inNi-niation
3.1 1 Business Associate agrees lo imirlerneut wcurity nicastaus to safquard KH that it accesses, I'llaintains,or transmits
as pan ofthis BA Agreement from millicrow softwire and other man-3nade and natural vuliterabEities to assjre tile
availability, integrity,and confidentiality orsuct,inforimrion.
Page 58 of 66
KCV-2129
1�14 Business Associate ag-rcs to coinjliy with ill otfict- applicable Confidentiah), I a%5 irickidim., bw flut lioilitcd to,
lestrictiom Un the sale or PHI ilild 3fly 0[ilifoations under if CILMULtitiabity Laws, delegated ti", the Alliance to
Buisiness 45sociaie, including arty o,Mvtuions under the Privacy Ride, zind agrees to use and chsciose only Ow
roini[I-10m Fleo,eSSary PI-11 to fi,11FOl ks obligations widti-this BA Agreement mud dic S rvicu Agreerricni,
+0 Permitted Uses and Disclasnres by Birsiness Associate,
L.NcepL wsmhelwise lifililod iii this Agrecinem ornny re[awd agreemcm, Bu5incsi Associate mety asc or disclose PHI
to perform functions,activitivs, or itn vicLs for, or on behalf(it. Alliance fis specified in any and all contracis with
Alliance providcd Ifiall such use or disclosure would nrx violult:the Vrwacv Rii1e 4dunc by Mianccurdw 111inIMUM
meccssary pohcjcs and procedures of the Alliance,
5ro Specilic INc,and Disclosure Proviskim.
SA Excupi as otherxiw [Onited in this SA Agrcuinottj the Service A" ;Fecrnciil or any Lm , Business
Associate intay tree NJI t1ir the Vn.)jicr mariagemenil and admiflistrIaLion ol'dw l3winmi Associate or ro carry ow the
lqgl rcspmwsibflities of the Business Associale,
5,2 EXCerpit Us o,tlj,cIr"jSC ljrjjited in this BA Agreement, the Servicc Agraerrwinr ar a,.wy Brjsrness
Asso6atc may disclose PI-11 For the propermanagment and odministraliou of the Rusnicss Associate. pi-ovided that
disOosures are ReqLiired By Low,or 13tisiricss Associate oblains,reasonable,mirraitwei I'mm the person w%vhurris the
inronnation is disclosed that it wdl ream ain confitlontmi aml ktsed(it ftiri4vi disclosed only as Required By I-aw or fe-w
the PUrpose fbi-%vhich it was diseloscd to,the Person,aIniJ tho person ooWks tits:Buslness AssocLac ofany imstances
ofvvhich It is nw,,irc in which Ore confidembahty ofifie information has becgi breached.
8risiiiess Associate rnay tress PIUJJ to provide data aggregation sevvices to the Alliance. as pen-nifted by [,he
Confidenflahtt Laws.but only when w'+cvifwafly aothorwcd in wriling by the Alliarlcc.
6,S) Obligations Ol'Alliance.
6,i The A liaric e shal I 11OW"Y Business A ssaciate or any restriction to the ww or disc lost irc o,f P 11-11 to which the Al Nan ce
has agreed toes the oxit:u(that suc It restriction,may affect Business Associate's use or disclosure of PHT
6 Permissible Requests by the Alliame. Except ri'll,data,ag rugatifall(IF itianagelment mid admine"Mrativo aclivities 0'
r3winm6 Associate, the Alliance Oak 1101 NqUCS( HIM B ItSin4OSS, AsS'0631e OW OV fliSCIOSe K°jl in any snartner that
would rim be permissibIC Under the Privacy RUIC if done by Alliance.
