Item V03 V.3
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
October 19, 2022
Agenda Item Number: V.3
Agenda Item Summary #11250
BULK ITEM: Yes DEPARTMENT: Social Services
TIME APPROXIMATE: STAFF CONTACT: Sheryl Graham (305) 292-4510
N/A
AGENDA ITEM WORDING: Approval of American Rescue Plan contract RP-2129.2 between
the Alliance for Aging, Inc. (AAA) and Monroe County Board of County Commissioners/Monroe
County Social Services for grant funding in the amount of $142,333.49 for contract period
10/01/2022 - 09/30/2023.
ITEM BACKGROUND: The primary purpose of this grant funding is to prevent,
prepare for, and respond to, coronavirus disease-19 (COVID-19); including provide
supportive services, nutrition services, preventive health, and provide support
services for family caregivers. Preference is given to older individuals with the
greatest economic need, and older individuals with the greatest social need, and
clients who continue to practice social distancing due to the COVID-19 public
emergency.
PREVIOUS RELEVANT BOCC ACTION: N/A
CONTRACT/AGREEMENT CHANGES:
new contract
STAFF RECOMMENDATION: Approval
DOCUMENTATION:
ARP RP-2129-2 CONTRACT000_jdm
FINANCIAL IMPACT:
Effective Date: 10/01/2022
Expiration Date: 09/30/2023
Packet Pg. 5050
V.3
Total Dollar Value of Contract: $142,333.49
Total Cost to County: 10% Cash Match
Current Year Portion:
Budgeted:
Source of Funds: Grant
CPI:
Indirect Costs:
Estimated Ongoing Costs Not Included in above dollar amounts:
Revenue Producing: No If yes, amount:
Grant: Yes
County Match: 10% Cash Match
Insurance Required: No
Additional Details:
10/19/22 NEW COST CENTER ADDED $142,333.49
REVIEWED BY:
Sheryl Graham Completed 10/07/2022 12:22 PM
James Molenaar Completed 10/07/2022 12:36 PM
Purchasing Completed 10/07/2022 2:02 PM
Budget and Finance Completed 10/07/2022 2:28 PM
Brian Bradley Completed 10/07/2022 3:32 PM
Lindsey Ballard Completed 10/11/2022 1:23 PM
Board of County Commissioners Pending 10/19/2022 9:00 AM
Packet Pg. 5051
RP-2129,2
A1,1..1ANCE F0,114 A(ANG, IINC%
S"FANI)ARD CONTIIAur
Amerkan Resette Plan
IMIS CONTRACT is ontemd into between die AHIme Or Aghig, Inc, hendriaher Warred to as the "Alliatice," and Mourae
Counly Boar(] ol'Cottnty Co,1111TINSIMIUM, SocWJ ServicesAwflonne Services, hc-rohiaf1,orrQfvrrvd to as the"Provider",and
colfedjveley rofcm-cd to as Me=W" 'Me temi Provider Or this pmpose may desWNite a vndw,sub-grsurte"w sub-mciown t1te
gauts to be DO= idetai6ed in.ATTACHMENT It, Exhibit-2 as necessary.
WITN E.,SS ETI I Tl I AT:
WHEREAS,the Alliance has estabhI slied through the,Area Pin Mat it is A noed ofu-,rtairr services as,desciribed herein j and
WHEREAS, the Provider his denionsUBted that it has the mquilte experbse suki abdiod to fbithibly 1wrAnn such se ices ns an
MqeWern MkimmMe AHWQ.
NOINTI 1031FORE,, in cormidenitimi of be sowkws U)be paharrited and Inymerus lcp be made, logother wnh thenwitual clovenants
and conckiwis herchattv set Rol, dw ME aVve as W11w
1. Purpose of Comm
The ptwpose of this contract is ki pToviJe services,inacccirdance w0h the imam and conditions specided in this conunct 1FICILANg'
all mutchmenm and exMits, (lie contract docurnent,
2, Definifious
AD L- Activities ofDaily Living
Al"
A11A Antericans vvidi D,kabififies Ao
Alliance - Arvi Agency oni Aging
AP(]., Assessed Priority Cortsunier Lim
CMIS-Hart Ink)rtnadorinaafi Rcgktnt6onTracMn,g Systern
DOEA- EMpixtrrient of"f"Ider A fluirs(Ile Ekpajmem)
MR Infiorni(afici,ri and Referral
lADL, - Aeuvidts afl),tily Living,
N4DD, Major DisastQr, Declaration
M(M Mernoranditan of Agreernent
MCH I-Monorandum of thidbotandinj.;
PSAs- Plannin,g and Service Arv.,,.j,,corresponding.,1(i Kkinfl-l)ade and M0,111-00 COILHI,60N
SPA- ServIe MOM Apokwkin
I J S DA -- I J n hed States Depart nw n t af Agri md tw�e
3. tocorporalkni of Darumenu istidn the Conwet
The contract incorporates by ruforence altachNnods,pmpmaloj sokkatKnOL Provider's Scmice Provider Application, and the
amw DOEA Propims mW SaKes Handbook, Any and aH contracts or apvcrnents es eartedl.between the Prc�avjder and Me
Alliance chning tha eRd No pubd of Mis oo,nuan sliall be governed in accordance nth de aphnhW hms and swwas.
4. Term of Contract
The cmaract AM begN at tag Ive(12:00) A,,M,,,, Eastern Stwdard Tim,on Ottober 1, 2022,or on the date the conwact has boert
sWwd by Ow last par, reTrired to Qn it, Mchever Is later. It shall mid at dale mi fifty nine (11:59) I" NI., Eastern Standard
151'ric,arl SvpIelliber 31), 2,0413,
Conhvel Anwunt
The Alliance agroes w py A cortruted semkes acardIg to floe Umms. and Whihns; of% conract in an anwuru no u,)
exceed JULJ13M sukka to the avaiNbiliq of Mmis. Any costs or rvices pWd A under any ther contma or from any other
son i,ce tire net el i gi We Ar pyrn M under this c mama.
6. Renewals
By rautual agreernent of the parties, AMAnce may nerwAy the cmwict Or two additional one-year pedods. Cocairtgent. upon
milisfitaory perfornianec Qvalu,zitions,by,the AHIrwe mid the aNaibbih,or hids,any renewal is suk�ject to the sarne terms as the
Page 1 of 72
RP1129.2
(),riginal contreict and any arnendmenK with flw exception nJ,cMzb11jshing unit ra es WA is describe(l furilh:er in this sQdion. I'lle
orighal ummuctual Ullit ift(tS are set fordi it We bid proposal and reply.
Requests to renegotiate the original contractual established rates are provided for in the Alliance's approved Iteirribursemcnt Rate
Rvv&Nv Policy, which, is hicorporated 1!uyreferenec.
This contract ntay, be eNiended UIM MlUtUal agreement kw one Madon perkW iu)t to emwd six months to ensuiry coofilluity (4
service, Services provided under this exterision MH be pakl for out of lite succeedirtg itgreerlwIlt WIWJLTIV
ConlilWancewUh Federal law
T I W cotitimo corimins Rderal funds, The fblk)wvnlg,shall apply:
7,1,1, 'I"he Flrovjdei-AaU cmnp"WV die provkjons,of 45 CFR 74 and&r 45 UIR 91 rural other applikable rellmWs.
T 12 If this coraw callurilts 1� deral Htnds and is over SIADIDWOU, the ProvidQi,- shall coniply with ill apjflicalfle
SWIwLards, Older)" or regulations issued undei, s. 106, of he Chan Air Ad as aniculded (�42 l),S,,(`. '740 1, et se"), S.
N8 of the Fedeml Water Nlluku Antrol Act as ammAd (33 LAW 1251. et seq]. Bainive On& 11738, as
acne nded,,and where appliciible Etivirotutiental 1roiieefion Agency regul,,itiq�)l1s40 CTR 30, Ile Prxn%rshall mpol-t
any vkAations,of: the a,fl.)ove to the Alliance.
TIT The WOW or agnu acting Rw he Wider, nlay riot use any Rxicral IArn(15 iweived in u,.onnectiqni with this
contract to in fluemm 1w^WSWA11 Dr apprqYsdons pmWkig belke the Congmssor my State legidamw� llw PmAder
litum coulplele all disclomwe Rwims as requAf specificAly dui:;CedliwAn of Asawames Wghmen whWh niml
be com p kwd mW yen ri iled w ith d u i s,signed cont r r.ad
TIA Inaccordancle, 1,011i Appendix A to 2 CTR 2 1,5, the Provitler shall cumpbl with Execuldve—WAer H 246, Equal
Enipiloynietti OpportunQ as amaxled by licumbe Chher 1 375 and others, and as supplemenled in Department
aA ktbor regulation 4 1W C[T 61) and 45 CFR 92, iraj!)j,)IJcabh.
I A A corlUac"ward with an aniomil epeeled l�o eqw] or ewed S25MOOTH and cm-Wil o1her contract amards shall;
not be made to parties listed on the govenwtut-Nde Exch-ided Pwlius list Symcm, in accordance with tl,w (WHA
guidelines, at 2 CH, 110 OW impl.ement Executive of 12549 and 126,8l 9, "Debannent and Suspension," The
Excluded Purties Lim Sy stem contahm Me nums alml-tics debanvd,suspended,or offienvke excluded by,agencies,
us Well as parties declared ineUgible anderstatutf",or regutalany audwri y c)II-icu than,[.-Ncculive()rder 12`49u The
I'l-OVidQ17 S11,111 COMP" With We provisions bef6r o doirig 'buqirtn<; or vinviing into subcontintos receiving if&deral
fhe 11"rovidershall complete and slat dwCu rt. haction and Assamarwes Auadunerit
prior Ix"I executkal of this contract.
T1 Ile Pwvider OwH nm employ an till M Ll 1hori zed alien. The Alliaw AW Q=sWer the einj)k)yn)en1 ,(j,f unauthorized alienis
a viobkm cOMe hninWolion and NalimmIlty Act(H U.S.C. 13,2,1 a)mid to linnigirwition RA"orm and Control, Act ot"1986
(8: U,Sk, 1 10 1), Suchvicilation shiall be,cal-lse Rw imilatend canctAtation of this contrao by the Allittracv,
T1 IfTe ProvIder A a nw,pvM prcwide and is SUIwjOd to Ownul Revenue %wice (IRS) wx exompi; m1anizatki mpoiling
requircnignts(filling a Ann 990 or Fonn 99NAO and has its tiw�vxcwnpt stiOus revoked f6r,failing to cont ply willt,Me filitig
requ,irentents ofthie 20016, Pensioti Protection Ad or Rw any Other rMSOTV Ole the Alliance in writing
w UW n Miry (M)days of reicei v�in,g Ift e IRS not i ce of re vocation.
TA 'Me ProOder shall comply widi lide 2 CFR Paii 05 regarding IjAcAg in Pumms,
7A Unless"exempt under 2) CFR Pan IX 11 Nbj the IfivAder shaH compY WM this reporting requirecri,ents offlio
Achas expressed in 2 CFR 170,
T 6, To con i p,ly Nv itl i Presi de rit ia I E N ec u I i ve Ord-er 129 8�9 anal S t at e o 11-Jori da Fx cc u t i v le Order N u nibe r I I!,-116
Ptx.wider ap rees tcl utilize the, U.S. 1),elmrinrent of I fonwlajid Semliq% Enviritv, systern to veri tlw eitilfloyinerit of al I
new ernj)loyeies hJud by Pimvider doming Ow cmWed Wnrl, BvO&r Anil] include in related sut)contraets a 1-trILdrerrient
thai suixommams atulfor vendors perAnATM or pwiding services Imirsuant to the swe contract utifizo the L-veri(y
systent w verjf�y entlAtlynialt uF A new eniployms hired by the subc,)njrj';jC tor and/or vendor chwing the conuict terrn.
Pl-ovidas nwaing Me Unns and condithns of dw OVY-i(y, System are delenied to be in conipliance wid'i this provisiorl.
Page 2 of 72
RP-2129�,2
8. Compliance 'ith Sta'te Law
8,1, This awltrioct ise\ecuted andenrowd no in the SWWWWa, and shall the consirtlelperfarnall md enibreal I all
respects in acconlarice vvith the Fic',orida law, AgWrig RKda provisions Or conrlAa of laws.
K2. Ile 1'roAdet-AuH wmpywith 287-058, Horidit Starutes,(J`.S,) as,wriended.
821, The Provider W provide units of ddheml*s, indtWing wporthg, OndIngs, andl (fi-afts, aas aJlccit-led in this
cmarac; %Akh be Corr au Wvager must reccivv and accept in writing,prior to payinent.
&22 TbC PWVWa NNLH conpt- wil dic Vwria mid Wal alga e by "hkh W eriteri.a, rna ist he niet fi w cuniplc lon
of Ws conowt as speiduhn ATI ACI I N/I FN 1 1, j(�,jj 111,
K23, Ile PwWa sAll sul!hnflt bills lbr feesi or adwr compensw5n Ric serviles or expmnes in sodWs ddail For a
pxoper pTe-muht and pass audit.
&2A V hernized payaaient fiw travel ex['!aOtiseq k jiel-rulitte(I in this contract, Hit PmvWa "ill mMnrii IiHs for any wK
expenses Wa accordimme m1h s. 11106n ES,or m suvh lower rat esas nr,aay be provided in this contract_.
824, The PmVida shall Maw puNk accus to aril docurnero, papan koers, or oler pdAW ruals as diefined in
stjbsectk�in 119,011(12), FS, madc or rutived. by the 11rovider in o)njuncdon wiflo ffiis coutract execpt, kir dw)se
records,which,are made confidenfial or exempt by law. The Provider's refusal to coinply with this provision sifiall
consdarte an inunechate bnmth uf contraet for which Ke AHrame Or Agirrg. W. nmy undarenly harAme 1he
con0ad,
&I WOW my to be transported wido- this contrail, the. h-tivider sfi,-all coinply m1h Me prov isrons,of Choapter 427, F,S , and
RK 441 Florida Administivive(lode(F. W Q.
9,4, Skilleono-imjr5 ancVDr vendors vdio are on W discrimin-atory vendor H9 nmy mit umisul buMness AM any pubhc W,
in mvwAmice wkh the pmvishns of&287J 34AS.
&I The WOW wild own ply m1h be pmOfons of v I I A6Z ES, and v 216341 FS, vdich problit be eMmKwe of
coninct Wnds Or the purpose of lobbying the legislatum judicial branch or a mate agency,
8A. In an"irdalmembli s. 28T135 ES., art.), Provider airy t4e Scrutinbcd Compardes myth AcAlks hi Wall List, die
ScruGized Companies with WNW iin( the trari Petrolcinn F"no-gy Sector IAL or flee SenuthAnd Chrripmries Im
l3qye(R-t Isor"'lel Lim (I Jsts)w created pult"suarn to s. 215.4 73 ES. anst 2154725, ES,or is enga�edl ill ar b0,NCOU of 1sraQJ,or
is engaged in business operalk!jris in Ctba or Syri,,,d, is incligible,to emer into or rene v as contract with the Dq)ar-(mQn1: for
goods 4:)r services of S1,000,01010 Or, niore. Puiams to * 287135 FS, Ow AHInce may mdame this twiWact if Ke
Pnw1kr is World to h;.lve subrnitted as false.. cerfification or its Maw on the Lim or Us Non Maud mi ke LK or is
engaged in a boyc)'[t of lsnwl or has,been engagod in NMOSS OpOrarjonS bj Cuba or Syda- FurTen Me Novider k subjw
lo civil Penalties, altorney's f es and corns and any casts Aw investigations that led to the findirig a f dtiahw, ccrtification-
jrhe Provider shall coinj)[ete and sign dre,Certi ficalicals and Assuinniwes A 1aachnwnl,j)rJ(!)r to thQ CXCCLAi0r1 Grlfli".CQVI(Ta,'C
Background Screening
A L Ile ProWer shill comNy vvith kutd, tn'quiv suI:)CoVl11'aC14')rs are ill conipliance with tahe of's. 430-0402 and
Chap ler 435, ES, as amended, ktre,inet rogarifing background scremAg Rw aH persons,who nmel that defirlion of a Ow
service provider and,who are not exempt fi&orro the Dcpartmenil NO 2 WkWamd,screening pursnant to s, 430,0402(2),,
(31 ITS, Ile PmOdu nuis Wso umiply with any applicable rules pmAmulfated by Te DeImment and We Agerwy Ar
I kAh Cam AdOdWaGn rymunig immumenwom,ors, 430%0402 and Ompter 435, F.S.
92 F'klrther inforlim.1tion the proudurcs J'Or bilckground screenirig is tbund,at
Age 3 of 72
RP-2129,2
11, G HvTa itcr Proced u res
'Pic 1havider shall conqdy wit i and eMWV SUbcontractor andVol-vendors conipHanm %vith Ibc, Nlininiurn (iuidefines lbr RechAcnt
Gdevance Procedures, AppendS R DOEA Pitogmais and Servikes Handbook, to address coinplaints rcgat-di ng the terin ination,
suspension or reductWn of smvle%as ruRn.red IT wceip of hinds,
10.t. Cornpkaiin Promidures
The J`rmider shall dnelop mW SlAmnau cmWhirs poudmes and ensure fl-rat sulmontlActuls Ww vmWon dnebp
and iniplQnwn(camplrtho plaxedures to prucess and resolve client dissatisl1tchmi with savices.Ccjl�nj.)lnntt procedures shal 1,
address the qualfty and thriel'iness 1�)fsiervices,, Pro,vidier arld, direct service worker corn[,)hdra ,car any otheradvice related
to cumphi% odwr than tenninadon. suspenshn orredtizOn W MAIM dWi:re(jl.dre the griovartee proces,,., as cicscribed in
Appen(,lix, J), Oulmi-Omwo of EWu Nibirs Progmms and Services Handbook. The coniplaint procedures shall OWde
notifiaWorl to all clierds ofdie corriptht pmwedure and hwhW1 trriclhing dw dmq nmwe of comphirth the doetwindin
Wwh waplaint and Wv Nowap with the dKIAD mmure s,aisfkictk�)n withfhe resokitioll
PolAic ftecord', u,vold ReItenifion
1 13) IMCLOon of this CMHMCL Pnwider agwes to all pnwkkmA of Charm H 9. RS. and aln, uVer
11)p I i C a.b I e I a%%, a Il il d s I'l a I I°
1 . 1 ,1 Keep riod mainlabi public rccords required I, the Ekpmmms to paAwm Ile coinmied soNivu,
I I J ,2 Upon request arum the Depsuintent's cumnlian ofloublic renal is.yriwide a cNwla;+,t of the requested
TCOX'As,orall:o)v Ill e rociz)r(ts, to be inspected or ctl0d WON a immiabW lime at a most that chics
not exceed the coo pno;kQd in Charm I PIF S- or dS iW r)lX1VidCd by 1011V.
I Ll 3 Ensure th,al JA[WiC I'CC0rdq IfUll: MV eN011iffl, or 0)tIl'id0flUI1 J11d h-0111 put.,flic records
dischwao r"Whvirnums am im dinclosod exm!pt as aud%Qed by law %- Me durviiion of Wc
convAct tani and [61h)wNjng completion of the comw if IN hvvWcr c1m, m imnsibr th.c
FCCOT(ls to the Alkancle,
11.1.1 Upcmi cornpleRn of We collunia the NoMer will chher tronsbr. at mo cost 0 the I)qwunnon,or
We Alliance.all public records in jumse"Ani of the M WT. (n- will keep and Mil"1411 in PUbliC
rands required b'N-Atc Mparlilumt. i roe NoMer tionsIrs all link Vic records 'lo 1h('.
up co on mplelion of the colinAer Pnivider shall (Ics1roy ull) plibliC I'V011AS 011M "Irl-e
cN,clllpt.. i'll. ccitil'identhl and exemp4. Roni public records dkchiure relidivinclils, I f We Provider
k ecr)s "Ind lua ill(a i iis pu bl W rm"As upon vani p Won of We coinracl- the ProOdar sha I I Tit eel rd I
apWicabN mquh-onients ail retailifng puflic raoxi*. All iowds =Td cleckonically nuist be
proOdul to lhQ Depaimcni in a Moat 1% is cmnlxifilfle wN,jjlj [he in fi)I'lual it),111 J,QrCjjm)()J()l,j)
S)Sterns of 11le
1 1 .2 Fhe ,A ll!ianee nlay this waitrao. ;Rn�, ollicr pr(rn isiolls I.rl,tlriw colltrala rol�
refusa I 1)� the Provider to comply wich ,VFTA(,,'1 I NJ 1-3017 1 of IN contracl b�, tiol arl lowii ig public; acceSS 10
aH WoOM lettcrs. or oflilei, nialcrial niadc or recej%cd 1)' lhe llr()Vitt�r in �",olljkilwtkl ul %,� ith this
croinlracl. airless the mcordS WV CXCMPL (11 001INVIVIAl and UNUMP1. 1hyrn Scclion 24(a) of An icle I of die
Shale (InstALHion and s, I 19117( 14 F.S
IF' WlE PROVIDEIR JLXS (,),UES'T[()NS' R1,',(;AR[1lfN(; THE APPIJCXFI0,N ()],° ("HAPTER 119.,
1a°°1,A)RIOA STATUTES, To 'min PROVURER'S DUTY To PROVIDE PUBLIC NEXIMS
RELATING IS1 111S, ("0,N"I'll A(-�T, (..0N`J'ACTTI(F� CUS"I'ODLAN OF P1,1131,117 RF-C Olu)s AT
1"U1a11C Recouxis 1300111hlahor
Depal"Inlient 4,4 1^,'Ider.