TO ffr?"ive Date and Termination
7.1 The Patities hereby agj.Ce fl4jal t[iis 3A Aoreemoit is efrective as ref the aale.abcme mid armloads,rcrskxlcs amO rcplacei
any oilier Business Asmiciale Agreement QorresiflY 41 efrect buhmeri the Alliance and Business,AssauiatL_
;7
7.2 TerminatiGn for Couse. Lpor the Alliawco's khowledge,of a material breach,by Business Associate, the AlliancC
nriay�
al Provide- an opportunity for Business Assoctarc to rnre [Irlo. breach tw end the Ociltitior and wirinaw this
agrecrnew, iflDwsitiess Associate does not cure if brca-tclb or end thic vloiattox, witlim the time Specified by die
Atliance or
(b) Irnmediaidy Icrininme Nis 13A Agreementand may ahc,ternn[nale the Ser%,ice Agreernew if ftarairrea5s,,�ssnr.i,rte
has breached a material term of this Agreerient and cure is not possible,
73 EMO ofTermination, Ewept as,prow,idcd in subparagrapti (1)'i of this section, upon ternainaflort(if ibis qIreement,
for InY reason, Busioesi Asujj",J,tcstrait rt tetra all PHI recul,vcd froirij Oic Alliancv ear created oi-mceived by Busimis
ASSMate on behalf of the Affiance.N. PHI shall he VvAhmuihcexpreskvritter; ANiwice
Page 59 of 66
KCV-2i219
0j This parovisiona sljali: apply to PH) that is in Ific posscsiion of subcontractors or agents of l3trsiness Associaatc,
Bositrcss Associate shall ream no copius to tlto 111-11,
tkl 11) the evenr tivit Busijws~ Associate or Afliance 6°Ierniijtcs that retorriing the Pt 11 is infcasiblc.nocification, or
(lie eorEdftlons that inake returri of PHI itifewsible straii be prcivid(�d to the Affiflate, Ifthe Affilliate ap, es that
termination is inteasible, Dwsines•s '1ssuciale tuay ret"flin Elie subject to the, t�Liuircrrierds of dais HA
Agreeniem,BUSIllessMsodate shall CmNnd the protectrons+)f thi 13A Agccerciem to stick retained,PHI and,licuit
furither roses and discloswes ofstich retained PHI fch' loo�g as But iiiess A�sL�ckite fnarnta[ns sucli 111111,
&0 Regulatory Refel"wices A m(crerce in Haiti ajtreejjj��,nt to o section io tire Privacy RUh or Sccurity Rule or odier,
Confidentiality L.m raacatrts the section theca 41 effoo or as Imly l),c amended in the future,
9'.() kmendment, The Parties ati-ce co take such action as is ucccssary to arnead this igreegww 11-ooi ciaie u'.i[inie as Fs
necessary fur the Alliance to comifly with the requiremerim of the Confiderifiality 1,mvs.
10.0 Sir rvival Any urin,coTidic tojn7 covollaw or obligation whioh requires perfornimv by cit wr puny hcneto iki;bsvqucm
to the termination tat hiw RA Agrreenient s1tall remain edwceable ogainst such party subwqucnt to s(wh lenilin'xic'm.
I I A Interpretation, Arty aiiibigrrity in this H.A Agreermna shall W resolved to perm it the Alliance to Coinply witit the
Confidcrttiatit�, Laws,
12,0 Nntices� All gotta a a aawtJ corrtraaunoe atrraaas rccptriramd,necessary or desired to hegivon pour' tjantto this HA Agroonem,
inchirfing i charige of address for pi.wposcs of such notices apid counnuvricarions- 'qcatl be in vvriting void delivered
personallw', to Ow other party or stet by e\prcss 24-hour quaranlecd courier or delivery scrvice, or by ctrti fied rnaill
of tfic United Stives POSUd Se-ViU, F,0151agge prprNid and NIUM rocclIA requ slkxl. aidressed in tic other party as
follows(at,to,such Mier pi,ace as arrY party way b,)'nolice to(he others 51•aecify):
To the "Xiliance: Alliance Gor Aging, Im.
Atwraiw ktaa Rothman
760 N1W 107 Avenue
Miami, Florido.33172
I'U LILISine5s A!;%ociate. Monroe County Board of CoLimy jonel S. Sociall Serviccs/lit-Hame
Services
1100 Sirnontoo Street. 211d rl001,
Key West, R, 33040
Any sueb notice sh,-all be deemed delivered LifX)n d0llkd fV„evt tftmy nottcc cannot be JOjvtrtWd or cklivery tho-eof is
de[ivary will be aleetat,2rai to have occurred on the dile stich delivery was arcempted-
3,61) Cove rnfitg,Li w. The laws of the State ol'F orida,without,giving effectIc ricincipics ufounflict,uflav6-,govern all
triatters arising tinder(Itis BA Aorevaienl.