AM% 4040 tNIOunade Wny
71'affialiassee, F'fi-nolda 32399,
8504102342
Page 4 of 72
RRAUR2.
12 AndS, Inspeedaim, lavestigallanq PuWk Rcmr&and ROM%
12.1
std'Rciew to reflect A ans, obl4ationg Lan biigmed balances,, incoirie,, interem ancl expenditures of fili"Ids
pvtidul by he UK=Under HIS CMUMCL Wilder Mmil adequatcly safi guard all m.1C11@,SS,eN 81111d,aS'SUre thO,ALN LJSQd
sAdy Ir Me pmpmn aWIuQzedQn&R,this contract. WhcnQvci, appropriate, Himull W%mation Owuld be rebted to
pu[i5rnuincv mid unit com (bita,
12,2 Thc Provider shall retahi all client recomls, Rmancial records,, supporting document, sraristical iveord, avid, any oler
dowumems (WeNdOg Wrock swmge nw&A) pwimm to Mis Contract for 41 period m�)Tsix (6) ye ars after Counpleti(mi of
On,contract or longer vOwn ruptimil bylaw.
as W-Urnmn pub of six(6)yvars atler die Midit report is ismicd or until resolution of any audit findings or litigation based
an Me Wmu oftivis mmurac; at no additional u�pst to,flie Delmr1irieni or the Alliancz
122.3. Upc)n (iQuiand, al no additional cost to, time Del!)artrnem or Me AHInce, the Wider will facilitaw the ch.iplication and
trainfir of any necords or documents during the required retenkon period in Fliiriigiraph 112,
1 2_�.Jr. J'lj� 1'ro%ridej,' Sjratll �issure that the records describal in US seelion shall be sui�jeet at aH re".1'sionable tinles, to i nis peel ion,
r,oview, copying,ormWit Q; Federak Tat, orotupasmnel daily WNAW by MeAkWue�
125 At A roammal-ile times Barr rah lo,ngas records are niainAlkilACCI, dtd `authorji�ed by the Alliance,the Departirrient and
F,ecler,ol'jklditors,,puirsuant ro 45 CFR&171 WE be Wkmvd full Access to and be right 0 examine any vof Me PmOda's
Qonlracts'arld trelateld no,c�irds and docuntents puthmm to this speRk CmMuct, t-egardless of tine t`brni in wvhkichi kept.
12.16. Fhe Providter shal I provide a Wandaland umWIStwe audit to the Allinm as speci f5Q,d in Mis contract and ensure that all
t-chted kirkparty Uwmictiknis are 4,fisclosed tom the audit(pf.
12 7. The Provkler Qiall comp ly and cam ),wrale imiriedJalely vvinth aqy inspeakmy reviewt Kntigmimis, Wr MGM deemed
imcemary by W of1w of to DqmrhnvWs WsimutmAjenend puNuart, to& 20A55, RS. PmvWer Wwr agnes Ow" it
SN'111 Jndbd) 41 rehmed Suk'Contracts a ond/or voton puRmn&g"o? or pu6d Qg
st,!rvia:Qs INJIP;nam to his core Mara W cmVuso A Mc AR=w Inspcck)r GencrW W any QWputinn mul it,
i nspecdoy w rvvic"AK hcu"W fuummnt on s, 20BO 50 1, S. 13) excup km of ON cmomo To 11M WC omwql dut
A WousAwls and "M cmnpb Wkh His SAWC6011
13J Ile ProWer shall e,�eciatc ussUrancus in ATTACIINIENT V1 ffia,t it "A not WimWe agakut any-Amman in the
provision of qerviceq ur 1,)Cnefils "wider this contract or in employmein became of aggr race. rdigh; chm; disabiklitty,
nakmai Won,nuirdal status or sex in complince with mate and Wend la vv and regulmiori.q. The Provider (`Irffierassures,
that all humidm,subcornnacturs, vendors, wNlrantemow otheis Nvkh Nwharn it aningns lo provide servizes car beneAls in
connection with arly of its progmtris Widavtiviksure iu)t disairributQ agi.ijnst clients or eniffloyees her�iluse oj`.nge, race,
Sigh%cohq all amWmility,nai i,onal origin, nialital Sivitus mar Sex"
112 Dwhg be kmi of Qk conumt the PmvWu sliudl coniWate and retain on Rk a WQ completo mid accunAe ChT Rights
Coniijiliance Checklisi, aitadied to pleas cionlract,
113 The [It"ovikler shall establish proQQdures pursuairt to federid law ru.) handle comphlits of diurimbakm hwolviing services
cr bmwfits dwough ME emmmet. %se procedums will hwimle no,tiping climm,emphite,and pailklonm(W the dght
io Hie as complaha m5h A qTrupdme G&W or maw wvQ
13A If MA cotwed cmdains Nem! Wds, these assurarrus my a emild,on of conkuwd recell of or bmwht firoin fednal
ffimneial assistance, and me WnIng upml Me PMVWM% hs Successors, transfereo , and assignc,es lbr the period during
whiel'i SUCK assimanco is provided. "Ibe Providcr further assures that all Subcontradors, vendors.,, or fathers with whoin it
arranges to provide or henefits,to pwi Rjams or mmpkyees in cumwedon wit any of its pmgmms and acdOWs
are not discriminating, againM� those particoams or empWyees hi Whibi of the above slatutes, regulations, guidieline%
Page 5 of 72
RP-2129,2
and sWrwkWY In the emm of hHure to cmnpt,We Ikovidlar undlet-Mands thal the AHWxe ntM allB disorshn, seekil
ontr,l order requiring cornp[imcc with the wrins orwis assural ormselk whar anxqviatlejudicia[or
including but iuit fintiled to,tertitinat iori of and denial offurthcr ivyii�stanee,
It ProOsWo of Senims
The 1'rolidder shall provide We servAs rehnred to inATTACHMENI'VII in the nianner ale scilibed in the Dqmrrmeral Progmms,
& Svi-vices 1hut(fbook a the ProyMa"s Service Provider Application (SPA), In he event of a conflict betmcen the Service
Provider Apph,calkni and this,contract,the contra lut language I)revafls.
I' MoNtedog by Me AlIliance
lie Pr-ovider lici-sons duly attl[torizedl Qy the Uiance to inspect mid sTy any rmard& p"em dommon% hadMies,
go,ods and 5Q'j-vijxs cal- the Provider llvhjcfi are relevant to this contract, and tea Rrner%liew any clients, enipk�,ylces anld,
subcontralutolvendor muployees of the Floviderl to assure the A110ce of the smisfaVog pulnuancle ofthe terms and,oxiditions
of CIA cmarw Folkiwhag such reviewl, the Aflince wHI ddivoto the Pmvida- a. wriuen ixport of ils Hndihg, and vvlm,e
appopiaw. the PKwWm- OmH domlop, as Wrimlive Auln Phn (('API Vw Provider hetvl)y agrees Etna finle[y, correct kill
deficilancies idenfi tied in he CAR
16. Coardinated NItiniUiring with ()1her Agencks
If to Pm6da noceives Wnding 'cairn one or romv ofthe State of FEW Oman smNiQc agcricic,s, inaddifion tea,A 11 in lice fitriding,
Men an joint nionhat-bg Wit including mxh atha agenbes nmy be schedWA For the piopiAos WOW conwo and InRivant to s,
287A571 VS. as anumdW, Florida's hltuman service agencies shall include title Department of (Itildren an(] 17aniihies, Ote
Dlaimarnora ollkal&, the Agency My Wsons with DAAUhk%We Dqmanimn of"Veterans A fahs,and the Depaninent WOO,
ARbAs Itan as ifluation and Te subsequent schedtdirg of such a. Ah by the dehgi�atc(,l ngtaicy's lead, administrative
emmiruitov (lie PrOw do.sliall commy and o"Wete with a]I rn(�nnlk.o,rs, inspoctolr�, and/or invcmig,-awrs,
16 1 Ne%w Contraet(ll Repul:ing-
Ile WmArdiall notify the Alliame Whin Wn(1W clays of emering ima a new,oianu with, mu obastow hmman savice
agonty- Fhe noflkcatkm shall AxIode the 516wing Wklmatkm: (1) contmethag Sue igcnQy and the aplil4cable oflice or
pr,;.,)grariR issuing the contradn(2)contirad name and numbal(3)connov Mart and owl datc�; (4)conh-actaniount;(5),conuitet
d1tscription,and Qouitnodiq, or servke; and(6)Conuact Manager name and ommael khrrivollun,
I T. 1 n tic in n H ilea tion
Ile %6der sital I indlenuiHI, save, delind. and hold harmless the; Depammu mull be A%wc, nqd j(,l, agents all(I eimployeles
Rom any mid all chims, dlainwhIn actknis, CZ)L15eS Cif J,Cliffll Ctf Whatever nallWe ot tharacter, arising out ll�)for by reason of-the
eXeCU61011 0 fth is `l1gJ-QQnieW: olr perl6rniance of he see ices panfled Rn hmAn. H k undasmod and agreed fleet the FKAdo- is
not required to indiminji), the Alliance R)r 05% ldemmds, aakns or emses of adWn arisirig solely out of the Alliance's
negligence.
18. Insuranev and Bantling
18.1 'fhe lbovids-01=11 prov% cwnWmmw adUqualle habifity insuratice cowerage durnig Me eNistencr of this coritract and any,
rcn,,wal(s) and eNtension(s) cif it, By execution of his conamt, indess it is as state apncy cur WhOshn n d.eTwd hy
subsedion 76328PJAW, Me lAvider accepts f011: responsibfli,ty for identifying and illowunining than type(s) and extent
of liability insunan" inassary to pmvide reasonaWe 17innell provailans liar the PTOOdU al Me cheats to be semed
under Mik comma o 'Um A H We shot be Acluded as an aduRdonal hnuwd on die Provider's liability i Itsum vice policy or
palicics and a (-opy of he COWMW Df huttrance W11 be farm"ided ,annUABY or wlwn any changes, occur. The knits of
Qoveroge under each pollity nilaintabied by die PmAda do neat Mmir the 1'rovidur's fiablifily and, obligatioris, under this
conUaa Ile Pm Oda Will numv that Me Allimwe haws eq,of the mom centre at written vlcrifig('alion of insurance CoVerra,4 throughout the lernicif ffiis contract, Such coverage niay 1!me ix,olvided by as self'hulurance progrmn utabliflied and operadng
UMICT Q hws of Te We of FWd&, Vile Alliance rvslerveq OW right U) rewdre addifio'111,11 iWISUraRCC it this
contrad,
18-2 '11117011glIAMIt be teRn DIT INS agreernera, thle 11rcivider Out mAnWn an Wwwwe bmW hvm om*onshle cornmucial
Knuranoe cwnpwy covehng all Wcers, directors, enqfloylees mml agens of Me Pmvidler awhwind to tundle funds
rQceivled or disbursed undil all,, agreerments and./or contracts incorporating this c(,infind by reATme in an ammmt
cornmanwoe with the Wnds handIA,the degree of risk as dolerninxid by the insu,rance complany and clorisistent%Vidi good
h omes pradem"
leave 6 of 72
RP-2 I ZU
19. Confidentfisfity of
The Pirovilder shaH riot toe or dic6se aq inkinadon conceriAng a re pient of suvkvs undo, this uirtu°act for any
probibiled by state or Fedaml la%v or regulmions eNcepl w4h the written cornent of a pm-son legally atahorizedl to give that con%oa
or when nirfluirized by law,
ZO, Health InsurannAkNoWliq and AuouMaWMy Act
Where appliablo Me Provider shall eanipj� Wdi die Heakh hnwwwe Pmulhlhy W Ammuillabi lity Act (if 19,96, Public Law
104-191 J, as xvd I as roll regi,datitins prornulgared thereunder(45 CFR 16D, 1624 and 1 MY
21. Incident RepmIQ
�2 1.1 The Provider I= WHY Me AMmme inmmdiawly bw no la kr Man !rcwt.y-eight (48)hours front the Provider"s,avareness
or di.sQovery eat o,)nditions that may materially affect this PmAderl, subcontractor',,, oir vendor's abilfty to perko,ni the
sorvioes requ6-od to be Perhmud uncler mW carat a, Surch nwke WH be mule orally to the Covrtraict NMafia ger (b)�;
telepin)iw) 16111 an Cniad U) ininrediatcly" follow,
2 1.2 The Provido-shall inirntechawly report knowkdge or reasonable SUSPOO11 ir�g]Qo,oi-exploitation,ON)child, aged,
pax no,or dkaWcd adult k) the Florida Abuse I ladle on It swewide 014ve WQpluniv iniviiher(1-800-9,6ABU SE), As
requird by Chaplas 39 and 415, F.S, dAs prirvibn k&IWWg upon le OwMer, sAconnows, vmWoix wd their
eniplayees.
22. Bankruptcy WtHkaden
K at Wq We dwing flic terwri ofdiis contract, Me Pr,�.!wicfer, is assy nee, milvoilracic."ws, vend(irN tier affifiates files a china lbr
bankrulitcy, the Provkler nrusl inuimcliatielly notify the A.111ma WhWn Wn (10),d4y.s afkr liotAcatimi, Me PruAder mum ako
provide the fifflowhig %nnMimi w the Uiance: (I;) the date of Ring of Ove bankruptcy polincin; (2) the case intir)ber, (3) Me
court name and than dhkion I mkich the pailion was Hled Q g, Nordiern EWE of l)jviMon); and (4) them
narne,addrcss,and telclifione nuniber of the hankruptcy attorney,
�23. Sponsorship and 1:11ullifichy
211 As wqKrod by s. 28125, FS, W the Provider N a nmygmvmmemal orgardankm wIldch spnisms as Ixogmni hmmeall
wholt, or in part by sWw Wds, inducling aq himh oNadned dmmoi this contract, A shall.,, iripublichig,Mvenwhig, or
describing the sponsorship of the program, state: "Sponsored by (Provider's riame), MQ State offlorida Department of
Elder Affairs and the Alfi;irtce for Aging, Inc," If sponsorship neWence is in written material, the words "State of
Florida, Department of Ellder ,Aff)� irs"and "Alldance for Aging, Inc." shall appear in at lcast the same size letters or type
as die rurne mad" he organivdion,
)t.,2 The Provider OW not use the ivouls4he State of Horida Departniva of Elder AVISW gar"Wharice for Argin1g, 1111C' t;0
indicate qxmw)rship all progmvi odicrwise financed,Imless,Sped fie audiorization has been uflikjined by the Alh,ance prior
10 ime.
21 AsAgurnents
2d.1 The, Provider WH not avWn the:righs and reVonskiliks mider this unitract wvithoul the prior written ap,j,,i,rova1 of'the
AHWo tdikti diafl not Ihe. unreasonably withheld. Any sublicense. avhgnni nl, or transf`cr other-wise occurring wilhoitt
prior,writteri appn�ival of the Ad We will consthate a rriaterial breach mat"floc contract,
24.2. 1-1iQ Alliance W at aN tune be emdlakto avWn or uanskq ht whole or pa-I, irs rights, duties,or obligations tincler this
cmitrad to aitalher agowy upon gKing priar wducii acAke to the NoWden hi the cvon the Alliance appruves transfer o'
to PwOdal obligohns,the 17rovi der rein ai its respons I I e Nr all WON perhm-med and A mpm ses incurred W em nectimr
n1th the ccnmmv
24.3 TbisQoWt,-WAwH mr-nain bhdingtVon the mweessors in owst orchhcrthc NvNiderorlhe Alliance,
Page 7 of 72
RP-21212
25. Subcontracts
25.1 'Hie NoviW is respolidble IN all wwi [,rerfun°licd pursumU to thl corittwrt whellre'r actually furnisl'led fry flie, 1'rovider or
its subc(�nilractors and,d"cir venc[ors. An,y subcorttracts dial I be evidenced by as mmitten docutnent:and sub,j�ect to any conditions
of approval Hie 10 Hance die nis rweessaiy� The 1huyider niuM vusure Mat the Uhme bm a ourent INI of ails ubewitrackws
andAirvendors, The Providla RmMer agrees Matte Alliance shall no, be liable to the subcontractor arld/or vendor`in any
guy or for any reamni,, The Prov%4 at As expermc, shil deNnd Me AHInce qgairlm any nwh Wals.
212 Ile Provider shall promptly pay any subcontrmtors andfor voidors upon receipt of'paytnent ftonr the A[Jian,ce. l"'adury (o
nwkc paymenis to roomy subconnnicfor zindAar vendor in acconlatwe nth s, 28T0585,, FS, unless offierwise su42d. in 01C
contract between (1,10 Provider and subcorrtract(:Pr kurdVor vendor,will acrid( in a penalW as RmOdM by Maw.
.26. Indelremlent Capacity of Provider
It is die invon an(,] undei--manding of We Pan is dmt the heAdm cw any or us subeontractors are irldel)endent
Nuddes and are iml cmployew of die Alliance and W law hWd Owlilselves out as orriployees or agents ol:'the Alliance;m,idwut
Weeine awholization horn dre Alliance, It is the fUnher intern and underslan(fing of the Parties Orat the Alliance(h),es not control
4'le prad% of We ProOder and Muld in be liable Ir any ivage and hoi,ir, eniployment discrinrination., or other
labor and ennpl(:mN/nient WOns agWnst the Panfler or us sAcolmnamN abAn vaWorm All deductions f6r, social soNuky,
%,vithla)[1clinp taNes' Wme mum coritributions to uneraph),ient coirlpmnathmi, hirlds and aril necessary imurame Irthe Prodder
shall be the su,le reslionsibil,ity ol"ithe Provkjer,
21 Payawnt
27.1. Payments wil I Inc,lmnle to Hie Pnwider pursuant to s. 215A24 ES, as services are ren(Jer-ed and invoiced by the Provider.
Fhe Allimice Wl Juive final approval ciTle i"Won for pqmciu and YAH approve dw invUe Ir pqnmu on, irow,
Provider has niel all wrins and conditions of'the contract, Unks Me bkl specAlcations, purchascorder, err ll!iis, c(:nitratt
qedl olerwism Ito appruved Woke will be submitted to the Alharl"'s fisQa11l secti(in fiir lmdgetainy apl!)roval and
j.rracessing. Di�putes arish1goverr arl(I payi,rients m,Nill be resolved in accuidancevokh the pcovkions ofs 210422
PIS.
2) 2. The Pamider agrees to submit bills for ties or Wer amVermsion Ir smvkcs or expenses in sufficient Will Rn a proper
jut audit and pma and! Memof Wier Provider shall comply %vkh the padcWar requArrients under the lbllomJng ki%vs,and
guidelines Mat arc applicable to the cumumas or agmements Worporating in this contra"by refirence: (a) paragiaj!Ai (16)
(b)of s.2 16.18[ FI,S,,regarding advancec(b) .ule 691-40.103 F.A.C.perlinirlg to OMSK of Expendhums Sm,sure
US,and,(c) the lnvWce ReWAvm=M Wit Rdbre mere GuWc Ir SWW F.\penA1iAurv.,,-,, fn�jrti the Depariniu'lt()f Finmwhl
Scl-vi,cQs at;
'rhe i3mvida will ceri:O',flval deutiled(Mcumematimi is avaikible lo supparinneh Sal on Me Arrhoed Noice or paynicro
request Am- cost rebribursed expense% Rxed rme or deHyelibles c(mhacts or ap-eemogs, OcKporming this contract by
including paid subconlractor an,d/or, vendor invoiceN and SH be produced "on rein ot by Ow AHArls, 1%
Prov%idl fudher cett#Unluedirbtaselnent requen;are only lkl,r ollow,--flale e,~peinsiesas defined in the laws arid guiding
circulan; OW in, Sections 4 t,'ifthis cormact, in Me Relirence (iuide fi,)r Stale ExpendRines, and any other- laws or
regtdkions, as applWYe.
2T3. 11m lluvW= its subcontracturs and/or venclors sJuH pmvide wits ofAdUmbles, including rep(wts, fin,dings,and drafter
as speciMed in the amimas or agivemems and muchirlons Akh incorporate this connect to he rmeked and aneMed by
the Contract Manager prior to paymient,
27A. Nrnentls will be nradle to the Provider based mi a coniphate and c4�)rrect invoice, iinvoices that are hworn.plele ol. with
hwomW toWl will not be pwcessed and W11 be romiled to A PTovWer Jbi, ccirreclion. Fiscal staff will not be a'blc t(")
c4�)rj-ecl or niakie, chainges W We hwokes. Rotunnhq Wims Rw allmeouns oray result itl failure to receive paynient for
Clot mont, Wokes shall be submined dmey an pa AITACHMENT V]If in order to avoid any jxryrriern dolays.
275. F,ich service perWried shanll be recorded as specified in Ow client inrortnadon, andl registration tracking sy stcni (CIRTS)
guidelines, Suppcirfing docunwntmion of savikes piwixlvd mum be uligate to per nit fiscal mid Impgranumatre evialln,'nion
and erimmv WW imanagemem.
Page, 8 of 72
RX2129.2
2% Re"win of Funds
Ite Prov%7 will relimn 0 the Alliance any civeTayrnerns due to uttearned Wrids or funds clkalknved and any inturest anhhutable
1) such flunds imusuant 10 the terins and ema6mu of NS COMW thou wax dkinned to Me PwWrAy Ow AWamn in die
event th"a the Prov% or ils bullpaWeni auditor discovers that an ovupayawnt has been madc-_ the Prxl,vider sbal] repay said
overpnyrnent inunciliately wilhoua prior notification hvin the Uhwc in Me mcut pliant the Adiance Hirst dkwvas art
muTymern has been made,the Cc)ntract Mariaga-, oil behaffa,fthie A thanc, wd! natiff the I"Wder by Inner or such fintlirigs.
Should repRyttreitt nol be nuide lbrlh�k-itfi, the Provider W1 be charged nt the lawfid rme ofirltereit on the Outskanding balance
Inu-sunrit to s. 55-1)[3, F,S.,after Alljonee,ncilifiottion or Provider drsstovel�y.
29. Data lniegrHy anal Safeguarding Inhirmallon
Ile Pnwider and its su beco tt racto i's an(Vor w,eirdlors skull fil[SUre �Afl al3propriale level D"aw sumly liar Me h1mriation Q
11rcmider is coll"fing or uAng in the pti-hrrrimme of this cm-Etract. An apprcjpri,arou lee of' wcurity ir-icludes drp])roving and,
vacking 011 PmOder ernoopes; that rmpmt psurn or AWmadon amess and ensm-ing that user access has been, rcituaved
all tenArmsed ariNqvWDw Provkfer, among 01heir mIukenv ova As, snum aacipatQ and prepaze for dle loss of" in4b]-ril'ation
processing cajiabilities All thita and sofiware shall be rnutinQ backed up to ensmv memoy fimm knos cunniMgm af. be
Computer syslem. 'rfie secudry ouvr the backed-up data k too be as stringent as the pRotectinn reWdred af We pdmaU symnr& The
Providu Mull emure 01 mWiriwomrs and/by vendum n5main wrilteti, procedures R')r corlrrputer S�Slenii back-upard; ree'Dver)'.
1he Provkhr AmH emn0cm and sign ATTACIMIENT 0 1 pHor to Me eximudar;of this canouct.
31L Social Nledillarid Persona](:ell Phone use.
3111 Inappimpidme use of sochl media and penalmd ccH phones may pose risks, to DOEA's confidentin] and propriewry
inkirrintioil and: may jeopardize complimme withi legal w�,bfigatiorls, By MgWn th caittract, Pro vilder agirees to the
Waming sooWl rnedJa and pasmud ed! p1mme use mqukerrients.
3(Q social 'Mediae Det'ined, The lerm Suchl NUTa wrid ior VOillAlkir includes, but is not firuileid tub,
mxhhwWarkhg wehim hkwL poka9v discimsion Puma,RSS kh,Woo shadrig,SMS1 including Dirva N'lessages,
(011% h4esuges.WM menagcs, MY mxhl ridwaks Ile hnsaigmm, TWAk,Srlapiclta,,tw(�ioogle I lari��P)uts, WhatsApp,
%gimn Fucka" Pintemst_ and "ruinein amd rontent shwhW Utwods swh as Fhckr and V avid rude. INs AdudIes Me
UansnAssion of so;W1 nwha through irly; cedidar or Whim timnsirldiskm via any cleanxi, interns. humna or oMer
wive less,
303 Application to aity divri; or incidenial WEA or An- We business- '['his Contu'liel applies- to any D(*A, Or wAfitr Mate
HaWess am&wwd on aq or dw Piuvida-'s, SILbcontractor's, or their entployees' sochl inedia accounts or through,
persoind cdwwr e man muniemorn.
30.4 Applicad,on to DOM A Mince. and NuNidcrs Equyunink Ilk caturact asap iks regard less ofwll,effier thesracial ructlia is
aw"sed us ing,W.)EA's FrWililies and eVipmed carequipment belonghig to provider,Subcontractor,mar their respective
ernoo)ves. Equyimew Wck&%but is not Whad UL povaM om"uten WuIar phones,personal digital Wsfanm simarl
WaWw% gat stoam Wmets,
3R5
wher slate bushmss condueWd by Sochi rnedia air 1WVUgh peawtal "I'lular iis subject to, Florida's
(Joverranew in,ffie Stinshine Law4 Fps ddWs Public Records Law(Chapter 119, [.'foridgi Slatutts),and the Reafth Insurance,
fIcn-Labilily and Accounwbility AO ;=Aj Camobtex wait h Maw Uws and other applicable W mv Maher detailed in
W Coma,
al
p 6i Any scacial niecha posts Which inchilde phollos, Videos, Or nanleS o,f Cl VWV vwunteu& sty RI or aMer=mes of DOEA
imy opy be pwwd whelt aulli,oirized by Imv and m1mi any reap hred JHPAA mWAwknts and any Wier coments or
pursuant to fedQnal,imstake WW am oit file w%ith the I"rovider's records,
3L comns or i merest
The Providurshall establish safFegoards to pnflflbit erniplo ees,Iboruralnnernbers,nianagenrent mul subicontraclors,frorn using,',their
polsition"', lbr as purpose thus Consdrules or ptwents Me appearance of personal or Cordlict of irlteresa or personal
gin.
No empyVe, oflka,or agent of the NoWder or subcontractor 94WI jmrtkjpmle arm selmdoq or hi he award of an a ernent
supported by state or fiAerat ftinds if a conthet ofintertst, nQ or upparenot, would be ifivolveT Such a conma wouw arke
when; (a) the enqVloye, Whom-, or aigent; (b) any rnernhu of bis/her 6nniediate filtnfly,, (C) his or ficr partner;, cn- (d) an
orgainbalibri which eniphys, or is about to eiriploy, an), of the above, has a Hrimidul or other intemst in the Furn seliected for
Page 9 of 72
RP-2129,2
awaml.Ile lAvvider m*subcontraday's officers,employees or agents,will neither solicit,nor accept gTatifities, bvors or anything
of'nnotictat vahic fi-mire Providers, li(!)tentia I Providers, or partios to,
%suarn to Umqu 4.Sectkat 2 of"the Depaimnom of Ekkr A ffaim Pirogi-mit and Wms Hwidbook no Proybu truy cono,
in aiq capachy, any maher of Is gavenn,Wg boani or any WK inetriba d a pawn on Me boardl co, finflly iriember of hs
Executive Diseclor.
"floc Providers' board mejohers and managemenil inust didme to die Afliamt; my, Mattonsbip whicli may be, or 1111ay be
periceivedl to be, as conflict with-i IQ (30) calaidar Qs of mi hdiOdual's original appointment or placentent ni
that position, c1l. it"the individual is scry In as an inwailienr UK Wy (30) cah%r (Loys of the Cola III ell[Cein"Ient of tld ,
conUIOLThe havidQrserriployees andsubcontractors must make the sanie d1sclosures desedhed.Whove to the thavidere Board
of Diteaors',. Conipfinrict this provision will be moinkored,
3L PWAc Why Wnte
Mwsuant U) s, 287 13110, a petwon or ME% who As bmn pWmd on he convOwd vormfor HM Wo6mg a amp.awn bor a
Pu Mica entity critrie nuty am submit a Wd, proposa 4 or rep,on a coiant W p mvialur arty goods im-wrvices k),n public entity; may
not stImh as Wd, 1!)rolios-al,or reply an as concoct whit a pUlAiC entity Purr Me consinuion or mpad of a hulk NdWing or puKHe
NW1 may not subnQ W pmpwdv or replies on bases 01"tval Property to a POOR adkq may jult beawardedl�'Jr perf6rm work
as a PUWWM, MWPHa. W.PIVAU Or ccumuhmirmishr a contract wit any pubHe endly, and may nut iransad business wvitfi
any pubtfic entity in, excess of the threshold arnount provided in & 287J)17, FS, Or CaRgm-yTwo I'm- a period of 36 nionAhs
NAWwh% Me dMe ofbeing p6cod on the corivictcd vend(�w ks UK PmvWa or my onts olh= or directom is comdcwd of
as public entity crin'te dmhg Ow perictJ of Mk apmerimm, he %viAer dud nwily We Alhaa,Qc inuncifiaWly, Ni�,,in-corripfiotnce
With IN statute Wall consfitwen,breach o,fthis agreen'lent"
33. Eumergency PrepaWness and Continuity of Operations
"Ile 11mvider shad, %QbAn thhly (30) calmular days of the eNecuMon of Mis cown, submit la the Contract h4anager verificat ion
onm emaVawy,pi,q)aroth'icss plan. ht the cvctit o(';in the FinoviclerfaU nNill die Alhame ukawrpmwy pmAdma.
In the event a siWatitin rcsulta in a cesstition of-wrvices bya sub-Providor"the Pro ida sliall raiiii responsilitlity Ibis perf6rin"Ince
under 1%contmet mW must Ullow procedurvs to ansurs:continuity of operadons %Wthoul Werryinn.
34. Lurchas-in
I'l.1: "I'lle Provider shall prootre prr�xklcts amd/or Services rectuired to porf"brim this contact in accoulance ;Wth s.413.036, F.S.
311 A HAS EXPRESSLY UNDERSTUOD A1913 AGREED "THin A NY ARTICIES THNF ARE ITIE SURA0'
Olf", OR RL`,QIJ1lZFD 11) CARRY Uvr. rHIS CONTRACI SHAIL 13F Pt. R(7'HASED I`R()�M A W)NPROF11
AGENCY F(Al DIE BUNI) ()R THE SEVERUY HNISDICAFFED THAT IS QUAI.11-11E]-) I"URSUANT TO
(211APTE'R 41.3, lN THE SAME MANNER AND UNDER 111F, SAME PR(KTD1JRES SET FOWni IN S.,
,113-036(t), AND (�2), ANI) FOR PURP(),SES (.)F JIHS U)NINACT ITIE PE16(),N, ["IRM— OR 0l11[',.,R
BUSINESS ENTI'VY ('ARRYING (),UT 111E PROVISWVS, 0[F—I'HlS (7,ONTRACT SlIALL ffl] I)EEN/1f`.D TO, 131",'
SUBSITFUTED FOR THE sTKrE AGENCY INSOFAR AS Df.ALING,S Wl'I'l I S11(:]-I QIJAIL117111E) NONPROP'll
AGENCY ARE(TWERNED.
W L2 Plumiant to & 413A3"1) and (4 h FS, he PmWer Amll no be reqaired topplocure a pix)(luct or service froln,
RESPECT W (k)te product or SCTViCC is not available Whin a reasonable delWery tinwu (b)die Provider is rt;qKivd by
la%v to procure the proW wnsmNke Rmn aq ageowy of Our Mon or (c) Hn PwWer damuhtes MM the perfQrnmw,["�
spocificaHons, p0ce, or(lualiq of the product or serve is am compmable to We lhovider's re,hements.
34.1.3 Addi(ionzil inkrntt,atk�)n about the dedgriated nonpront ago my areal the products it (4fers is ,,Evailable rat
1-1 I'hQ ProvkIer may rxItUase antic es whidi are Ke Qlca of or are required to carry out arty contract or agreement. (ioni
111.1son Rehabi I iuuivie hiclustries, and Diversified Enterprises, Jrtc— (PRIDE) identified under (.1tapter 9,46, F.S.— in, the
s,tinie numner and ender the procedures set rorth in mdneoions 9415 1 X2)ami(4), F.S, For pjurl)oses ofthis cciiimad., the
Provt(ler shall be deenied io lie substivuled Rv that Adlince hwolhr as dealings with PRI[)E, T[iis clau.w is not al.)pkatblo
to skJacontractors unl�eSS OtIICIINViSe 1'e(ttl ired by, W. Pun abbrariMed HM of pn,ductgservices avai lati[e frorn nuay
be oblahicid at lit II)s)ipr ii(�le-en terpfises,orgl.
Page 10 of 72
RP-2129.2
3C2 '17ne PmKu 0011 pwculv any oNyclied produts or maledah, whkh mv the Qyct of or am reqrdmd to carry IS
Coltirwr in occordance,With,the provisions of s. 403.7065, 1 .S..
3& 'Me P U R IND Fw-rn
'On PUR VRW Forruir is Irervby incorporated by rel'crc rice and available at::
In the e"M oF mqnann id between dw PUR I NO Folin and any terms or corufltii-,ins i�J arly corill',RkA 0'r 4.rL"n,Venlo1rt tunas or
conditions tile contract shad take Reoedercv, oveir the I(11* 1000 Fonn, Ifosveye; Wlhe endfaingWrin or candidans in the
PUR IND Forin ive required!,Any seclKnof be FkwMa SG des,thetenns twcoadhim colm5wel M rite VUR HMO Fwm Miall]
lake precedence.
36. use or swe iouitis t, Purchase or [nq)rove Medal Ilroj)erly
No In& undcoMs,conuct V611 be USed Ily—Ow PnvvWer w 1),orc-h'ase m iMtrinrerw e Real llropert):,
Any slate furtds, provided Rw Me lxwduse of or impnwuments to real pro,,perly are coritingent upon the Provider
grarding,M the sWr as wuQj imerest in the propertyw heast to the arnoulm of!Matte firtuls l')rovid,ed for at Icast 5 yews
from Me relate of purchwe or the complahn of Me improvemenN or as NO%reWdred by 1mv.
37. ]data nt&QLi)mQhK lUv
371 11 Ohs comma is awmmlled shells nal d in g and W;my d isanvry4 h Y e wK rr ter eq,ri g halle rri ateri a 1, is de ve Io ped, prc)(h i�.id
or fnr Wch ownersWp ws pwvhmed in the e,,Oursvc)for as a result KA'Nvork or services [rcrf6rnled mider this cottircict 111c
Provider KH reAr dire Ascoveryinvorthn ar rnawWo Me A Hine W be rellgrvd to Me EMparAWL Uy amd al pmerm
rigMs or coIjilliss acendng inxier finis coraism am hereby rnenvd to We Stale of Par% in accordance Cltaiwr
2R6, ES, Purmw to 1 287A571 (5XQ as amended, die only exceplimm U) lis PMN/isix))l ShAl be those that arc clearly
cx1iresseciand reasonably valued in this coruract,
37.2 11 thic 1ninmy bully me of this camuct is Me cremian of hKeaual joperty, tile Slate cif I`Ioricki shall relain all
unswunUmd dght to use such Inopemy, notwidwandbg my awl rervicnt made ino-suaril to this sec&n 33,
37,3 I Nkh cominurt is awarded solely Ademl hmd& life mras and conditiorls are gcivenred by 2(.TR.Part 200.3 15 or 45 CVR
§ 7532Z as aplAkable.
38. INspute Rooluthin
Any 0poe camernirw perhmnime of We catitraci A0 Im de,cided by Ow A Hilince Cmuract klamWm Win AaH mduce he
decision 5 whit&T and save an.cMj; wi Me Pnnider,
391., No Waiwir of Sovereign Ininrunity
hAWAng cont:aWed in this agmanent is in mmled to save aS 11 Waiver ot'so,wreign finninnity by any entily to which s(�aNvteigu
inlarrinily Inlay be aplAic4ll'fle,
40, NInue
Hiny dispMe adyes oul of this contract, the venue of sock legal rNxxwsc swRl be loiarniKade Uxudy, Fladda.
4L Entire(Amwrao
71-11h. coltract Conlains all Me lernis arid condIANn agreed upon by the parties. No ond aVvernerus or mirmsawations shall be
"Hd or binding ygm dw Alitiance or dw Pmvidu unless expressly-coniauwd heirein or by a witten arriendirient to this oontract
signed by heath Parties.
42. Force Majeaure
The Parties w0l no be liable An arV dehl)s or bilures in perInnaricc due to ch-currislances b"ond Sh omrnW, RaWched Me
Party experiencing the forec maIlcurc coirdition provides ininiediate vuhMn notiMcation In the other paq and skes all rrasanaWc
cffixts to cure t1w condifion.
Sevammul Cbmse
T'he Punks agree that if a coon of compowt jukdiction deems mq Inn (A7 condition herein w4l or onnWeablv. the other
pvWms are severabte to that void provision and shall reniklin,in full fbrcc and effe!o
Page 11 of 72
R42129.2
U Candhion Precedent to Contrad: Appiralwintlions
Ile NNW area; Unt the Mliance's performance and abligiifion to pay tonder this contract is contingent upon in arnniql
appropriation by the A.eg!iS1k01ire.
45. AdditionlDeleflon
The Panks a0ve dmq wnwWWWhig the wnns of Me pami-ernmo ductiments and actions leading to this contract, the Alliance
neserves The tight uj add or to delete any of the services required under IN coirtrnt w1mi demnalto be I dw lowl Iterew af to
elder p�,jjnflai i(-in targeted by Me Ama Plan mid iredmed lo as mWen ari'midnicnt signed by boW lKinks, The Panks gull negmiate
conipeimation for any aAditional services added.
441 Nvaker
T'he delay or failtim by Me ARiarwe to exereise or enfoEco any of Its righis. mild this a,'Onlrao S11,111 aoi consthRiie or be delettled,11
waivei-of the Alliance's right thereafter to enforce those rights.,nor shall any single or parrW exercise ofany, such right pirechide
any wher(a- hirlher exeivise Wreof or he excivike of arty twher ript.
47, Com,pliance
'Me ProOder Alall abide by all nprilicable ct.irrent f�,,deral stalu,Aes, la"s, rules and rcgpdations as well as, applicable ctRirrent state
si,Mttes, lmvs, nfles and mguhtiam, policks of the Alliance =1 the [kpadnwri, and the Wnms of Mis Wnhwa, Ile Panics
agmc dNo Whire of Ow I'ToOder to abW by thme Wws,ndes, rygulmion,lvhckq no Innis of Ik Cowtrad W pie WW
wi evant of WAR of the WOW and st.6j,"t Te ProviAaAo disdoMary actiout inthiding con-mlivQ action, i,mznm�ninced
s,jxc kil nit.nottoritig, temporary assialiption of die upamdori of 4.)ne ar niore toraractual sQrvieQs, pluevient of the Provider oil
prob"t(knia'ry Staltis, iniposing a irnoratorkirn on Pr,��)vider action, Wipiming financhl penWdw Mr wqxr1dritance cv
nonconlplli�n�nnce, or other widin4listritlive actimi to hnniediate, unHwal conhitel canwehation at he dkcredon of Me Al thrice,
I f be A H We Rods TM Me l4mvid,er Mils to abide by all aMllicabk cuncin kdoraJ aW Mae malihev tow n&s wW rnultniorts.,
as well as cuiWihions of this ConvacL the 1%Hiance shall provikle Me Provicier allotice ofVnihiticiii whkh 1W I hdu&as cmiche
stateinmo of the spitific violatki,ris of Me f0mvider and the MUS EVhCd UIX111 ft),C'Mabl iSh ["Ile Vi(A,41
l,fl� tt neeei�t �(tliar tit!iwam anf'�rinil"ntinira.,this,l'na��mi i�la~r shall han.wra:tww°em°uty��arrnc d=n f)aday,u+;taa ueslaa,rmitd tarn file nntic.c�f "�'icil�,ttmabam, "N`lae
Thovider's TvsponSC T11115t AcIde an sUternew of any(Spned isstws ofmawrial % mul a coriciso wateinont of the specific Ikets,
die Mvvidcr contends warrant reversal, or deviation fiorn the Allioncel lymp osed. acting including on exNarmthn of homw We
alk"gv"d fik,'ts rclate 10 die qxciRC Mike, statmes,0"ontmetuw to
Failure ol"the lInwider to re"pDad to the Notice ofWadatimi,Wilihn twenlynone(2 1)chip shaR be demnal a Wvr of Me rWhts
ouH in ed aNwe and 0 e A H 1 we w 0 1 pnr weed agki i rim the Prov id or 1,)y de fin u I t..
I'le AN= apon receiving a Wdy Rid wslvnse w a Notice of Vkbdmq wi.11 fi,ww-ard the jv5pomw and till accompanying
doctnilew-,,,djon to the Ca mad Winger 10 review and Consider, fhe Ccintracq Manager jlmt within 30 d"s alle"he rmeifit of
the lfovidm"s respons, file an Wer which bys am the final detenionation action by the Alliance.
48. Final Invoice
The floOder shall almh be Rnal invoice for payinwrto dw AHInce as specified in dvis onntnict, Ifthe 11wider WIS IDsubtifit
H=1 reWwo Rw payment as specified in this coiar=4 then all dghts to 1myrtiont nray be fin-Ceited and be Afliance wiiay niot honor
arty re ltiiesis stibrititte&Any paymov dw tinder ate tents aflids contract irtay be withfidd wind tall,rep oils dae fio)ni the Provider
and necessary aMustments baso have bun agmwul,by Me AHWwe.