14,0 Severability, V'any provision in this agreerrivni is unearorceable to arty eNtQnt,Elie of this BA,Agreement,
or apOica6on of thal provision to any persuns or circumstattces other diati those,,its it)whicli it is held UnCnfurceaNe,
will not be affected by that a,rrar rafotaa caahiiity and will be erfarcerible to the fidlasl extent pertttrtled by law,
15.0 Saccessurs. Any successor to Business Associate (,wiletliel by direct or indueut or by purcliase, "Wrgef'
consolidation.,or otherwise) is required to assume Business AssAniate's ob,Hgaticns under this BA AgraeniLnt aaid
agree to,Perform their in the sarne:mantitm and to tfie swite extent that Bus,6css Associate WOUld have beet)required
to if that succession liad not takers place. This assumption by the successor,of the Business A soclate's obligations
s'ball be by wwjtcert agreentent saa is fact ory to ilic ,k ljiaocc,
Page 60 of 66
CVO 2129
160 Entire A r rr ent, '116 BA rt rcecnr ttt,logetha r with the �ryimr Agreement, the c4tim agrctm rrtt Of
the panics r6ating tea the svNiect ivattor of ffiis BA Agroment and fiuparsedes nii other and or wrulteil:asrear env..or
oii6 s rcWing Chcrctrr, ,xctpt that this agr"mcnt does meat lirrl l tilt amendment of ibis agrtrt mnr in accordance
wild section 9 0,of this 86 Agtec icnt:
Ali;iattce for ,gist toe,
'o ..
Y° Catr May 3,2021
.....
(srgrt lorc)
ttstrt ss A s ri ae ("Ounty,t:arnmissioners, ciat Servite 'ltt�4fame Sarah s
By
isigrt�ttatr°�°l -
, 6 E Cud N ",AMIINEY,
,( 0. aor ,
MA:
a r
CLEWaw a V
Page 61 of.6
KCV 2.12
ATTACHMENT G
.iliaarmce for-Aging, Me.
Agjng and Disability l cscrturcc Ccntcr/FJdcr l iclpirtme
AGING ,AND DISABILITY RESOURCE CENTER(AEI RC) —OUTS }UROI) k'uNC TIf' N
I. If.applicable, the provider agrees to the t°anllcawi :
A. Perform ADRC outsourced functions in accordance with the Alliance's policies and procedures.
i, Policies and Procedvrets (Or.OUISoairced Fatrmc¢ican-Sc:area nin
6- Poluc ices and PlMedVraeS [cra-6.UtSOUrced FUc'acruon-Trig g
iii,. Policies and Procedures for Activation Fron] wallim— Client Services
iv. Policies and Procedures fvr f,(u rtmminaation frowl `m akl a- Client servicei
8, Maintain wait lists in CIRTS irm accotdaarice v irh f OEA Fetjcrirc:aarCHb1.
C. Adhere to prioritiaaaalion and taar gc6ng poa icy as set forth in the DOEA programs and Service's,
l iaarrdbouk, ams applicable,
Dd Fnsa.ure the Provider's Dkmsttur Plan rcaflro is ADRC t7rutw arced Functions, nn uvllx,1 or as neot'led
to incorporgate,awl. RC outsourced functicnsa
E. Lnsure aagaaitam c ontlicts of interest and inappropriate scl l=reler'rais by referring c:onSLrMers ira need
of options counseling nr long-term care services beyond, the provider'`s,scrape of servic:ea; to the.
Aging and Disability l cwr.rrcQ t.wter.
F. ensure that services provided are in the clients' best interest, are the most cost effective, of 4i lm
clrrntrty,and are responsive and appropriate to the assessed needs,
Tho Assessed Priority Consumer List (r"rl CIL) is ummatinur fined when aorwices fi.alad d by the dnpartmooh tiara~ rrcat
available, Contracted Providers ofrcgistercd servioas for Local Services Program (LSP) and Older Americans
Act(OAA)and CdCsAA must maintain wriaaitin- lists in the Cl III'S database for rc iwtcred scrvice., ivlmcrt funding,
is mg available.
Page 62 of 66
KCV-2129
Alliance for AlOng, ]nc.
Aging anti Disability Resource Center/Eider Helpline
POlicy and Procodure for Outsourecd Itinction—Screening
Creafian Date: March 5, 2008
Revision Date: OtLober 2019
Review Date., OcLober'91019
ObJective: To casure that as comprehensive list of Clients in rimd ofservices is maintained int CIRTS by
appropriate fundillp"source and that the A10C is thereby able to effcclively ga[lge the JQvel ofelder
Service need in IVI i anni-Dade and N lorlrne(.totes.,.Policy: To ohtairi necemary in forram ion firom clients in order-to assim in determining level of need and
efiggibiliLY for vegistcredwiviceu filaded lht'011�11 OAA and LSP and CAFfiFS prog,r.,arls.