4% Renegolliallons w NiodlAcations
NtokiJ fications (ifille proviMmm of Ns cmitma shall,be Wkl ony whmok,y have been rQdtwed lo, writing and, (kily signed by
boM putles,
51 SnWemWn of Wirk:
The AllAwce nny in ju sob d6cmdon,swiperid any or nmfl ackbes under this contract mid my convul or agmmnenl WoMoUng
in this con1mv, at any, Chme, wdieii in dw bet imenosts of to AHAwe to do sm -Me Allikoncia shall provide the Provider writtert
notice oulkning the partictdars of,'mmpertsi,on. 1`�'Xarrlpks of dw Wow or sw;pQrisk,)n incktde, biflare not limited to,, badgeuNry
constraints,declaration of onergency,or oflier stich,cirewnstancos. A rter rv,cewim' g a wqxnsit'm nofice,the 1"rovider sh,al]counply
with the notice Hind Atall no auqu mq pmehaw oi-d.or& MOO& nhwty days, or ww lwger period agreed to by the Provider, the
Page, 12 of 7Z
R41129,2
AUNwe W 6% 0) Am a nolice authorizhig resunipimi, of'wmk, W %4kh tinit activity sludl rQsirnw, or (2j) terruin-ate the,
cm1hicl Or pa-chase(Wer, Suspension of wet WH nut muWe Te ProOder to any ad1hunal comperrimbon,
5L lirminalban
51 A Terinhimbn fm Convenience.]]%is contract rnaty be MaNted by either PWY WithOld C91USe U[ion no,less thain thirty (30)
calendar thays' notice in writing to the otber party unless a sooner We is cnannHy agreed upon hi writing Said riotice
WH be d6vered by 11S. Postal SmNkv %01 Wkwkm cW delivoy or mW eNpeclited, delivery, service iiiat provides
vemmion or mnry or by hand ddivQry to the Alkance Coninact Ntanager c)r tl,w trepresen.tafive offlic llrovidu
responsible fbi, achninistrahlon offfic, c:ontr'acl, Jlw ProvWet, OwN nw Wish any product after it receives the natke ot'
lenninmioM except as necessary to contplete the ow8hued portion of Me cmaict, if any. The f"ravider shafl Tin( be
caul it to reconr any emwelhitimi changes or lost tiro its See rives on eniail regarding thus painpQ.
5L2 Tamhatkn fOr Cfl.L[Se. "I"he AlUance may tenrdnatu this Contract if Me Provi,du Ws ki(1)del N,er the product wkidn the
time specified in the contract or any cxwrtsion, (2) undtikain aidequate progress, thus endarigering poerfbrnmlrice or the
contrim, o) honor mv ierm or me convict, (4) abide Q any slaknal—requirement, regulatory reLIURTOTIC11t, HCCAI.Sftig
requirement, or Departmem pWky or (5) in We event hmds W pMmnan becmue unawdbbk IT Mis comi-aa. lbe
A111we W be Me fillal.MIAFiorny as to die avadhbihty and adeWvwy offunds, In die event of tcrrinnalic)ri,afthis ca.ntriwt,
be PmvWx W be corrkl3en-satod Ibi- any mutt sMINOW" completed prior lo the date of termination. Rule 60A-
1,006(3)„ FA-C,goverris th,e I)TOCCEIIII-Q MKI consequmces ofdQfault, The flnnideir sfiall continue work on ally wvork not
torininkned. Excel!)t for de6whs of stdoconhodurs ad any Go he ProOdu dull nol� be liaIile Rn, an.), excess. co,ms ifflic
fiaiklre to!perf6ri't"I the contract arises froni evmms cotulplmb; beymW the cotorul, and without the fbuk,m- negugYnce,of'
the ProvixIaNthe fitilure to perfin-in is canrjsc(,l by die,dQfhuh of a subconumclor at atty lit and ifthe came of Me de lull
is comilyleteb;beyond.Mz comrad orbmh,A Wider and the subcoi-aractor, and without the fbriflt or negligence ofeaher,
the Provider shall not I)e hable for any enns cash Ow Nue w pot inn, unless the subconoweal pmduos or services
wmv WNW horn othan,owees A smWou time Mr the NoWder to iticel the required delivery Sdled,Ule. If, aflCr
ienninatictri. it is dem?ermi)ied that the ProWer ims not in deW or Out the iliefiault %vas e\cusaMe, the rights and
obhgmions of be Panics shall be the smic an if A terinination WW been Wted IN the cunmnience of1he A[Hance. lie
rights and rernctlies of A Himme Q this(AausQ are iriaialditicgl to any 1yfller rights"Ind reunecljes provided 1),y law or under
he Contract,
513 l Jpon expirktGtm or ternlinadon of this cornrAo, tliQ Proviidcr and subcontractors shall transfi�r all Intblic records irl its
possessim to than Alliance and destroy army dupkatv public records that are exemp or cWdemiaW and excaqm hunt
public records,(fi!sclosuln retluirements at no Qm"o Me Alliamc AM electmidcaly gored mcords shal l. be prt'nided to
the AllInce 5 a Intral thief s conMah,We Wh the AHWnces WnrimianAechnology symetnQ).
5L sucusurrs
This cmvact Imll mmah bhchng upon die succusams in hww of eWwr the Uhme im,11te Provider, subJect to thc 1o&igir1nQ1r1
pr(wisittris in Section 22 above.
51 Ellciaroide vcords and Signature
53,11 'Die Alliance awhochn, but does not nNuitv Me kwovkki- to creme aW Win elearonic records and to use clecti-cmic
sigtiattues W conduct transactions nemmary to canj; out the lums of whis cmmraa A WOK that cremes and rVains
dearottic rworcls,and usts dectronic signtures to condttO (ransete(joins shall v.)jjnply kVith ffiC NCJL61'0111trn contairled in
the Uttifim"m Eleetromic Yransaclion A0, s. NUT VS. All e[ectrarvic recoMs, mum be fiffly audilable; are subject Ict
Florida's Public Records Law,Ch, 119, FQ inusl comp" wifli SwIn 29, Duta hit4zgrityand Safeguarding lnforrn,,di,on�
must mahaam all confidentia1hy,as upralkablez and niust be reaked and mai,ntmined by the Provider to the snxnc extent w,
nctri-dectr-conic:records are remkied and ni-aintained as required by this contract.
53,2 fhe .AlHance's awharizm4iu put-swint to this section does,not authorizv electronic transactions between the Ilrovid:er mid
Me AlIlkince. Um ProvQr is to omWwl e9dronk namnloin Wi the Alliance only upon (All-ther WWII
comma by the A H We.
53J I lPIC)11 [VqUeMl)y thQ Alliance, the ProviAer W provW1 Me AHIKe wr [)eparinient with nori-electronic(paper) copies of,
record& Nori-electronic (paper) copies proviJed k) the Allince of my doultnern that vvas originally in c1ccoviiie forin
Page 13 A 72
RP-2129.2
with an electronic sigrialitre:must indicate the person and,tire person.'s capacity vAo elearoWally AWK Te dmunima oli
away copy of" lie doci,anent,
54. Spechil Vrovisinn,.,i:
The Provideragrees 0 die RAlowhig pmvW=
54.1 htvcsfig.,,Rt ion of Crini inil Allcg-atiojls;
Array rqwit that irriplics crinrinal iriteirt on Me part of Te Pmvider or aany sulxontracnjid,�and/or Nvnd(irs and %:vas referred
to as gottmmsual cr investigatory agency isaisl be, sent to the AlIhme—If Me Prvvi,der ha,,', rvtrson lo lielieve that the
allegatocs %vH I lie rolerred to,dw SWQAMirney, a hi",eiffiirminent agency,the (Jriked 'States Athwiley's office, or othier
gmtmmental agency,the Rviddor All WHY Q A Hime himiedlwy, A copy of all docuineirls, mvpods,notes or Wetr
wduen nmicrial concerning the investig"'I t i on, Whether hi ffie posSCSS4rrl 1�)r tile Pr(�),vidcr., its subcontractors, k�n veirkdors,
must be sent to the Alhanise's contract mariager with,a summary of the investigation aridallegations,
512 Volunwas:
The llrovider shall ensure the use of trained volutifers in prmiding dixect services delivered to ukkr Whviduals and
iridivickials with dis,aliditics needing such services. If passilAe, die Provide- shall, work iii ctiordination with c)]-gallizaticals
that We experience in pnwiling twhig, Qoww, and shponds Q volumeers or particyaw (well as oqpnizations
our: federal scrvicc pnopurns adritinistered by the C"orjxvatiorr for National and Clalirraudry Servicel, in
cornnwnity seivke Wqs.
5C3 Eldhivemea
543,1 ],iikicc)o,r(laiicewkhswton430M4, F.S.the Alhanceimay. ivhhoutmkWgarmy it
agahni this canbact m6nd &K swowt I Me A H hue finds diac
5132 An inwhional or neghges act of the Ruvider has imaluially aRbeted Te heakhoveiRw,or saQ MISMs serval
pwsuamto arly coinict or avrerim, m s0stmvtialily, and nepdvely affixted Ile operation of wrvices covered
under my empact car ogmunrcm;
5113 The PwvWer heks finandd MaNky suffick"Itt to rucer Commowd omgzltiq.lr'ms 4.)r that conlracwal ftinth; Nave lic,,en
54,J,4 Th e Pro%,°ide r lava col 1,11 ii i tte(I lir L I I(it'll Q or rc peat ed Y i of M knis D IT KgM arm reg u I atory s[a i idards,regard kss o J"wh el h er
mwh Jaws or regulafkms am enkmed by the Allihme; or Me 12mvider has, coirmlitted or 1-cpQated vi(flafions of
A H Wri cc s mn&udq;
5135 Ile Pro viclerdias kdkd kv Writic the proWN or eqmnWn of services after- die chchiration of a galre of
erricipanqlaiwor
513A Ile Pwthdcr has failed to adliere to die wils ofany cownwt or'kgreeprient firicolpol-aflng in this ci�)111T;ICL
5133 In that akernative, the Uhwc myq at its sole discredon,take against lite Provider, iniJuding
ecorrectiNc arakirl, unannounced speAl moniRwing, temporary kissunq!�tioji of the operatiq,)n of one or more
contraCtUal 5trVices, pkicQrneri(oftbe PmvWu an pmNi6mmy smw% KnIssing a mamtorimi mi Pmvikler aakin,
help:osing Mimichil Inurraides Ar nontleribrimance,or other adrninimmive acthli-
54A In nukhrigany detertnination under has provision the AHWxe my,rely upon tht Nndhgs 0harrotiter MaW or-Weiml agawy,
or other regalmory ticidy. ,any'elainis A cbminges for bivach ofany cormraet or agreerricirt are cxcnipt froni administrative
pcoceedhigs and shal I be brought bel"orc flie appropriate einfity^ in be Venue Of'Mial-114-Dade ("oulity.
5,43 tj,�o sal'Se rVite 1XII la rs:
The Provider wil] optinolar he use of contma hmds by sembg be nmAnion possibiv nuniber ofinflividuals with, the
services alhnved[)y flik; Fri�)vider will spend all Rmds pmwkkd by Sh coirInal k) pmvixle such soviles.
5W SWOUNDdich Rqwlrt:
The Provida- vvRl abirrit a corn, Widated surp,1u&;def`[cit rej!wrt ilt as 6orinat provided by the Alliance to the AlHance's
Page 14 of 72
RRA1202
Cominct PdAnager in cotgmukin mwith this reqaircd inoritHy billing submission. This repoirt. is for this contract between
die lhovider and the AHiance. The rvport %k,ill ividude the f6l lowing:
Ak I The PwAderl daidled Plan on how the smpkm or deRdt spendiij;exceedky Me I%VrAwkhvi H be rewlved;
54,6 2 Nunil-fee of chns nwmay on die APO,Mat rembe a piar4y ranking score of 1bur(4)or Rye (5);
5AU Number c4dieroams utrwy on Me APt:_ .desWmad as Wirthiso Risk.
54,6A NRunbLr of clients semed and Agiong and Disability ke,,,ourco Centcr("ADRC-) client
fti accordance wit its stwplus/d0kh marraWN1101t POACK ill OThr tutu lMaXi1MiZC ',IWAilable filloding and irtinknize
the tip ne that rmlenAl dims mum wait fior services, 11he pubmwe in its c,-,an!redL1Ce fun(fing awards if
the Plovider is not spendhig accordhkg to rnololhb, plans and is padect"I to Am-a swphos at Me end of We yva.r.
5C7 Tm&WW Ile Prodder will attend A nNphed wiin[ilgs arid ineetings schedulc by thc A llljance
55. CoqU."�,;J man ago,
'Fhe,Alfi�ance n-u,'4y substhwe array A H See omploye to serve an the Anvact %lanager
56, (0ficial P'ayet and lUproenbuhms (Narnt, Addmsq and Iflepbone Numben)
'17he manie, addivss, aW teAqVin nwrtber of area; repr-csottativv r(ir We Alliame Ar ON cmmwt R
NLIN B. Ro'dirruill,JD, L,L M, Presideni ill)(1 CEO
760 N W 10 7th Avc,So i l�e 214
Nfiarii i, Hirri,da 3 3172:
(305)670-6500, Ext, 224
The irmmmine,addivs,imd ldepNme rwniber of the represenUtive,fit'flic Pr(ivider responAhe R)r adni injstv�afioti ofthe Program under
..........................' .........................— . .
G000ly`
01"'Cokulty,C'..o......m.........
i ll i s sto ilers. Slacial
Ilic Flro%k[ea.manic.as d1own on jxq--,CI flhis savil"noWe Sal kc
A voolrac and of the oNiciapa-yec to 1100 Shnoomm Snvcn 2"J Floor
Nwhorn Me pajliern shall be made R KeyWesi. FL 33010
t tl r 2L1V11!11!
W!I NAMra
Fle nalne ol"111C ColIUM PeI'SORI ol,1ho, Providili,and Nlonroe(7oum(y Boat-d of Cuuxll� Cca-nitflssioncr�. sociA
simuk Wvss mhae hnolwil W HnitibumN
Fecords arc ilia irut a i ned is:;
Key AN em. F 1.3 3 0M)
............................... ....... 5 10
shoyl(hubmil
I lic iianic- address,and Wlepheaw moiso ordw Morinpc County Board of(`ouw�,C"conniksiortox, 1,iiwial
repruscinafivc offfic for SUR01.1hame semwes
alnonistrarion of Me pnImm indallds cm0rad is; I 100 S i mono mi Save. V F Wo r
Kc�w West- 1,1,
301292-1510
Alliance for Ag,ing. finc.
Fhe seclion and loeat ion ka i1bin IN:AAA %%here Fiscid Departrilent
d Regnms Rv Pq nwm wad Reccip mW EWetWhire 7641,VA' Suilv 214
Inns are U)be inakal is: h4kini, FhOda 331721155
...... ................................................. ------ ..........
11w ixinn+e. addyess. and seRphone nonWer oftlie Alliance Fal-Aging. Inc.
Conkrack Nlarj�iger for Ow AAA Ir Ais comr.acq is: 760 N VV MA 4 A wun SW k 2 1,4
Mind. Rxida 331724135
..............---........... 3015-61110-65(N)
Page 25 of 72
RP-21,29,2
I 1pon,Qbange 01"repres'entafives(names,addmme%jQpkme nwmbas) by either pwty, noico shd be provided in Arita ig to Te
wher early mid the no6noWn ituadled W dw allout of IN oment.
57. All Terras anid Conditions Included
Ilk conont mW its; AhachnienIs and any CKItibits referenced in,said ,an aduneld, uzgether with any docurliaents incorporated by
reference, tontain alp Ke terms and condilioris aWval upon by the Panks. Rere we no pr-ovisions., terims, conditionv or
nbli,gaflons other than tk*C Wnwhed havht and dais commet AaH momsede aH pvAmis consmunications, represelilzitkins Or
either mflan mnatal between die Wes,
Hy signing Hiiis conhad, Mo Padies apvc Out Ony liave mad and agme U)Me endie contract.
IN 'N1'FNF.S.-S TITFIZIEOF', lhe Parties hudo, hue ear sed thk owlsmt, to be executed, by Own- WmAgurl MAN as dWy
ainhorized-
M
COMAUSSIONERS, SOCIAL
SERVICESIN-110NIE SI'RVICES ]W%
S I(i N E[) B Y: SIGNED BY:
NAME .......... NAME MAX 13, R(),F1,1MMA.N,H), U.M.
'ITFLE: TITLE-,; PRESIDENT AND(TO
DATE DATE;
James D. Digitally signed by James D.
Molenaar
Molenaar EUM 200 MW I I A 829 0410'
Approved as to Form and Legal Sufficiency
James D. Molenaar
Asst. County Attorney
MONROE COUNTY ATTORNEY'S OFFICE
Page 16 of 72
RP-2129,2
IN I)EXTO(",'ONTRACT Ad"I ACIENIENTS
..............
ATTACHNI EN'T ATCAC 11UNIVAT' DESCRIPT10N
ATTACHN'U`N"�F T ...
.......... .I-ATEMEN'T OF WORK
.... ............... .........................-- ---- --— --- ...... ..............
M'TA C1 I NI E N..... .T II FINAN("IAL CONIPLIANCE A UDITAT"t PNCI INIEN-1
A ........................................TIACTIMEN 1.01'FREPLATIONSI 1W I)FTERMINA,TION,
L'EXI HBIT I
" ) ...........
FEDt"HAL RES( URCE'S ANVARDET) PURSUANT'I"0111 11S )UMEENIENT
............................""'..............................ATFA 0"INI l"INT I I I CIEKI,-I1-'ICAT10NS AND ASS1,11ANCES
A 11'A I LM 1:,NT VI ASSURANCES- l,C)N PRO(A.AMS
1ti,7HNIEN, 71 �, ..........................
111 DO r S- UN1 Nfi%,R,� B)"SU'RV I CI A N 1) 'HT1 1"', .................................. ...........
................ -.............................
FLAC71-IN111,N] V111 ANMUCAN UE PLAN CO RAC"I R.I.,P'()R'f ALENDAR
.........................- ......................-
ATTA CI I INA I.,NTI X RFOATST FOR PA" N"N'lENT
...........E .................... AND I NI O's ' I " S...........P.. PR
......
ti'I ACIINlINTX, F"071P'T DE RV...I.C.....E.......S...........(....R.......
I13B f"AHIBIT I ..........CITD ........
ATTAX."11NJEN'l" X, RI"
EI'NIT 01S F R F PO Rill 1,()R N t" I'R I 1110 N S E,R NF I(.'ES IR 1:03 C I)
EXHIBIT2
................... .........................
N 11-C( S I R 1`1`0 R.I"[;'0,R 1( AREGIV1.111 SUPPORT
,A'I".A CH Nif E.NT X, R EC E I Pl A N 1.) U
I"Al-11HIT3
.......................I...........ATFAC I f I,\' F N 11' X, ) UNTCOST REPORTF(M CARI"GWER, YUP11,01U,
EA I I 1 13 11'4 s E 1�v I c (Ii P,3[))
.........................----—- ..................................
I'I'A(11'1-[.\,I ENT X, RECEIPTAND UNH, C0S,1" RH:'10H: 'I- FOR CARE'lGIVER. SUPPORT
I-AIIHIBI'l 5 SUR\,PK EIS (REP.3,E)
................-
A1, 11-A CI INI I E NVV X I ARP(it�ARTI.-'R:LY REPO RI
............................... ...................................
VI-TAC,11 N1 I.,N 1 13
DEPARTMENT OF EJDER AFJ-"Af'RS' ClVff.,R.IGI-ITS COMPLIANCE
CHECKLISTAND INSTRUCTIONS
..............................-
,ATTA CI IM EN I' D 11 A(K.G ROU N D SC'R:.]::.ENI NG-A 1-111)A V IT 0F COM PLI A N CE
..........
A T"I'ACH Nif E NT F BUSINESS ASSM,71ATE, AGREII�.I NIENT
...........
X-FrX C-1 I Nil—EN'I CS........................................... X'b1R(-7F0,IAC'Y ANT), PROCH)"URE"s F(W OU'll"SIOUR( I:,
D 11 M"HONS
'I............. -...................
Pa g e 17 of 7'2
RR-21M2
ATTACI IAI EN'1' I
ALLIANCE INC,
STA"TEME'N"I"01�'WDRK
American Restue I'llan
SE(A'10N 1: SERVICENTO HE PROVIDEI),
1.1 Al Hance AwAginrg, Inc. Mission Statepment
Yhe Alfianee niis5ion is to prtmucle andadvocale f6r the optilrial (juafity of lifo Hm older alks and dwir WHO,
1.2 11'rograin Mara ilia 'I'a rama;
Ai-t-a Plan: A plan dQvQl,,'oj)e(1by the area agamy on aghgowlhA%a arld coundnated sen-im delWay jmWal
1 Us phnnhy aml saywc, "Ire'a ill necordxacc nth Te Sechon 306 (42 IE&C. 3020 of aw (M&r Arnatam 01 and
Del'xil'trilent instruelions-
Child! An individud Ka k nor more fhan 18 yeus of age or mi IdNiAlad with disabi Hy.
Disaster Reliel*Semites; Adm Witration on Onurintio I AQ QCL)comuleis dis&&Ier rchcfscrvivQs ftw Older indivkhn.ds
tt!j be any all,owkablc
0AA services duritig Me perkid oweml by Flodda's Major D[&aster !AcWVAn (MDD)that are 1.)rovidect t,o eligibl,,'e older
individuals o,E- ('antily carcj.,,ivQrs as dehncd under the 0AA-
F'amily Caregiver:. Anadi,lh, fiarrifly roeinher,or another indlivklual- w0w is an irdlortnal pro"WidacWhyhome and commimky
ewe to mi aker likidtiod,
Fink When an older individuia.1 is uriable k) po-ftlnn at kaM Iwo AcdKes of 1)arHy lOng (ADIA) withaut substanthil
hmun assWinw, including,vQrb,al VQ111ilOng,physical cueing or supervisialoor due to cogni6ve w oba nwnW impa4mern,
recluires qubstandul superAlion because the Sdividual,behaves in aAnanner that poses a schmis hwhh wAaNty hward to the
ifidN idual or-n:),anc),ther individual,
Grandparent! Agrandparent or s1cj)-giriandpareill Ufa cNIT or a reIM& of at chfld by blood, tnarriago Or radoj-ldon and %vho
Hws whh the XW; rs A pdmaiy =gAr of the child because the bialogkall o"dqAvc parenN mv au nildo cw unwilhiag
to serve as die prVinary calvgAr of the chO& and has a legal reladonsh ip ta, 1Ni ,child,SLICh as legal custody or guardianship
or is raising die chit'd in forarl ally,
Major Disaster DeTlaration; Stal.cs, may reqi,jes( and relevive an MAID by the F'resident under the Sliafford Act- Fhl,'rida's
rtqmst was 4ppavod in NUT %5kh pelwhled Me Allhime and KPINOVW010 Me aqa IMMIS!,Of Hle Rinds made avoibble
Wider contract fin- disaster r-04A, 01.1" ('01der individilials, Afthough, The h4DD endedalai June 26, 2021 when the St:ate's
olrlel'goncy order ccased,thew Uxibilifles,�vere alli:m'cid to confin,tie in contracts that',vere in Queas the drue time lArivrgenq,
()rder wj,s lifted. As in-iany c,( the serv0s and pbns Q Antedcan Rescue Phin (ARP) funding %vas subinidwil to the
Deparlillent prior((,)the F'niergency Order being I= the HeKiIhies aHowall during the MEN)Nvfl[ li�e all(nvekj ill the ARI'
cmulact.
L3 Cenenal Desti-illition
1.3-A General Staternerit
Ile pdraAry-ya-pose ofthe Antzrican Rescue f1an QW-am is o preveno jmvpare Q mW r"mnd to cmumvinm d%w-19
(CO"D-Ny Kluding supportive servihm nunhion services, preventive lwalh and mvport saNkes Nx fhmdy camjers,
1.3.2 Authority
;M1 apNkaldc f0deial W ingANK, WK wamnbh0s prograill iar tray tiairi rc6t.-w guides and shnilai-
Page 18 at 72
RP-2129 2
n. Maly of FcJual Domcmic Assisrancc rqo, 93,(),V3, 93,014. 93,(A 5, Q3.02. and 93.0.51,
h. f)kkr Amoricims Act and l 9(a5 as arnended 20 IN
c. Arncric in RescLic 111,jn Aci�
d. 1.2 U.S.C'- 147d,
e. 12 1,I.S.C. §31)3, 4 2 U.S.U. tim60 I
11 Ruk 5&AA llv% Adrnh&ruYhx UK OAC')-,
g. S-Lcflcm 130.1,01, I'lorida Sca,iri,rles (F'.S ): anil
11, f)(")LA A!atkl Services [hrudywk, uIvich is 1wrQh3 OwwrpmMml by relOwnce. k) hwhdc aM
Owleor.
1.13 Scope Service
The Pra�)vide is re4l,)orksible Rw Me proWari-onatzic,WL and uperwimral cif tire Arnefican RCSCLIQ, Nan Pirograni,
wthh this emmea,
13A MWK Progmni Goals
The nikkim,goals of the Atrierkall kCSCLIC Pbn Prupmn am N) Inevent, prepare for, and re"warn dtma C()VIIDA9� inckidisig
suppaive see vmid ko m g & olChide, onsmNeqpvveea , anmtp O j
COVID-19 vaccination otarvQ; odmation, and aswi.aWd wrvices with helping older adults get vaccinations;, and
servkes Ot address social kOadom including ac%des Or invennients in te6notogical eqt6prnent
1:3,5 Lea,dership,and Advocacy
As a clejnmed 1%cM IMWL an pruyWor is ciwintraged it) provk10 coorclhwak m ofservic,-es, for older indivicluals. "Flie,
[1wv[&r midst a[so 1,irovide COFAMILArlily WAdd-sllij)Dn agi, Aws=1 wrve as lhe amdvocw ateaird f6cal pt),int for the eldefly
Within the C0111110.111ity in cooperation with agencies,tupiniMmis and irWividuals pnkoathg & acdviks Mn&d by die
Ukmw Advocacy shmdd hwkW? AmidMing pwAke dutnges in public or jwivaw policies atul aidutcles towards older
pmvmq tan Ng acAn to improve, madify, or elknOwn s"Miticts whkh aherselly inipul on INvs of oldir penmn, ot-
npwmK% gqpwt Rw older pasms amd lGir intemss. Axlvaucy wMics may be broadly SUIPI),011iNT (4'111C �'Clleral
hveresm of aMer permuns ortnq involve specilic aeti,vifies on laelvil IF c,4'individnak,
1.4 C lie ntsloBeServed
1 A 1 (�ienend Description
'Me Arnetnican ROSCIAe Plan, Proprant gives preferonce to oklcr i"hThak whh pmalest econonic neal and older indNiduals
whir arc est will neul (whh pailluktr anodion to low-ROUle Older iWIM&MIS, inchiding knv-ihcw.wrie, ntinority older
individuals,aflderindivi,duals%%,i6i liniked F.'ngksh profkimwy,and oldcT hdMInk residing in ntral,areas).ItUld ChentS whO
are pracl iciing sock,,d TwawhV due w i�,to(-a)VJD-]9 pol)l ic Cincrgency
1-4 1, Atnerican IR.crSCLAQ, Plan Progratri, GenQral Client E'ligthifity
a. Arnerican RC�CLIO Plarl Program
Cixrsurnom shall nol 1:)e drially Qnt-ol led in an Arnerican Rescue Pbn PwWwin and as NIMIcaki caphawd I angliml
Cam PmWtam,except cm nsuniors 03 need or ArnwiQan RvsQuv Plan I-egoal Assislance services and.Airrerican ReSCLIe
Plan congregme%wkitiml SON&q includitT trun,nuition,to and fironr(!r�)ngregale nwal sites.
4 Anw6mn Resew P6n Prop-arn Rw Supportive Services unidel' 'R[le 111-B,A�Jfthc Act
i. Indiv iduals iriust be iigc siMy (60) or oldet7 and
ii. I&RIA sMsi mwe smN kes arc p,rov kkkI to, i n d iv idtia Is regard less o f age,
c. Anisharr Racrie Plan PMPMM Sr ?00-11ion Servicm tinder TAW INC I amt ITC2 of be Older Abriedcans Act
(k,neral fiwtors dr-al shall be erinsidcred in cohilANg p0irky fi)r flie receipl Of[Wit"ition SCI-VkOS i[ICILIde ltro-w
Us ponons who:
i- Cannot a1°l6rd lo,vtt adeclkiately,
i i.. fAAck tho skffl.,mi or kmm,wlQdgo to sckct and IPrep7aGre trottrisIving and wiell-balanced tneals,
iih INve HOW inobiliywhich may impair dwit, capacity ton sliql) and cook fb,r tilernselves;
N. I lave is diwbOng illy ess m ptaked condition reqoifing
v. Have been screened M a hyh Wdional riAq or
Page 19 of 72
RP-212942
vK AN unaWe to obta I nadti on beURBe I 11C indkidual h pmOWAg ,social dimancing due to C°OV I D-I 9.
id, Atneric-an Rescut Pkan Pwpwn RmCWVnegme NuAtion SiavicesuaderWe 11 PC'I of the Okla A rnerkans Act
4 In adlthn to owning the general nw&hn saw-ims el igibihty rcqui)-ements HMA W Section L?I v abm,c,
indvi[duals ehghlc ti.) receive ntjtrJfic)n:services include thQ, l'ol lowing;
0') Indivkluals age sixty(60)tw()Rler,
(2) Any spouse (riegardless of ago) who res,ides ;at honw with or irtwnds Ow dinh% cmnr wAh Whor
eligible spouse;�
(3) 1"ersons with a disabdipq reganfiess of'age,w,w lrur reside iva as Ni using fiwility axcupjed prAvarily by oWa-
individ,xi,als wheire congmgme nutrilAn savines my prodded or honw delivered tneals aredeRvered,
(�4) Disabled persons who reside at [1.0'ale with or acamijiniry mi digibk rwnun to rhen[ining comer,
(5) Voluatemij;Wulim o"g, who Wde al horno with or pivyide essaliW setlices on a wphw bmis
dwhT meM hours;
ltil persons;;ll nuldtional risk who,haw-e physical, eiric)t[onal, cir behavim-al QOKI(I 60115 I'vilich would prevent
thern hvm oblMning nwriAn; and
G.7,l llerwrl's at nut'rifion"I'l risk who arre soeiafly ol other,%,ise isolated and unable (a oblaill,nuttrition,
e. Arnwhan Rmaie Plan Prograni f4i, flome Dehlemd NutxRion Sorvices unda Fidc Oldler Aniericans
Act
i- In adclit4in o) rneding we at rail mORK serOms d WMHkp w9hommms listed in Seaki IA ho above,
indixidu,ils aiirr�r be ullable 6�"l altend a cu,ngmgme nWhOOT1 PVgMnL Lodkidunh ellibk to mceive horne
de likered mea h i rm I ode the JbHuidng:
I MH Oh W S ',lgCd S iN I Y(toll`)or o Ider%v ho a re in p ac i t ateul liet aq Esc (f f i I bwss, d i sa[A I tly, or iso hat ion,
(2) A home MOW nwAs wdWent's spousle, regardless of age, iftliv, pnwisj,on of the collateral rrleM
mWpms rn W nu W Ag Te pawn aOo me',
(3) 1 ad i 6 d ual s md M d ha N 114%mgud Nss ofage, wh o resid e at home wl i t I i lunn L^dc,I i vered rtx!�al s recipients
and are dependent 4�,in thent fbir carle, and,
Persons 0 mjtri4ional risk who lu"ive pl'l,ysical, On'lolional, cur behavionil ccoiduions, which would rnake
their INwence at conpvgme nusition sits happ,opHne;
(5) PQrsons alt nunOmml risk who are socially or othenv We kolmed, induding those who are selPhola6ing
at horn e due (o CDVID-19',and Uffiable to atlend as cwgregaAc armlAn site; or.
(6) WON&age hO or okkr vAo we wmMe to prelmro ineak due to a fiick offacilifies, an
inability R)shop, cook,ijrprepare awals saRly,or a lack of apprapdato knowledge or OR,
f. Aincric,an Rcwue Plan Pro rant kir Prevenud& Walth Serviwg Un&r Thk 11H) oNhe Older Antlerican Acts
i. Target itl,divkluals 111,11st be age sixty(60,) or okler, and
ii. Priority "'d I bQ gNen to A&vidw,ls Wdng On nwdcAy Wasawd areas-
Amokan Rescue Plain 1,`n�)gn-un for Fzintily ('ktregiver Support Pmpan IN%TWe HAE of Me Okler An'terie'all
Ads
indiviclu,"lls irlclude�
(2) (J,nandparellts Waage H Ry-Hve(55)or Wd oc okkr indi viduals Haug Q lifty-live(55)or wilder) YdRo are relative
caregikers,
0, For msphe ilad Rlpplernenml serNes, as flunfly caregiver mum be prowiding care for an older individual who
meds the definition,of the tenrn "frail"as defirwd abovo.
iii. Priority will be give;n to family careovas who,provide cant Air WHviduak wilh,Alzheimer's disease arld related
di'sorders With neurologic al zmd organic I)rairi dysfuncuan and too gnindparorus or older individuals Mio aire
reNtive cwvovers x0m Imodde cm-e f7i)r children with sew ro di,�;abifihcs,
Page,20 of 72
RP01242
S ECT I()N II .-M A N'N E R 0 FS E ItVIC E PROV IS 10 N
2.1 Service Tashs
hi order to nwhieve to gmN of AvArrickali Mum Phin Pwpim, 11w Providershal I ensure 1he fbtknvirig iasbus:
(1) ("Hent, Eligibility Detcrnl6laGon: I'lle Provider shall erasure Iflat al!q!flicant data is ovaluated annually to (Ictennine
Q,Iigibililylii,icmrtc�) rwtil!de6ngsuvke& Efigibil,ky to blecorivoa Mini is based cm vileeting, the rquirervacids described in
liars comet.
(2) 1 argeli rig -ij id &r"n i ng of'Sery ice Dd Way Pair N e v C I i erits
pn,)QvdurQs Qons%rt w1h Amaicart Rescue Plan Progjvtni, taitgcling anict screening,criteria..
(3) PnWarn ServiceE lie Provider shad erisure dw provibn of as cwrtinumn of savikes that ineets, [lie diversc needs of
elders and their camovem The Movider shaill ensitre Be perkmaiwe md rVon perforinante c'lfthe (bilmving services
are in aceordaitcc- With the current D()J°.A Programs and Services flandbook.
(14 Progymn 1.1igilidi(y Rcquircinvilts
FlWhiliQ (0011
Inadies inust inect Ow AlkwhigQW0 M be cligiNe Rw pnTrvim palcoahn:
i,. Ala-,qzcm!y, dim. has �, �nlm in&r AmeNan Rnale Plan Pmgmw imd
h. A nuirn,icm scrvico pro cr that sums Ms awl is imidor Me jinimbetkvi cimhul, nuawgomcial
and niudd amhori, ordic Allimice ruxi the Department
b. Provider's Nuirition Survicc Oporations
I lie Provider shall cnnwc the nowhicyl somice opemiOns of dw Miclai trlool the rc2quivvmcins ol" this
contn"Ict, �js vvc1l as any ofl-KA, "AI)JIlic 11,fle regllke4�nvi and policks pvw6hd by time:cw rural XAD% VnTmms
and I kll1dbc'-Pl" lhi. of lfc-ald-i mind I hmmn Smi Let I M% IXHI anal KeW Mith
DFUNIC many odwragmwy devipwied W imput nmd cllu�dhy for the statc� 11w llrovidcr lrlvjst
1ra;,rCC I0raarelilj IJIC ,'Mlimicc s,'whMion&B"alons.especially 1hose 6" inakdo Wfh q1thy vlolkakms
,ind providc a cqn ofaw nmort k) the Alhanco "Ohin, 24 hmits. Clostites inust be rop orlekl ill illiccli'alely.
AN SUNIN20111.1JOCLI INVI movicc voi(M nmNt pivnQ a %%rVai curooke ankm plan to the MILAN)n MAN-
I"or ttn.� higll priorily 4w QW64,.ini MAdWs an ambatki inspectiom [he emNdkv vokm pl;ms mum be
BRxOwd by dw PMl,Vidc1-'.s RD'ond MOM to Te A114mce to enstue ti,tat deficil.-ricies are reriliedied..
c. Prescribed Nutritional RQq1tdrenienis
t I le Pr(tvider shall. ensure 1hat each meal prcivikled wiclerlihis contract niects time follmvirig criteria:
i. Complies with thic. currcll( Dickary° Guidelines for Americans, pubhshed by the Secrolaiics of the
Dervirtment of Fk,,,ahh aWA hmmn Services and the Dqpnmem of Apkuhwe;
i,E. Provides a ini,brulurn of 33 In pareni of Te Mug r°cflercracsr intakes/adequate intakes an age 70A
k,,.vn,fle a.,, established by Me Fbod and Ihnihitimi Boarcl oNhe Maimml Acadany of Scinian; an(J
iii. Is served (t=orri and appmved Allialwe nvenu.
(5) ffic perl'orn-l'uricc v;Qllkkd"Sd
(6) (,i,)rnIfly %vith time A A Owe's Nutrition policics,an(I proce(.Itrires,
17 Ile UK= has Q,1ontv,,tQtQd AT technology savim thmigh CLARN, CARE PREMr ELN4 IRUALT& am d
AGELF,.SS INN(NATI(K Where appropriate, Provider shall coinply ~vith the rise of Me lmhnoWgy sevicic
eontrads,to support in reduchIg social iSrolaatiurn and kineliness and tea SUPport Caregivers.
adds ccann, hoNves Ow kno of subomnavor andkar voi&w, Men M F%wkIvr AM rimclalp Ow hnowrianarion of
is agivvment with We m6colmsclaw or wnM Ifany Munharwe ocn,as duo inq-�suv w R dilay wa izvovi orsisi,,'
(0)) chlys or lrioro [lie of Ow dw PoRmnaawc of the sAcmWvMxAomkc the Provislo.
Ml mQ6 dw Alliance(AwMact NAmmgcr in "Tiking of such deby, I he Prn,ider sh.all uol perini� a
to jwnmn sovices mhWd lo ON cmmso v6dunn luvAig a binclinig Ilic.
Alhmmv "ill me b�! cjrhabk R r a,my ot�,H atiorls ol,claill'is cesulling froln si,lch
2.27,1 Cop ics,of Subco n tracts,/Vendori
The-Provider shall submit a cop), at] subcontrILUS andlor venM to the Alliance Contract Nktna�;er within,
thinly (30)cfays orewculikin of each subcontract agreenteni. f"Irrolighou(the conlract perik)d, the Pr(.,tvider shall
inimiedWey sulam,it aad changes tio subcontractors to the Alliance Manager,
222 Mitaing the Perf6i'mance of" S Vendors
The Provider shall nriorfimq at lea s owe per yew, each of its sulleon(l,,,actors,sub-recipients, venck.)rs, and/or
Page 21 of 72
RP-2.129.2
eMSAMns paW frorn funds provided under this contnact,
'A.. ""I UID,, -RVOPiCll(tS - I'lie Provider shall pedQu thcW, adairinklorative, and progranwatic monitoring to ensure:
Contractual comphanciv, r1scal pWPAMMadC Per(brinarwe and e(,impliance with aplificable
state and il haws aixhvpAMioaS, The 11in!)Vid'er sl'tall, rnordtor 10 erlsi-117C that th])Q SlChQ(InljCS are jlj'rCt, the
bl-LdgC11 and scope ofv,,ork are acconipHdwd whWn Te spedHed We pedads, and anther perlbi-n-lance goals
smad Mks emmact am achriewd.
b Vlandws - Ile ProMm"haH puRmn artcl 1!)rogramnniatic rrionitoring tal ensure Coll1trelett.111.1,
wirriphimm Pm9smatiadc ped3mance mW cm-nNiance Nvith appheablestate an;d OWN= aml regul,adons,
The PlMder shal.] rttorl to uslurm Out lime schedulles,are alet, and,the sccq!�e of work is aot:c,,),niptis,hed within
tyre specMed We pandq and oflicr po-1,61-Inance goals sillmed in this contrac are achiewd, The 11rr)v idle r
W11 pulmm a nmdMzd MA nmdk&ng W Wkidle WHInghwokchig procedures ansp reconciliaMon kv enSLWC
Hs ad Ocanuntas HY aid Sustaimbdity,
l Provider shall ensure that al I require d chent data for slerOces IlurcnN,icled b),' SUI)COraractors and/cm- vendors are
einter,(,,d in the CIRTS daudiase Ver the Depweds ORTS Plally Guidelines Fhe dioa itrust be entured the
(1RTS daiabase bc('6re the Vrovider m1aiRs We Reqws; liar Nynwm and Expendill-lSe ItCj)(Ml 'it) the Allktnce
The Novicier shall esMsh, Barre Fentes xvilh its valKhm to misime conwHanm with due dates
liar Te Sytests Ali," Paynt eat and LExpenditin-Q Reports k)the Alliance,
M SMHbg ReWAmmeMs
11 SWANg [owls
I he I 11-cividol S1,nffl �.�Bsign it's krmi and sul l'lQCdCLl to jlerfim-io, tho t,,vsks, rclspoillsibililics
Arid dllriCS LIVIdLl- IQ "OUnWI aml onsure that subc("Ismims WO vcnAws Wcan adepwwwaff swomdogb .
2 3.2 Proressionlld Quali,fications
I llc Providul ShAl CIUMV dua all;AWMMSMnuible kw pofmning any dbukes or iluxOms "illfin dos comrsio have
dw Wohn.6olis as qw6fi"lin Ow D01,-A "uid Survilces I kindbook.