I Providers will collect illf6ritt4tion from callers and conclrrct a 701iS assessilient, Alternativclv, if as
7OIA(B)assessment already exists or is provided froin another Provider the inkmilation frotil the 701,B
can be tltzilize&
2. T'he Provider will dclermii,w the services Itceded' alld [Ile appropriate fLinding source(s) that provides
the ticeded swrvices,
lithe caller is ire necd of a wrvicc(s)that is not provided by the Provider. the Pmvider will refer caller,
to the ADK Elder Helplinc, as well as, to other,contracted Providers and corninunity organizations,
3. The caller will be provided with gertcral inforniatiOn regarding,tho AI)R(' as well m the ADRC Elder
Hvlpline cotitm:t number,
4, The Caller will be infortned of the serviccs and fLunding som-cos that they are being placed on the wait
list for in CiRTS,
5. For stare-cease rnaliagc<l programs, the Providt.sr wIll creme a client record in CtRTS (if there is Im
exisditg record)and enm the services needed liar'the caller by fitniding,source and servce- [I NherQ is
ati existing record in CIRTS,the appropriate filelds wifl be updated],
& If Provider de(errni ties that the caller may qualify for more thall one Program for which tile Provider
is runded, the Provider is encouraged (o enter the appropriate iaformaji()nj under multiple furtcling,
SOLimcs, [if there is an axisting cl[ient record it)CIRTS,the client record in CIRTS will be updated with
appropiiaw Mforniatior11,
7. The Provider will infon,n, caller that they will receive an anriki�il re-assessment based on DOE Wait
List Reassessme tit, stafldard5 and CrIcourage caller to cantact the ADRC FIder I-Telpline with any
qoestioris.
Page 63 of 66
KCV-2129
Alhaucc for Aging, Ine,
Aging and Disability Resource ConterlElder Flolpline
Poky and Procc(lure for
Outsourceti runction-Triage
Creation Date. March 5,2008
Revision Date- October 20)9
Reviov Date: October 20 19
Objective: I o ensure that clients,in need ofDOEA t1unded stir aic es ircceive services bass ci oil the highosi ICvefl of
iwed, first.as funding becomes avai lable.
Policy: To assist clicitts ire ohi,aining� DOEA f6rdcd services ais funding becomes available, based oil level of
need asp (Icterm i ned by a C I RTS priority score.
Procedure.
I The Provider wfll conduct annual reassessments hasod on DOE,A Wit Ust Reassessnient Standards.
2 If there is 110 CUMV111 7OtA or E3 in ORTS. the Provider wi[l conduct the arintial (70h) as
appropriate. Based oil the in Formation pi,ovidod via the 701 SIA(B) assessmem, the Provider Will Update
the client infornuiflor,iji CIRTS specifically as it perrains to li vel of need for svrvices,by k1r),ding SOLEWCC,
The N.-ovid(N.will erasure that the C110$ priorit'7,aliorl Score is,accurately tilainta;tied, according to DOEA
Standards. If a significant change has occurred prior to the annual re-screenivo. the Provider InLISt re-
screen. Definitions and cxaniples Or1'Sj�,jjrjC,,,jt C11,'11, e are doc wrote nt"i in the DOE Prograins&ScrvicQs
fvlailMli Chapwr 2.
4 If thc caller is in need ofaservilee(s) that is not provided by thv Provikr, the Proviidor will rct'Qr caller tri,
the ADRC Elder 1-1clphjle, as well as, to other contracted Providers ard community m-gamutioas. Tho
caller will be inform(�d of the services and fiEndivir 90HII-Cl—, that the wait list for nrid/or have becit rcmoved
frOM the Wait Ilse ('err.
5, The Novider MR remind dient of the ADR.0 Elder Help Line contact number and to coriuict the ADR,C
Elder Help Line w4di any questions or concerns.
6, As l'undi,ng becomes avaiitaWe, d"ie Paivid4.-r Avill i-1,111 (.1RT.S Priorrtiza6on Report and activaic clients
accordim,to DOFAStandards(ref`erw ADRCClien Activation Policies-andProcedures), Thccorilract.xl
l'(-CJV'CIe1- "'W apply tar-geiiillg Crito-iia, arS appl-Olanate, to prioritized clients, to ensure aciivadoi)s meet
programmatic requirements.,
Page 64 of 66
Allia nee for Aging, I ftc
Aging an(] Disability Rcsout-ce Center EIder Helpline
Policy,and Procedure for
Avfivaion from Wait List—Clients/Services
Creation Date- March 5.2008
Revision Date- October 2019
Review Date: Octobco 20,19
()bJective:To ensuro that elders in need ol'DOEA foriced services in Miami-DadQ and Monroe CmaitjQs and on
the CHITS `wait list begin to reccivc services as, Funding,
poticy: ADRC,wfli work"ith ?rovIdcrs to on""wre that clients waiting for DOFA funded suviccs lac in to
receive those sei-vlcos as hutding becom us avai lable,
Procedure:,
I Provider will activate client.s or C IRTS Nvait list knsod on DOE A priorkizafion peilices wid runding.
uvullabi6ty,
Tlu, Provider%)Ml update CI S staws 1-.)y Funding source and act-vice foi,ary,,;erviceq being activated for
the clicRit using appropriate CIRTS codes..