2,33 Service Tinn2s
1he lYovWer shall cnnnv thl; pmwi0m; or soNknes 1Qvd in this andnict dul-ing nonnW NNOns Imurs upliess
il ler t inics ,]I C n-lclre eqlpropri,,,kw the 1-1-10cl dic, pa rull.11 lit In�nls()I'[I'll,; L.,onlrlcl- aIml at sl I'al l I ncill I kcn, il S,
suble(norackus mhlAw icnAws io cnswc Ow) am a"dkible U1 povicle s�1-6ces (11,11-illg 110IR-S rOSPk),o,Si%,'Q' t0 CHOW
I)OCCIS a11!ad dlUriglg 1.11,ose urlics Mlil.,h heel, rlecds of the scl viix annoinny I
114 We orvownwas A Upwd A Pixn,ision ol,'Available Services
The Provider shall Me ine of RAW volunteer's in, prolviding dirw smNkes diclivo-led to u:,4der itildividitals kind
individuals avkh cliwMes rwelirig such serikes, If posibl, die Provic� r 51),alt %Vork in Coclrdilkatk�n with
organdatkis Owl havc experwricle i.n providing whing, placmumm, Euml luipands Or vlaluniven or pankQsaw(mich as
wyanizathns =Tyhig out Fidend senhe proplams administewd by the Clopm-ation lbr Kational arxt (7oirtirrimi,ity
SmviceL in comniunhy smNice sotings,
2.4 Defiverahles
I'lilll Sectil"'ill 1,11c spocil-Ic qualill"411lahle illik"S k:.4, dll,1Cs and Sourco 4Jocunww"Ition rQcluired tun,
CVWOWC the cornmokm OF OW l"Isks sptnoi6lod in this conlract Hic. 1,11 ovidcr 111I.RS1 S,ublo:k roxpliirod in
To Ame ald nml nun spod Ed Por i I il.,n inkiiii I Itil I I r(orrnatice levels u:) I'll,c.ulcl. Fac h tic I i w!I-,,11)1 e ri i ust he a cc,o,Ixed ioolrifinp
bl,ti the All illlnco Contract
11,1 cnido-ShAl ciumv dw prooskm OFa cam 4M l(no ot,sel-,,ices that IWCN HW Wale RMdS WWI MW twi"aww Vers
The cnmuc the pol-Im-inanclomM reporting or'dic NAA"hy smic" in accordance nit Weament DMA
Progmms aml KiNkes HandMA and Ns cortilract, delivol inus hwhWc a wpal smMsOjol'
IhQ foUlcrl m..unhur or chums sorsecL numNy oF sew vice ul, ImOkld hy soNkle and rwe pa senke uAt with
calcublions dw equal t1W RXal invoice annoum,
The Proviki, Shall provide the,services descilled in Me cantract in mordance with he aamnt EX)EA Progirarn -,,illd Services
Handbook. Units,ofsavice WH be p,Md pursuant to die rates establishiLd in ATTA(71 INIENTVIL
Addkional SMONd Ad 015bilhis nmy be allowe(i and are refloctod on ATTA(1IMEN"rVH,
Page 22 of 72
RP-2129,2
10 s L1'vv Cii.'s i I Ic I k IkJt., t I I o Co I hi%v i ng
2W Arnedon Rescue Plan for Supportive Servkes upulerTitle 111-B of(hie 01dier Aivierican,s Axt
S oppordw saN Kies NO d e a v0oy a F comm u n i q-ba sed awl hom a dv H vaed s,vvi i ces that su,I�qvrt the quMA y a 1:"
HN An Wdu indiiiillwk bow0hig there remain independent and ptiaxluicflve. Services include the fofl,o%ving�
0) AM [by Am; (14) Personal Carew
(2) Ca I.Qgi vor-Tra ini Rig& Supporr., 05) PO Suppon Ser6ces,
(3) (,'horc& (711,om (Enhanced); (5) ReanAon;
(4 (7on i pan i oi nsh i p; (17) Facdiiy�)
Counwkng(O'eroMological), (18) Screening and Assessn'tent,
EMM An I Mining,-, (19) Shoppin,g AsMsattwe,
Emmynivy AW Rupwric; (20,11 Shol'i Tern) Case Ma 11111�ulllfflt
(8) How, (21) Specialijzedl lw edicaal quiptriern,
(9) 1 lealdw-urc Naviigatq:w; Services,and SqVHes,,
(Ul Hmimmoka-, ('22) TCAR.E�
(I 11 I knising (23) liechnolqgy,
(12) Ixgul A"Wonce; (2 4), 'Felephone Rea,smuance, artid
(0) Material Aid;
2A2 Arneidican Reune Pbn Rrr Congregate NutdUon Services under Thk I I I-Clor the Older Anwricans Act
Nutriticm siervices ariir.dvsignind to rviduce hunger and kxid inwcui,ilya,nd tua pxninole soicialization kind the health and
wdkkhW of WS Wdividu-nIs throu,gh acccss ro nutrition and 4�)thie�, disease previenlion, kll�ld heakh pron'lofiorl,
Sc-1-ViCQS 4101.1de 11ilk! 1,6110wil"I
2' C'a:,)ngrogaite Inn"As
(3) 1 joll-no Defivered MQ.,ds;
(4) NuIrSon v,ducatkyll and n'to60011, Col"IFISO ing,
(5), Shopping Assk(ancoand
(6), "tielepbone Reassuran.cc.
III AmeWau Kinvur Phm Rw thwe DeMiered NoWhon uvices under TMe "KC2 of Hw 01der Anurkans Ad
Nutrititin sorvicesaiv v4signivid to reduivic hungerwnd fain W inSCC1U'jW antl W PMMMC M)AHMAn and Ow AM and
weWrig oCioldcr indivWk thweigh accessi w nutfilion and other disease 1xvven,fion and heal-th j!)rionlotion
wrviiccs. Sc1-AiQcS inctudic the Colknving�
(1) 1 ka n is Dch veral AM Ca 6;
(2'1 Nutrition education
(.43 Nuirition counsding;
(4) SQnxiiing and MscsmnivW',
(Y Shapong A"skraRcs and
(6) Mcphone Reasmwance,
2AA Axnedmn Rescue Pion Mr PreveMbe SwwWs undivrTifle 1114) of the Older Arnericans Act
T)ts,ease Prievention and Hicailh 1hornorion (EBDPHP) sawkes have been deincntstratod dnough,
QVI'Alu,ation to be e6octive foi, improving heatth and Wbeing or reducing diseaNse, disabifity, and/or injury wriotig
oWer adW%. lie ACL deMns EBDPHP servim as meahg h4hMmewl Criteria. Oral) servicie� that Ineet the
hJgliwst lvvvl Criteria am allowable under aw HID Propsm, EBDPHP senkes mml be didNavid pm° Te
mquiernents of le proipwu and anwe ptugmin fiddity, EBDP11P SCI"ViCeS,inChide the
(1) 1% Matter of Mance, (0) 11ekdth,caric Navigator;
(2), Bingoicise-, (7) flotneMeds;
(3) U ronA c Mease St I Kh4a nageawn t (8) Progrmna de hdamplin Pursonal de la Diabiwes;
PMV1111 (9) IS QVIAKH Ou'an, ktovingfi.,)r Bekw], Bal",anee
(4 , Dual des Self-Kbnagevnent 11'rograni; (I fig[lest-Level),',
(5) Enhance 111nemi, (10) Achnialogy,
Page 23 of 72
RP-2129.2
(11) Telephone Reasstirance, 3) A Awwo de Aluill6rig and
(12) IWnmido%Arolde inn SahnQ
2113. Ca mover Su ppm! SW us(H I E Propwni)
'rk hUmving savibes am intende,d to ptvWc, tfireQi help to c«nregivers. amiss in Ke arms of hcMdq nuOhn and
hnanchl lit nwy and assim camgivers in niaking decisions and problem solvin'g rolatc'd to their ear cgi'ving roller and
resixmisihil itie&
(�8) I-Iorne Delivered Mealq;
AdO IIq Cam (1) ReWhe Services,(fin,lloyne& Facihly),-,
(�2) I Q) Sc reen ing/A sses:�inei it
(liadividwd,&Gt°oLq)); I III Shopping Assimarwe,
(�) Caimgiver (12) 'irchAQ,
,(4) caring fbir Yotk' Caring for Me, 13) Technolok
(5 O' n,inseling(Giler(intological.), (14) Teleph(:wie Reasstirance; anal
((a a, 115) Otregivier Stipport Groaps
(D Wth Chm NaOpwr;
2AA Wregiver Support Sitppknnenial Services(I 11ES Pii,)graltl)
The followi ng Services aarrn providul to complmneol the caro proAded by camlovem
0 ('hore Services;,
(2) I-WIMIg lMPVVaMaU"
Katerial Aick and
Speciakud Vletfica ,,fl Ser%rces and SkIlIphQs,,
!&T WagWer Suppml Chwndparent Scrvk.es(tiltA,,�' 11rot!rairt)a
SavAs Rw gmWoments or alkler inld&wk who are rclatkv caregivers, designed to hel!p ri'teel I[jeir uIrow"Vag
obligations inchide he lblloNving:
Legal Assistance,
(IMMva Tmhhjdmvm;
(3 Ca rcgiker I`ollo)v-tale�
(It (]iroikps;
(5 Caring fi)'r Yotl'Caring Rv NIC;
0 (7hi Id Day Cain;
(7 (71unntsc I ing(G eron to log ica I
(8) Educathn/TrAing,
(9) Fle'allh Care Na-aJgator,
(J 0) Lega[ ,Assisuance;
(11) Pet StIpplort services�'
(12) Screening& Assessn'tent',
(13) War,
,(14)
(15) Telephone ReassLitance, andl
(16) Tansponation
Z5 Repor-ts
Tho l"rovider is responsible Rr reWonding in a Indy NsHmi M allitionai rouUne andlor special recitiesas for infirm-m-atio'n and
reparls mquired by he AHInce W Provider nwo atablWi Am dales Or an), subconlrams andim vendms that pernit he
Provider to med the ARamel reportAg nNuirements,
2,51 Retrospective Unit Cost rVit-thodohigy
'I'lie llrovic[er4tall subriik We ReirmpedNe Wit Coo WdiodoAgy to die AHWwe aramallyaw latar Wan 90 days after
the provider Fiscal year end. fhe Retrospective Unit Coo f0ethadWo,gy WH refta actmll, of'p,nividjjI,g each,Service
Ar Me precedig Provider fiqcal ye ar- if the Provider desires to renegotiwe itS 1`611111'Urstntent rates, Ifig Provider shall
rn ake as mquest I mah ing to the A I Hance in acxwdance wj th the A I I i ante's approved US bur som ent FLUe R ev i ew PO icy,
which is jnc(,.)rjx)iqiled, I')y refierenco-
Page 24 of 72
RP-21212
2,5,2 Surplus/Defleft Reporl
The 111-ovidvi- vvill respond k; the consolklawd SurpludDel'icit repclrt in as f6rnuit provided byA the Alliance to tho
Mance's conhict nianagim Surplus/Deficit repo is must be submifted wifli the inonthly request for paymern, This
nTmi is A al"ervices,provided in Ills agmemeni AxaMmating in It Comma between the Provida and the AlHance.
Tlic repall Nvill include the fiflhlwini;:
(1) A HM ofaU Wpkes and Teir currcins(zitus regarding stripho ar alma ficil,and why they difle,r frorn its original bUdget
pntections.
(2) A dcWHed plan (in ho v Ille sklt-JAUS Or deficit spending exceeding the 11,gi) inonthly thir"hold Oill be ire,wawlwed I,lie
p[oll Illust Rricludc specimc bujFj numbers to wHect how the [`n�wider plans,to address the variance,
(3) PNurnber ol'idicills currenty on the witfist(AKT),
1(4) Number ii 1A,hidulih,cated ( liens scrvvd.
253 C I RTS
("fiTril Infia"lliatkm -.1lid [Rcgisixalion 'Firoolking ystern (CIRTS) ReF"U;
The Provider shall input A.RF-giQcil`ic dWa Wo `RR TS or WRIT dqwndkg cm Me iwnw%is RoYiJed by the
ARNwe, to elnurc (1R"IS doita uucuracy. The Pi-cwi(Wr shall usv Cl RTS (�or eURISImmWed mpxts whkh WcWde
we 11A on A g:
(I) C'liern Rcp'(111s;
(2) Monitoring Rcports;
(3 Scrviccs Rcpolls,; and
(14 OultolnQ Measures Report-s.
(5) Final Ropuds,
15A Pwgn m I HodlMs
"I lac ilrovidcr slwH m1milt Specific evenis,flial occurred Tht-Provider
.,diall providc a ncv; success story, quMe. Wstiniorvial, or hurnandWrest vi�gnetle, 1he hi,gfifthts Mull WmAwn Rw I
gericral Womm" Wth no acrorwrtas or technical ternis, For A agnicies or (Yjaninnions that are reGenced W the
highlWho be PlooKer sWH pwvWe a b6dWesci-InNn of their in Won ornvle�nw aaWe owe AW be confMcmly
us(d ill the Inghliglu narrative, in ln-der to idlelltif� ill(,-specTe h1viclmd or enthy that per%ned the zictivig desedbed
in the higWightAlie ["rovi,der shall i-(!viQw and edit l2mysm fhollighis Wr Whyn rwm dabdki relevmwe, specificity,
lluilian interest, rind giumm,Wr M wbmWAN therm tole Allklnce�
W5 HedW and Wellness RepowIN-. Waldo and Wellness Reports:
Ile PrWdlcr 5fizill subillit N1011thly Reports ka EBDAiP serAces on the dates specit-iled in Auachment
'OIL Ile AM= Wthy Aging stral'I""111], prlwidc Provider vddi an Excel rpon Wmpho Wh any Uhs Ar AWth
mW WOW CourneVeiNims oRbvd hwNTqg AAWMWkms (mmulwKI Ilt-timrsMps Nphred as neededl and,
Success Stoics (rqorted at least:mice each ?day),
(I), 1111,61-luatico provided in Mv Mon0i" Programinatic Reliort numt match CIRTS diatki kind 1['ie ReqUeSt f0l lia,)Illmt
(2), The Provider shall reviov proglrarn dam me n tafion t(j, eitsure docurnernation is complete and adequiilely, suIq,!wris
t1kc iliformation reported on the Nlontilly Pmgmmmak Report prim to mMiNnig a ReMmm Ir pay merit, The
Provider vvdl attest to he mvWw in he "Cornntents" section of Me Wndtly Prograinniatic Report and provide
TAvani inWriation regarding the doctlinientaticin as needed,
(3) Wgrmv docuntentathn W hichAe A Me NAWNg demerits: Sign4n Sheets or Amendwee Ogg flyus ar
doculnertlation denionstimling efforts to mcruk padcomis and promme EBI)NIP services Pld.o vided; CUrren't
fil6litaull, cerlific,-,tles; coInd ofprqgnmm Acense(Wappl-icabkj and any RanisreqWred by dwspeiRepirogmn.
(4) PiRwider slall enwre At Sign-lin Sheets clr' Attenhzice Ixgs acetuawly reflect (haes, titntS, flikin't0s ofIlrograins,
participant 11'antes, mw Immos) of pwWant fac0haNQ1, If Me Auenslatwe lag elms not irwhicle a spmce ifot
participant signatures, a SlAn We vAM Qlawl-es and dates ulUSt Efeconlixuty it. Excepflonq niay be kh1l,)proved,
by the Arlh,ance Clantrao Manager, Requests tnust be made to the AHInce A Why and kept with pmysilk
c[rxuniertuafion,
Page 25 of 72
RP11212
(5) Participants milast sivi their norne on pt-cigrain Sign& Sheirts or Altendhwwe Log& If a partk4unt is unabk in Q11
the&naine, die instruckn, imay sign by pmxy Igor the pwAcoam (irtcluding their owri initials ,widdate) %vith a FIOW
on die Tgn-hi Sheet explaining flie need Rit- the Proxy%
0) 11w Provivier AH aW& by A 1pippmti, flidehy; rapAnterim and alinmily obsuve deliver.y of[AIDI'll[P services,
A note mill be itniudeti A Oc WWI %gatnimalic Repon, in the cornments section,%vhen a lirograrri, hAs lic'nal
o[AmNcd. 11mumentalm perWhing to the observation wil] be kep and provWvHo We ARIne qpn mquest.
(7) CDSME AWAshoy) data must be enwred ink),the (I)SN't E Ratzibase
Ile hvAder AW umwa le A113mv Wormit Manager in We eNvni of an amagemy or an exigort cAmnMance
",hine to provider is tumble to inaktain an aspect of N15W of he EBDH IP wmke",& nthirnmar rnaAmmri
nuni,ber of jmrticipaiw) bolm Me cad or we waksholi, Al the Alliiince h teafthy Aging staff, flie sery ice ritay be
rchubursed Wer this emnia-act; howcver, 1 I"the Milli,inlaction is discovemd after the pv.)grain has fin,is],wd,during
the Request Car Payment Wces, or as as i-insuilt of as &A mvkw. Me Pnn*kr WH no tie reitribmsed IN Me
woltAmp a shall reiriibl.fl'St the All bwe Ru be coshif die wmhAq1-
(9) Ile %Odersha:ll collabonato and partner with to extend the reach ofEBIA11-1HP services, Pattnershi�l)s
and colbboradons may be developed with, DOH, the Florida Departinent of 40hiNren mid Famills, USDA's
Nutrition P'u)graiii, insurance tonipanies, Cosem Ar Disease ( oiatufl and Previention, Area 1"feeildt EdLleaaliOil
Gentets, lotal heafth cauntils, pubfic and private iainverstlies, 6derally 41tilaht-11VA.] hCalth CHTOCS„ UAIrn)' heidth
depailinents, and Florida's Age-Frilmidy AnununhW PArtnush4m sWH be desigircd to stinikil'are, innovation of
new approaches anzi aakilesin EBDPHP smvke dewsp grewer Q'ap'avily' and lc verat,,,,e other fiindiriig sourceS,
shall almi address bulling and sustabig an it amduiv A the dinnihiatkm 4:d'E111),11HPsevicars„
"This includes, but is not liritiled to, recrialtinctA of Vai'llers ari'd partic4mirls, covering cia�)sls fbi, licenses, and
replicating progi,itinfidelity.
1(l0)'The I't'iavi(k-,r shall docutnenil, and providQ to the AlRonce upmi request, evidienc-e f6trrially
WmmWh Nkmotanda UUMAt. Vic PiovidVI, vtiJl] be re,i�luired keel) tt'ack ol"
pulnWips in Ote NInKly %ginimmmic Report. Each awnth We Provider shall revilew dais infi:mnation and
provide LtIldatCStOthat
2,56 .ARII'Quarterly Report
"f1wpisovillermiaH mornit a QLmsedy RqxAt in a hon0pinav0ded by the All4tric, as Owd 6 ATTA01MEmm wit l
We Awoke submitted each qwwm% IS Allineo cmn:tnot wtanagCT Will PrOVidC 111C Vrq�svider With an ENGel 11CINJAIIIe Nvit[i
tab crisis W each,quarter. A fluarter is dAwd as as caWndu c;iarta%
2.6 Records and Doctintentah[tyn
I he IWO agwes H) nmine nOWde u) lX,,pwr;nwr;; wriffan;Vor o, pmy dc&Wmwd by dw Wnx-,c'
arldAn' A coiqract relm"I renads and Axyurnomaijay Ile PRn1kr Amil mBwv IN! ulkahn smd
luailltk:lian('e cd'A pnTizimaAawd iul�a-inati(Ai and docurnowition 011 t)T 1,116h sryS('ojn atu.rsputro,nivcl ["I) ffw Alli«:llice
,,I nd/car I hu [Jel!),ul ni".I I L N"Ini I I L'c I 1'�I'I ICC i,I I L:I UOCS %111 i d QNJN-�i Is a ix I backups(4011 dam ai 0 syments acawding to I Xpa amen I
simidards. [)ala nin be usaNc and in �,,i rcadabl!e 1`ornmil 1:a%' I'llo
2.6. ci R�.'rs f)ata Maintenance
The Provider will ensme the accuraw cohchon mid nia i litel Izi lice of"Chent and, service infirrrnkititpn (41 at 11)ondilY hasis
fir(�)tn the CIR I'S ol. aaugyr Such systeni designated by the Alliance.MahHenance iincluclles Valid: eNpOrtS and, backLIPS ofall
data and synerris aum%g R) Allisuice and WEA swrldard& Ile Pn'j0der nius adh.cre lx) the Alhartco CIRTS lloa
hwgrij policies& pi-ocultims, cncorlx)raIQ,(I by rQk!rence. Wit order to ensure data accuracy',
2.6.2 Ilita Integrity arld- Back-up 11rocei(hires
I fi� 11rovidcl sh'all mailo"ain v'rilicil policios ruid procclues JA c(onputer syern backLm and rconvU aml OW
We Au smi-te rcquAnient of is subcmumons awMx vowo"Abwe policies and, Shull be
Page 26 of 72
RP-2129,2
23 PerWrImance Sped0cadons
231 OWvmws arld(1puts OQGvnwnze Nhanwes)—At a iltiVIA111111111,HIC 1"I'(WidCr vilust:
Emme A pmvkon of the savices desedbed in IN contra el are in accor(kince "JAh the cuumv EX)EA lvopim.s
and Services Handbook and I Me Nlmvwr of Smvice thoviskit desQdbed in, cis connw.
(Zj I Ornely and avownW, m1m U to Mc Allime A infiormadoli described iri this cono,act,
Develop, di:)ctinnK mid. k4mv MmUgEs in the Service Novider .Applieation (SPA) to support the Depantnent',s
poommance oI,I(,con1Q rneasklres in the fiollo:kvirtg criteria!
a) 6V`6 of riew so-vice mcoiOnts nth higlOsk nutddon somes nil Wipove their WHOW slmus,,
d) 62 351 at nncww sery ke rec-ipietv s vd H nu W n 4�)r in'i l)rove the i r [A D,L's ,issQ�ygjj owl( g!q�ire,
e) 8996 of AWAY and fKAY-assited car egivas n!H sel Arqw tlrc y are very likely h) provide care,
2 7.2 aNKI E'VeAtUltiO11 N4011Mk5l0g)"
111 oA I I in lice will review ad c"We to peAmm,nee of Me Prmaider under ffic terins ofthis contracc, Monitoring shall
be cmducled dwmgh Mt omwt with Me PwvWer throl.l.gh telCPh011e, III "Tifilig, and/01. an (li'l-ske visit. The
A.Aliance's determination of"ameptable performance shall be conclusive. The 111rovider agrees to cooperate with the
Alfiance in nionAlo,ring the Imogress of complakm oftfie service tasks and de[iveraliles.]"he Alfinnee niay klse, but is not
fin'tiled to, ofle 01' 1,61k)wiog rndllo,ds R'll, [11A�mitoring�
(1) Desk rovimvs and ana.lytica[ rQviews,,
(2) Sthedulof umdMild, and Nowup mvMv Wils,
1(3) (:]jorit Osjts;,
Revitw ofindeporident auditor's reports;
(51 Review of INW-pary, docurnells and/or evakultknl:
(6), keviovv of pnigi-css ivporls,
(7) Roviem- of cushmver sathdidion stirveyn,
(8) Apted-upon prmxdures review b,,van emertual i-iuditor or covistihant,
(9) Lirnited-scape ;"Ind
(10) Other procedul"V's as doeriled,necessary,
2.73 SQj-vieA:s
fhe Provider sluill ensure At Olt participalits Served tinder this agremment am eAWWe A A pmWmH4 alml Mw all
rinoriddy aind/or qu-axWrly per(6rnlarlce repm and Amwil records are inahilained fOr each rejxn,ting period and,
-sublinitled a,; M ipulalQ(t in 14,15, 2A and 23,
Any pmpmla suVices, perhmniance reports or Mumial, recta nis not rinahig We raplemenis of M05
Cmmict AmN nut he dWibW rigor reimb,irnmew Wer this pwgmn�Hlc ens mmxWwd with Why UnWW&mponWg
1he pwWmn skull be bmve Wy by Me 11rovidor The PdHance rapm.ms .utiniediale notice ofarly
significant an&orsy Stem i 0 infracdons that cornpimnike the WMer's ability to,provide participant services,to achieve
pro,graniniatic pvrfi)nnancc 01'to provide S(xitld flinancial n'lariagenient oflhQ pro,gram,
2.8 Provider's Financial()[Illigafi(Inlis
2.8.1 Consumer Contributions
('()pisurnQr con'n-iMms my to be unseal under the folknViing merrns:
I) FliQ [It-fivider rrssLUes cl�'j I'll I)l iance With Seclion 315 of the OAA as arnmded in 21006, in regard to consurnor
2) Vokudwy contributJolmare mm to be used Ar cost Amdrig or mawhinj.,,,;,
3) AccurnuMd voWntary comilwdms am W k awd pior to irqueOng WA r6mbtusemompticl
4) Vi,)hsn(arN colitribUti011s are io be used:ordy to eximnd servicc°s.
Page 27 of 72,
RP01212
2.8.3 1 1.w c'A'Serviele Dollan,
The Provider is explected U)spend 01 fiden4,state and i�fflior funds ptrovided by [lie Alhance lieu the pitwpose symcil'ied in
the contract. The, Provider must rnaoliq.,,Q the savice doHan in sudi a nuinna so as,to aw)icll having a vvail list, a dieficit,
cor a.sAirplus of fa nd� at Me odmf dw clarano pabid. Ir each pwigmm imnaged by Um Pmvicler. Prapsm suirpkiw.s-
11110SA be reported to the A I H.-,'Ence.
1K4 Surplus l 0CIIIXUIV
hi accoidance wiih his surpkisildchch rnamagomma policies, in order on imaxintize available Rmidiq and ndAmbe die
thie that pcoendal clkwts mum vmk Gv services, dw Allbrice in Rs sole discredion can reduce fundiiag awards if the
Provider is not spendQ according W rnonflily plans and is projected Ui incurzi,suplus at Me end of Um year,
2,8,5 11re Provider agrees to use Kids as domded in die, Budgid Suinniary, ATIACHMENT V111. Any ch,kinges hi the
annowas of f0deral funds [dentified on the Budget Unirnary for services wlithbi each idle (Suppon Services,1JWrhio:ri
Services Caregiver Support Services) are allowed without QxmiTo,ci amendnient, Providers ni adhere to Alliance's
Modifiol Spending Policy, a]lowed, under this Contract, fiworpoi-ated by reference,
2AA Ile hiovider dul I noatch, at least ten paeng(i w%)orthe lideml suvke Jim,&received, The Provider's match will be
inadle in,the foonn (fl"cash, artd/oir in-kind resources,exicept G Soldivirs 1wavided pursuant Stan American Rescue Plan for
Prvvewive Services under fWe HVD of the Older Purriericans A& Ile %violer shad rep,()d imatch hinds by title eau, i
mondi on Me Receips mW thd Cost Report identified K AITAU wFur A Exhhhs 1, T I and 5, At dw end of die,
Collitiraict perkd,the Provider 111LIS1 fllofle[t ntakh Amakan Rulaw Plan W that mWkv as tumcli,
2AI ARPFwWs
The PnwkkT amums coryphance with Section 306 of Me OWer Anoicans Ad,asamended in 20061,thal funds rec6ved
uncles ART will not hie used to pay any lmi-t of am cost (iFICILAQ an Wristrobvic anQ kwumd by Te PmvWu to
mahmw as 0MRIMMI M�aOmmercial N66MNWP that is not cirrjed cut to irnpleinent ARP servilices,
2.9 ALLIANCE'S RESI'ONSIBILITIES:
1%1 Pmpvm Guidmice and 11dirikal AsKsimice
The AMA=wH I provide to the%vWn guidance viand tMao ical assistance as needed M ensmv die stnommll NUMmilivilt
of dw lomamet by Hie Provider. The Fln"wido's Inkist at told Zdl required ti-ahing,session andrialectirigs. The stippwL or
Lack thereof, shall rmt rehme Mz provider filoin ffil I perlbrnuiricQ 4:,11cornract
si,,,,c'rK),N111: NIETHOD01i' PAYNIENT
Oki
The Mishold of Payrrimn Ar ON carivact is a earnbQ601L Of'fixed SSW rate, cost reimburseinenL and ad"wre paymems,
mdQect to die avaAlabiliq of Rinds an,d, ProUlar palummics 1Ire AHMme%Q1 pay Me Pmvitler upm swis%Dry camplaion
of as sWeHied in Salion 11 and in aerardance Ah rather Ivius mW con,ditions of lie mnwwl.
3.1.1 Fixed Fee/th'tit Rater
Pqwient for lVed 1a"ed0h Ralc�,sliall not exceed nuuounts eslaNiked in AT'FACI-IMENT V11, per unit of service.,
112 Com ReimNirsenrent
Ilayntent tri he adindmd only Ru allowaMe experrolhurv, which aiv in a,wcordance 01 the suOws Wed Sed in,
ATTA01mEnT VH. All AM Reinthursenent Requests kv Payment imust inducle the Receipt kaid, Exi'),enditm-e
1i (ATIACI IMENT X)beghjljing vvid,j flie fit-M nionth of the contract
3.13 Advance Payments
The PmAJa mmy rci up to two (2) niandis of advances at the stain of the cormia pubd to ca"r pmgmin
alshn histradve and soNice costs, 'Ile payrneril of an advmce will be emit in gent tipoo,ii tlae sufficiency and amourn a f
flunds relel to Me DisparMient by the Toe offlorilda("budget rdease7j'Die Provider requests Q adviaame payment
requke to mQUen approval of Q Mliiance and the Deparlment's Contract.Manager. For the first month's,
Page 28 of 72
RP-2129.2
advance request.the Ptc)viclu-slikill prcwide the Alliance Contracl Mana,ger docunicniatiori JUStifyitig 1[te
need Rw a n a d v anc e a nd duc H b i ag lit)w t he I'm nd s %v i 111 bc d istri lak i tcd, I f fire I lrx�)v i der is it(I ttem�i n g t u,vo(2�) I 1i o]111 uj
o f a d vances,doc unietimij on an ust be pto v j ded re neo Ag 0 w Qmh needs of Te Prov Wer mdth Or dw init 11 mm Q)
rnomhs and shotAd be supported thmugh a cash-flaw analysis wmdwr Wmintion appvpdau to demanstrzire be
Contractor's financial treed, for the second nimith cif advances, If sufficient budget is axaihhl% and the Alliance's
C'ontiracl Manager, I W or her We dKOWL has derannined that there is as justified need for an advance, the
Department 11ray issue aMwmvd whance payments up to 30 days ah, but nM pdm to amertchmeni new6w W.,
be Alliance and Me Dqmrtnteirt immy bsue approved advance payrneMs after July I;a of the contmo year. All advaiice
pgynietils WH be reconciled and recouped lix)ni the third through be twdAh num1h, I�econci liarion and r'C,CO3Uj)img 09'
advances imade under this corinvo are to be emnoeted in acet)rdancevvith,ATTAC71 IMENTNRI 1,
3,2 Metbod(,�of Invoice Payment
Pay rnera Klmll barnWe upn the Pmvidees presentahmi ofmi Amoke subsequent to the aweplAnce and approvM byAhe Allbiwe
of We dolivvrables shown on the imWe and lraynieni has I)een received, Croin the lbrni and,subsiance ofeach
hiuv A s ubv Ned by Me Pro v Wer W be as RA Evs�
111 Rcqucst paynient on as rnamidy Nmis for Me who ofservives establislmd in this can=,pr(n,,ided in conrotillante vvith,
OIQ as described in the EX)EA %gruns and Services I handhook, and at 1he rates established in
ATTACI MIENT VIL Doc!lurnetitalion of wake ddivery niust include arcpon consisting,1"If1he filflgiwhlg� nuirlber cp[,
clienin sciwo& iturnberofsavice units pmvided by savice, and rate pe"wrvice unit wide calcidations that equal die toul
fiiv,oicc amiouim—Any chaRge to the twal comma arnotual:require�a. kninal cirineiidinent,
322 Rw Pmvider AW ummd idaw all sdicotmiame ReWwms for Payment and Bpenditure Spans that support Requests,
Q payment aint shall suWmA to the Allimee ushg forrns Request for 111,'Eynient (ATIFACHMENT IX), Receipt and
F-',xpQndi0,jj-c Reports (ATTACHIMENT ) fior ser",ices.
123 AH Rqumts for Pyweiv W be Nued cwt to s0ndsion of mmahly Expenditme RqmNs beginnQ with We
month of the contract,, The, schCCIL11C ('01" SUbtnission or advance requesB, and Kokes is Wake SdwdWe,
AT hey CI IMENVI' Vill,
12A In order 0) pwperly ntawge Me pmgmni budget, the Provider must subrilk invoices thr paynient no bier than (KI days
troffer the end,of the month in mlich Me expanse was imumvid,except that Wces utincit be,subirritted after Close Our
Report &ate, Invoices suhttitted We WH require the approval of tyre AHWwel Cmdmcr Mairager Late invoices will
net be paid tudess jusWarIn is suhn Awd and apprrowtd by the BMW Manager,
325 "Die PmOder W mMnWn downimumbn to suport paytrwit mquegs "tich AMR be Mqllh W the A HWwq the
Dvpeirinrent,,and that Deljaitillent c&I",iiiancial Services,or othcrouthorized stale and fi,,dieral personnel rilron recluest.
32A AH paynwnts under the tenors of this contractare ctmthgMil upon Q;the II Wslattue, and sject
to the avadability off-uncls,
13 flymant VHMhMdMg
Any pqrnern due by the Alliance unkr die omn of W emilmd nay be whMeW law Aing die receipt and qWrovdl by the
Alliance of WI financial and prcp ranrrriafic relioris due froni the ProvWci- and any w1justinents thereto, iiicl,ucling any
dis-,illowance not resolved as outlined ii'l tliis contract.
3.4 Final Invoice Instructionis
IS Proviller dm1l mWit the HmI Req�Ltest f6i, Payment to die Alliance no Eater than 30 days aft On coituact perhid eWs mid
as refc,renced iin ATTACI INIEN'T'V1 H. i r be ammo ract in Imi-ninated p6or to the end dwe of Me oonu=4 Own Me Provkla niust
submit the Hml mliem for Imyntent to the Al Brun ee no mime than 30 dyi after ffie contract is ternfinated If the Provider kiihs,
to,do sx),all right to pay man is RWed,azid Me Alliance twill not honor any requests subinirtedafter the aforesaid titne pNAd.
3.5 Providers" Monthly CIRTS Rtporls
Page 29 of 72
RP-2129.2
-1 he Provider niust rwi wonddy C I RTS rqwrin and veriff chol and suvice data A 1ir(ARTS is a inck"M TO repml nunt
be sulmaktal in the A HNue whh Me imonthly rqkwst fo,r farm,irtao and expriditure repoul and rinusi lie rvvie kvd Iby theta
Al HiArite belloiv the Providvi's F�^qimsjt Iaou pay°lnvlt and cxllendilury reports con be upproved b),, lie �Nllkrncv.
3.16 CIRTS Data Entries
lie NovWa nmM enter all reqAmd dam Ar ohents and wen lass in Me Cl RTS dMobne per Me FWA ProWams and
Services Handwok and die C I RTS Wer-Maimal - A g A g PmWerNehunk LISMI(IoC,'ne(l in Docuovents,on the 'III p'
PmWeis mum enter dds dam ink the CIRTS prWr lam sutin-Lining thQRr reqUeSIS 1br
asSUIV conilfliance with due dates for the i-equeMs Rm,paynacm mid expendhure reports Out nuis1he mkm HWd lino the A]liance,
SECIFION IN'. SPECIAL 1"ROVISIONS
4.1 Pr(�pvider"sFin,anciiA,ll01)ligitlio,tts
TIA Mkchhig, fowl of EKW,1,and Earinorkiftg Requiroinerits
Tlw PmvWa divill amwh W Imm ten percent(I OQ of the cost fbr serve Res funded dirough this contraQt, QxQept for
SCINiCeS Ira Vkled PLUSI.Aktul Ilk) A121CdCall, ReSCUO Phil: for Prevonfi%it services under Fide I H-D of the Okler Aniedcans
ACL The mawh %vill be nutle hi Me Win of cash aWoHnAbd wommes. lie Provider shall ivport LiRawli fiulds by
We enh nwmh At dw end of Me contract period, the CoiMmum must pnverY rimsh Arnwhmi, IN= Man hm ds
Out MQV as Match
-1�1�2 Consurl,ler (�'onlri,but�kms
Cori sual er contributiorls are to be used Under the IbIlowing lams:
11. The Provider assints comphmice Wh Sea% 315 or be OAA"m amended in 2020,r egar(finj;. con sunter
contHbutiong
21 V'olutim, cmudWmn am no lo,be used for untsharh% o"WhIg;
31 VbWWwT tire to 1,me Lg�td only t(m expmld Services; and
(Septeinber 20211 —Septenibor 2024) KR 1121
4,1.3,, Use of Service Dol-lams and NhnAgunmg of dw Assos�ed Priority C,onSLIPner I ist
'I he Pro,vidQr is expected 10 Spend afl federal, statute, and wher finds ruovided by Me DelmomoU A Me purpme
specified in this contact. Fm°cach pragaim managgil by time;, Provider, die Provider Intist 11"I",inage the sc,rvice(hillhar"; ill
such a mamie"s to avbd lmving an nwil At W as sulThls allAWs M he end of Me conowl perJo? If dw lUkri,ce
doennines &I die F'rovAller has LuA spendinH servive fillids"I'4xordingly" lie Alliance tmny travlssli�r fillids,to odaer
Pwviclms dwWg dit emmia period and;or adjul.4 tiara bs,eq Lien I It'unding alhwa6ons,as allowalble under Ogle and Weral
law.
4AA Arnerkan Rama Plan Fwidls
1,he Pro%,ider assures cornphnnee wi,dl 'S"Qction ,1010 of,111,Q(")AA, as amended in 2021 and will not huds PeNved
un&r Me Arnelkan Resuui,, Plan to pay any part urn com OAK an admWistratV cog) hicuued by Me! NoWr lo
mainwfn a atutmhiouzal are' wri-in-Invial iWandip tfral k rus =01 ou,t to intplemenCride, Ill
Al A the of Savice WMars and managetrinit mar Amased Priodtj Mianumer List�
The Provider I,,expected to spend all hAnds provided by he A Awe ku the purpose,specified in die ountract, The
Prodda Limst nianage be svvke dollms in such a manner so as to avoid Wing a waft. list and Surplus of rundsal the
end of'tfi,Q contrad:pact d G euh proglani nian-aged by the Provider,
4.2 Inchleal Reporting
'Me Pmvider OwlWY Me Allkwv illiniedikiloly hut no Miter than Iny-eQN148"ows kwu he Provkla%awaL ones"n
discovery ofchangv mlnwd arm as Provider aulliorized Proviso, Im nmy mmte&Q, aflfea the Provider's ability to perfiorm flue
.scrvices requ ircd to,be pe'l-fill-Wined under flits,contritd and KAWWONg l7mvia Such nmke siall be made mWY to Me
PagE 30 of 72
RP01212
ATUnce Comma Wlanaga-(by teleowne)M an emad to hmnediteylbHow, Kluditig be Provider's plan f6r provision of
the set'vice authorized in 11roviso,
43 Investigation of0rintinal Allievations
Artyrq*rt that finplics aimAwl hitent cm The pad of the Novider of any SWwommuon and referrod to an g(',')vmvnmWW or
hivestigator',y figenq inust be sent lu the AHWnce which mAl W twn Wrivard the inAnnadon to t1he Depart.inent. lfthe
AHWxe hn mmson to beheve that die allegaLcms %vH1 be rdbnvd U) the state Aumm, as lawenWevnein agency,die united
States Attorney's office,or other goverriniental agency,, we,Afliance shall nutify the Inspector General at the Da partrn�w
imiiiedialely A c(q)y of all dOCUITLtIHS, rep-oats,noWs or oler Wtvii mawkil concerning the investigation, %vitother in we
jx)ssessiori of the llro,vidor or Subcuimmdw nunt be smut to die AHiance whidi vWH A turn send be material to the
Diepartment's Inspector General with a mimma:ry(if the investigation and aflegatioms.
4A Volunteer's
The Provider shall mumv we use or uahwd vo6nNem in pvMg dhvd suNkes defivMd U)Oldff indiVidUalS, arid
individuals,wi th disabilities needing such wmhev I f we Provider W wok K cooiAhatkm %Ah oTWWWs that
have eq)eri,enee in pr(�)viding trairting, placenicni, avid s6livnds Rw volunwem or Partkipants (Such as organ,iZatioins carryin,g
ou,t f6deral &er['%,jCe Pr()granis adntini,stcred by the CmpwMkin Or NaOunal mW(Immuid; SeNNY in conimtmhy sovVe
sdtings,
'Die TOW der,shall suhm A an amnial uA&VIkaled ropurt homn on the k�,,inmat prxuvided b), the A lian,ce. The data
cWleo On period is hom July I io,June 30, 11or ea th calendar yew, Ile dma suhnisibn elate G 5 bminess dMi RAlowhig Ke
WSW die cwnma puiod,
Page 31 of 72
RP-2129,2
A71"FAC71I1 ME'N'r 11
A11 AC I I N1 ENFIF II
FINANCIAL AND COMPLIANCE AUDIT
Ile admitho-ation of resource� aw'arded by the Aflianceto,the provider rrLay tiesuby ect to arrdi s arld/or rn(,irntorung by IN
Affiar ic.,eaj KKyr[I v EX1xvii imad as clew ri bed in 1h 1 s sed ion.