3. Client aiay b,,- Wt on wait list oll'a, difflerem Funding source flian, the one being activated if the Providor
de rmines, dint it is appropdaie,
4. Chut niav also be left cart wait list in CI S if they are being acfivatcd by the Providcr Under a temporary
noo-DOEA funding sourcc and the Provider cleterinincs LI'mi the ChenCS rieed will persist after the
tcmporayy funding source is exhaumed.
5 The PI ovider will i nforvi fhe client of any scrviovsh'tinding iource that they arc bcing activ,ated fi,')ras wetl
as th(.-)se smius and funding soorces that they will continue to be Await listed for.
6, The Provider,vill inform client to,contact the AC R(� E"Ider Helplinc 'll'they have any qncstions or concerns
regarding the status of any of their sorvice�,.
Page 65 of 66
KCV-2129
Al'Ji.,ince for Agitig, Jac,
Agingand DisabilioF Resource CcrtteiAlder Relplitic
Policy and Procedure for
Ternifitation frorn Wait Li,.,,t—Clierits/Services
Creation Daw: March 5, 2008
Revision Date; October 2019
Review Date-, October".1019
ohjcdive� To ens'are that tl'IQ comprehumive listordierai ir need of serviccs h'i CIR."I'S is apprph oatety
mainWified by fart dflg source mid that that ADR,C is thereby able to effectively ,'ujuge dw current levy l
ni'eldrr service need W Miaml-Dade and Momnee Counties"
pojiey�' ADRE MU mairwin an accurarejild current list of,dicilts in need of elder services in Miat*-Duie
aild Monroe counlics with the as's islance,OfIlik! A1)R(:'Cotaracjcij 1'11,ovlcjcr,s,
I `!`lac 1-1'rovidcr will re-ref'reeli dieniq whidj the Provider' initially placed on [lie CIRT wait list f6r services
bzit;cd or) DOER Rea-m-ssuicrit S(andartk
r. The re-screening.may be in tyre form o F a phone scre enj ng or a ham vis[t epencil rig on the dicnt's Maws
(Le.
- ,
3, The �i'lrovei w idill detarn '11t is 110 ii"�d(or e6tile)f gj! ar any (if the services theywerc
wail-fisted 161" LI
4. "I"I"w Novider Nvill terininate the client from the wail fist (entirely or by specific servicC.) Lising the
appropilate CIPTS tennimaticii wdu for any scrvices,N-fit ndingsource For which 0'1e ch'enl is deternilned
to no longer be eligible tbr Or 110 loqur in need of.
5, The llrm4der wdl inCbrm the clicm ot'any servicesd6nding soiarce that dicy are bcing remc,:)ve.J frmi the
wail list for,
6 '11"he Provider will infr)rjjj client Of t1lClir ability to be re-added to the wail list if their level of need should
chanm
7- Tke Provider wM is foi-rn clieni to contact lhe ADRC Elder-Kflpline iIdicy have'any question orconccrns
re,garding tkiif'Wdrit hSI SIIII[AS,
8, ReCerence DOEA Prograix6 and Services Handbook ais applicable,
Page 66 of 66
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Final Audit Report 2021-05-03
Created: 2021-05-03
By: Stan Mcneese(mcneeses@allianceforaging.org)
Status: Signed
Transaction ID: CBJCHBCAABAADOrP-ptY_1gxP3cCCiL9dEY7fEq_5Aa
TCAA Monroe KCV-2129 Provider signed" History
13."1 Document created by Stan Mcneese (mcneeses@allianceforaging.org)
2021-05-03-8:25:18 PM GMT-IP address:52.201.156.234
Document emailed to Max B. Rothman (rothmanm@allianceforaging.org) for signature
2021-05-03-8:28:08 PM GMT
Email viewed by Max B. Rothman (rothmanm@allianceforaging.org)
2021-05-03-9:29:23 PM GMT-IP address:76.109.240.37
r ru. Document e-signed by Max B. Rothman (rothmanm@allianceforaging.org)
Signature Date:2021-05-03-9:30:47 PM GMT-Time Source:server-IP address:76.109.240.37
m4}r Agreement completed.
2021-05-03-9:30:47 PM GMT
Adobe Sign
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