L NION11VIRING
In adItAntorewiews ofaudin-coliducted inaccordancewhir 2 CFR. Pan 2 0 D (WIIIIQXA�y
POVisecf), and s, 2l5,97, FS, (see "AUESITS" betou). mankot-ing pnxeckims ntay include, but riot he limited to, on-Ate
CAN ly die AHAnct; andAr the Deparunern surfl! hruked scope
other prtwQd,ures. Fly entering into this agivemeM. Me ProOder agrees M cmmply and cuqemte WT any moldwring
cKerned appivpriate by Me AMWre, In My eveni the Alliance Wor"he Dqmnment doarnWs bar a
filniwd SQ'[a)pc -judit col`Hichi'lvidel- is appropiri"Ile, die%Vkleragrees to comp" %vill't any adidificinal pravided b.),;
dw A IlianQc andkir IN DqmdmeM tO Me P"WidCT Skldi WE The 10wider WS7 agrees lo conqMy—and
cooporan with any inspedions, revlewX AvestUbw ar- audits ckerned nmessary by die Alliance andOr the
Deparinient.
AUDITS
1"AR"If 1: FEDERALLV FUNDED
1-hisparl ha"limble gONVUrlinecri oral
as revAed,
lint the CVent lIVArt tire Provider expends S750YOUD cir nKne hi Weal awwAs dudng W fiscal year the Pmvdu mum heave as MnWe
or prograniapeckc auctil cwwhwW,d in accoirdance with the pm&isims of'2 CR, Par 2(4), EXHIBIT "2 to this agmvet-rlerrt iii,dicates
Wad resoalves awalrded though die AlHalice by this agreemem. In detennhirip,1he f&loral a%%arck expended ill uS year,1IR:
MuNkler Aid! condder aH smu-vQs off"ederal incInding f6leral resources received W Me Alliance, The detierniinati,iln of
amvunB of Wdral awwds expasded shDWd be in amordame w5h the guideRims, esu.i.b[i,shed by 2 CFR Pact 20,0. Air audit of"the
PnWer onnhwad by the Audilitri-(Jerreral in weordajwc:with the proVions oll (TR Pail 200. %011 meet the requilvinents of1his
parl,
In comwctimi mith the audit requirements adWssed bi Part 1, paragraph L be ProviW shall fulfill t[it requirQriwrits rehative to
a,Nlldil:QQ respolisibifiries as provided in 2 (71"R Pun 20,0,508,
If he I"t-ovidev eqmWs less than S750J)(1,0,00 iin 1'i:dera[l awards in is 15scal year, an audit canducted W accordance widt the
Fwavisiaris of 2 CTIR Pan 201 is rim ivqWm& in Me everil that the 11,ovidai- expends less Man S750jORDD in Wderal awards in W
Nwal year and Kos to have an audit ci�.j nd tic led iirl accordance nvitlh the pmWdorls of'2 CER. Part 200,the most offl-re aucht nuist be
paid fron't raur-fecleral reSOUrces(Le., tire cost of W Wit nuum be Paid Wn MUM reSOUI'00 ol,)tairned koin oflior thawl, federal
nuities.)
An Wit amducteld inac(xji-dairlice Nvith this pall sha,ll Cover the eirtfire ctrgpnImAn Rw Me a%ranizarkin's fis,cal year. CompHance
findings wited M,agreernenis with Me All hue shH be based on the agreement's re,drementsincNciing any ruk, ivgWatims,
or stafifts refierenced in be agreentait, The Financiall statenwnB W dkdo,se whether or not the inmWIng ruNtrument way met
for each applicable agmemem, All questioned costs and liabiJitics drre to,die AHiance arkbor Te DepartmeIA AW be FuHy
diSdDsed in the Midi report with tvferenee to dw Alfi,,ance agreement 4wolved. If riot ofli,eim,ke Wasuhn mquAd by 2 CPR
Pan 2005 IRAhe Esc edule of ex"nditures of federal awarcls shal] idlefNli.h CXIMIdiurres by agreeinent nuri'l1wr fbi-each,agireenlent
with he AllInce hi eW during die autt period, Fitian,cial reponing packages requhed under tivis pan mmi be sudmaNd Wth
die earlier of 30 days after tneceipt ofthe aUdit report or 9 months aHer be end of the Movider's SO year end.
Page 32 of 72
R421212
PARTU: ISTATE FLINDED
Thus part is aRAmIle Hke Mmher is as non-stme entity'ws,defined by s. 215.97(2), F'S'
In 11w evvrit flivu 1hQ 17rovider expends at U)MI arnatint of sime Ananicial assimumv eptal to or in eNcess of S750,0,011,00 in any final
year of such Provider (or fiscal yems ending Sepeniber 30, 2004 or thereaffter), We Provklu niust have as Staid; shoo or pr6ev-
specific audit ftw such fiscal year in accoudance whh & 21511 ESq applicable rules of the Departnimit of flnanckd Servicem and
Chap ers 10,550 (W gmammanal entities) or IOA50 (nm;proht and liver-profit organiza6ims), IRules of flit Audin'tr Gencrid,
EXIIIBIT2 to this agreeninit AdkaWs sum financial assimAme a"Wed thn)ugh the AlWe by % agiverneim. hi detennut.mg
dw maw financiW assiMance expended Kim HmW yu,the Pmvider W 0ornider all sourucs or swte (dnancial assisimm, hicludirig,,
male finandal antsmue m0nd hom die AlIbmwe, 00a state apnides. and other non-slate emMes, Statt Rmndaf awWwwv
does not include Wdlerad dkeel or pess4umqh awads and re sauces recehS Yy a noissmie emity Rr Fedeml rvvgrant niambitig
requirvi-noAs,
In connection with 11w atidit requirements addressed A. Pan It pwagmph 1, Ne fluOder shall ensure that the audit complies witfif
fe ruRikem,ems tW s. 215VAlq K& Mis, includes subnfisslion of as f."inancial rejx)rting Iaatekaag tiros clofined by :s. 715 97(2), FS,
and(TapWr 11155a oucal goverrinivrital embes)w ICL650(nonpranl arml for-pinAt organizqtj(�Ias), Rules ofthe Auditor Gen,end.
If Te Provida expaWs W dun S75100MOU in MW financ!W aniMmice I Rs hwal yeu(17or fismd yews erichng September 34),
2004 or Aervahuy an Wit QwWucWd in acconhince with die pmvWmu of s. 215A7, IRS, is nol mqWm& In Me eveiv tWit be
Provider eNptrids less than S750,000.00 in qate finanei,,'NI a sistari,cc in its fiscal year and elects to have an aladit tonductod, in,
amoMame with dw Prown. or s. 2 1 TWT FA. the omlmf At Wit nnsaw pMd Dmu to nowstato WIN resmuws 0 x, Me
cost ofsuohati audh nium be paid ftain the Provider resources oWaked Wn Mher Own SWW entwes)�
An Wit amiducted in accordance wiT Mk pad Omll cover the erit0v oMadization, lbr [lit ism piriization's fiscal year. Coiti )IiarivC
firidhgg rdMed to ugrccrwoits wit[i Me Wrive W be based cii HW apCOMMS MqUi,rernernsi, iiielwliqg any applicable miles,
reglijafi'i'ins'4�)r Si"'flutes"The financial Sikilo'nems W dscloso whdher twitut die maWbing requirenicit was me Av ewh qjHmb1c
agremnent Al I questioried costs and I iiEbi Mks &w to Te AllWice NuH be Nly dihdmul 4 die audit roport wifli rvforcriee to the
Allince agreernal WWII`rim olerwise disclosed aS Mqtfir0d,by Rule 691���5.0,03, F'A,C,the schedule of expendimires arstate
firimichl asshlance WH Mondry eqe"hwn by qgivernent rinniber tbr each agreament Wi the Alliku'we in elfut durin,'die audit
Pao& 11MM5.1 mpludrig paQk'ages required oncller I& pan must be minnittal WE 45 dys Aw ddlery of Me WA rep art,
but-ito haer"llian L2 moubahuthe WMet's W1 yovend lo,r-Iocfl govo-rintellu'll entities. Non-profit or )r-profil:organi;nnions
art, rectiaired to be gulmuked swidth 45 days aflu Way of Me Wh rMon, bw no hiet Mari 9 inonghs afio- [her PR)vider's, fiscal
yvar end, NotividistaWirig dw a"UnWHq of IN (rw1bw to Alliance nctains ;I'll righl, "Ind obfigp nitn) ltean1o'nitor and oversec,the
perInrumwe of dris 4greement as oudked thrmighout thl doc:untar MW PIUMMM to W
It. PART' M. RTA'010' SUBNJISSJ0,N
Copies ohr�!pori:ing packages for WE comWed in acawdmcc midi 2 CF R Pat 2N, mid rucloh-ed by PART I of Ohs agreement
sAH be wNWal, when requied by 2 CFR Pail 21)(1512, by or an belml f of We 10wider directly to each of the Rfflowing:
1°he.Al1kwee ai oacli ofthe fiollowing addl-Qsws;
Alliance Ifix Aging, Inc.
AIM: Fiscal Deparlinent
760 �NW 107':" Avenue
*auk e 214,
Wand, FL 3317'2
Page 33 of 72
RP11212
Fm HmW yeu2014nd later, pimmmit 02 CFR §N0.512, the repuning p;rcha,geancthe data collea On Sm must be mImAted
electrordually to flie Fedml Awidit
Pum,nam Ul,2 CFR §NOJ rj all oler lIckral agmN pmadumgh WE aDd when iWamsted W a mponitig pachge and dal
colw,clii(�ln follm altist obta in it b�y accessing Me I'Meml BAR CW%Whmme,
The MmWer shall stibinnt a copy ofan) I'll arl'agelm oll letter issited by the anchtor,to the [Itkrida NINn-irwient off[der Affairs a dw
fW I mvi ng addrem:
Miance thr Aging, Inc.
AW Fiscal Department
7160 NW 10VI Avenne
Salle 214
Rdiand, FL 33172
Additional(., copies of finandM repaling4ackages mqui-ed by dds crontrzwt's, Financj�al (7ompliance Audit Attachment, P-,iir-t l[
shall be sthifltted by or cm, btlialf(,)CWhy Provicler direoly tl�l each ofthe fiplkmi,ng:
"flie Horida Dcparnn(,,ntof'[".1der Affairs at 1he to]lowing address!
Alliance ror Aging, Inc.
A Fiscal Departnicas
760 NW 107111 Ave maim
Suite 214
Miami, FL 33172
/Nimlilor I's Office m: d1c. uIig �Iddrcss.
Sho 4 Mrida A uWMr Gerimal
Chalide Pepper l3nilding, li400no
574 111 West NIaTsen Stmcj�
1101ahassev, FlnrhJa U399-1450
Any rcli,orts, manelgermmm letter, W Omer ittforinal ion reqkiii-ed to lie stflinlitted to dw Evepanmm pmsmm to Wk cmilad Mull be
stibril itted I irmely in accurdmice ivkh 2 Uit Part 2DO, Flmha St. mmy and Chal,)ters- 10-5511 rhea al governmiental colities)rat I 0,650
(nonti,rofit and Ow-proht oMamizatimul Wes of the Auditor Gotend,as applkmble
Pyovidets, "when suNnWAg firimial mpadirrg pockages to We Depannient for atLdlils done in lAccordarwe %vidj2CI-IR, Part 20,C) or
Wpm IM550 Pocal gcmvrnnnmMal Wks) or I4rA50 (monfm6l aid RimproM oTmO mil mo, Wes of Be Auditor Gerrera[,
s1wWd AWRme MR date thal the repooing package wa's Clefive'red ti') the Provider in unmspimdence eliccontpanyhaler 11te rvpotiing
package.
PART IV, 11VA74)[41) 1UTI-WHON
The Provider Shall retain smflicient records dQn,1111IStrataig its CI)II1,1flionce Wh he ternm ofthis upvitract fim,as pericid c:)fsix (6)years
korli dw dme le andh rqmi 4 issued, and dud WWm the Deprtmml m its designee, [lie CV;1,) or AndiUm-Gencral acc,ess to saich,
records upon rvqkiQsf.Ile ProOdu shaH mmmv Am mWit w0419 p"er; are made available to Me Alliance aWbor the Dqndmnt
or its designee, C!10,or Nadkor Gemend upon reqtwst for as period of six(6)years ftorn the date time atidn report is isslied, I'lifless
extended in wrifirig by the DQpaqnjeIlt,,
Page 34 of 72
RP01212
ATT AC I I N1 ENT I I
FINANCI[AL, AND COIN11"I.AANCE AUDur ATTA(7,'JJmFNT
EXHIBIT I
PARTI: AVD,[TIRl�',[.AT'[(.)NS[ill,"] t','I'ERMINAI'[O,N
F'roviJus who mc6ve mow or I eral resources ni,a),or may not be Sul oct to Me audit requiremmm (02 Part §200,500, and,/o,r s.
21191 ES, ProOden ;do ara data nnined to be rocipicnts or 4�)f fi,deral awards and/or state finan,cial as�kLincu may be
Q00 lo,dw Wit relivnients if Hm audit Harr hWid requiret-neius set hwth in Pon I and1or har� I I ot,]Exhibil I is 111'eL Providers
have Ibeen detei'aiined to be %liendors are not sub,ject to, ate requaments or 2 CFR Part §200.38, andjor s. 215,97, F,S� Rga egg of
ii,hetfier di c audit -aro Inet,Providers Who haw" beQndocrulined ul�be recipients Or subrecilxiews offederal awards and;or.
tate 1,11 nancial assiontwe must comMy ;04 aWhmbk pwgiAnintalk and Hsml comfliance rquh-erricrits.
In accordance iviai 2 CFR PA §MO mWkw Rule 6945AD6,, FAC', Provider Inns h,eci-i doerni ivied to he�
Vindimmol sn.dajectta,21 Cl."R Part§200.38amml/ors,2[5,97,1:,S,
Qpa to 2 CTR Pad §MUA6 wd §NM13 mW/or & 2 1 EWE FS,
ENMIA organizatimi not sulleo , 2 CFR Pad §201) an&br s, 2 15,,97, F,S, For 1,ederal awarck, for-j!lrofrt
mgmhathm am twetnM; Ar Mae financhl am6we prclim puNk uWvu&i&% conumuniq calleget district schoM
HaM% Unches of swe (Raah) gmtmmunq and 6anu sdwifls are excmpt, Exempt organizatioris raust comply
Nvith all, coniplimee rqu0nants forth witliki ih+, Q,a:nnract or awaxid do'cuni'lent,
NOIEKIT a PmAder 6 damwlwd to be a of Weral Emd or nae I'mancial assistance and has Deem approved
by 14e Alhance to subcannue; dwy rinmi cninply Qth s, 215B71,O, ET, mW Rule 691-,500,6, FA( [stato firtancial fis'd.st"'Ince]
and 2 CTR 01 §NW3M"Idaid awxchf-
P ART II: F I SC A 1,(A)M P L I A N C E 11 EQU 114,V NJ F N'"I'S
FEDE RAL AUARDS OR STATE MATCHINI-' FUNDS ON FEDERAL AWARI)S. Providers recur ,e Fed.oral
awmAq state nialtenanoe ofeffbrt ftmds, or Moo rnakhfng Ws on Fedeml awardis and %to am dammined to be a vahrecioma
anni comply wkh th,e followhig fiscal kaws, rules and rqpjlafions�
STA"IT'Si, LOCAL GOVERNNJf,,N"rS AND INDIAN TR, 1R1-.S NIUST [,'OLLOW.
2 CPR Pad §TAAj&AAnt whQW:
2 C F R Pad §NMIO I- A dni,ird shwhi ve Req u hnnia i NA
21, CFR PWI �20,0.500- Audlit Rquirenienis
Rel';n, mm;cCpuaicla [)(�)r Strtc I: Iacualitu,ura.:w
(),ther fi�Qal rQquiraaiienN sel f0h, hi prograrn law% ruks and mpamBis
NON-PRO FIT ORGAN IZATIONS NJ USTH)LI X)W:
2 CAI?Pail§2 00 A00-A I I-Coq Prinz i p ks"
2 CFR Pan §TX1A00-Admjnisqadve Requketnents
2 CFR Pon §=Mh Audt Rxqhmmars Refhmwe Guidle Rx State
Other fimcal requirements so Writh in prognun lawt ruks and pplat0m.,
JEDU('-'A"FJONA1, INSTITUTIONS (EVEN IF A PART' OF A STATE OR L0,(`,A[- GOVERNMEN`V) 1V1J,J!S-r
FOLLOW,
2 CI`R Par( §2()OA 18- Cart Principles"
2 0"R Part §2(,'10,,100-Ad vni ni strat�i N,e Req ul[re I I'l ents
2 CFR Pan §NX),500-Audit Requi renients Reference GUride ["or StaNi
Ot I ier ti sc a] req i i i ran i on I s set fi)rt h i it prog rari,ii laws, a 16 a ad reg L 1,Int i o,1 is
Page 35 of 72
RR.,2.12 9.2
*Some F'edml prfigrams rimy bQ oxcnipted from coru,jiliance "ith, the Cost F'I'fiICij'ACS (11'CLOars a� ncAe.d. in the 2 CF'R, Parl
§2()0.400(5)(c)-
""'For (cindirto possect th,rough U.S, I fealth and I Juman Services, 45 (°i"R, 92� fbr funding tmsqed, through t)-s- Dep:11,1111,1'evill
off"Aucation,, 34 (11.1180,
STATE FINANCIAL ASSISTANCE. 111-ov i(�IQ r-S who receive State f-linancial assistance and vvito are tc) be �n,
red must oornply with flic, ('(Aloving fiwal laws,mles and regulations:
Sectiork 2 15..97', F.Ii.
Chapter 691-5, I'la- Admin. Oyde
StItte Pro'i�et s Clon 11-A i'm ice Suppkivvwut RO'cr-cme Guide
R)r Stale E'xPcndilures
Other fiscal retjLlitellWIAS het foilh in program laws, niles and rqgulalibns
I'lle Reinairlikr.of"This pagQ, I VA:1111oltionally 111ank
Page, 36 of 7'2,
RP01212
XFFAC,I I MENT I I
FINANCIAL, AND C'(JNJJ'1E1ANCE AUFAT ATTACKIVIENT
SUNIINIARY
Now Ilk 2 CFR. 200,33 L, as mvvised, and s. 215.97, V.S., FCCILlirc that in Nwma6un ahnd Fidmi Pmgmns and SmW Pnjeas
QhOvd A ATTACA INIEVIF I L Exhibil I be pvW&d U) Me reciMent. InAnmKon comaded N a preAcAn of hmdiri,gmmrcQs
and re]Med amoums Imsed on Me amsmi budge.
1. FEDERAI. IIE53URCES AVVARDEDIA)DIE SUBRECHIEN*1'�l:11..JI:Z')',IJAN'l"'1'()'['HIS
CON SIS17 OFITIE 1()LL0iX'1NG::
.....................................—
FUNIANC SOURCE CFDA WMATT
an Rumm Phn Mr %pporAvo SaNkes
Lf S A ka h h and I Iunmn S av kes 93144
under'fit I e I I I-�B of t h e()Ider A tn eric arts A ct
- i� ...................................................................................A In m can He 1� rep U s, Heahh"and I luni"an services $38A6193
kinder'Fifle 111-(1 o('(he()Jkler'Aimericans Act--, ...........------ "I',,',',,"",'--........... ......................
I.................
..........l .......
AltltriCMi Resow PQ Rn- Hmne khvoTd NNAs Us 1 04101 and I 11mizin e sr vicvs 93AM S,10 3bK 56
L1�A E.L�LJ�111-(2:ofthe OldcrAnwrivails Act
--Xnw&an Re scut Plan for Prevent& HeAh under
TRW 104�1'of1he Older Arncricans Act C.G.S. 112 a I(h w id I I in nai i S er v icc s 93,043,
"T" W'47`�, �yms
y [Itunan
w ndc r Ti d e I[I-F,or: t he(",)I d er A i pet ica j i s Act
................................................................— ...........................
TO TA L FE'l)E'RA L A,IVA R D —[:,S 7142,-�:41.49
................................ ........................................
(�°OMPIJANCF REQLlRENIENTS A11111,1CAB1 E iwym FEDERdd. RESOURCES A VARDED III RSLUNT
C()N'1"RA(7'1m ARE ASF()LLOWS:
FE D E R A 1, Fk J N D
2 C F R.Pml 200-t J A Smi A dY n 6 oat ve RaM 0 mmm a v Cbg Pir j Pic j p I e s 4 a i id A uch t R ec�l Ll i tUll Cl I I� Co r I edera 1�A w a rd.s..0 N1 11
CKAw Ad 33 - AuW 0 of SMWI I D"I %mmmm and Now MKI OymAmdws
Z STATE RESOURCES ANVARDEXn)THE REXAPIEPwr PURSUANTTOTHIS CONTRAC FCONSISTOV
111F F()1J,,()W1N(Jp-,
PQATC1HN(j RESCXJCES FOR FEDERAL PROGRAMS
.......... .............................................
.............
PR(XARAN4 -fTrLF F.Q.-NKA-hKJ--SQi J RCE —AIIN111C11IJ14 T
.................................................................................................. .............
.................. .......................................................................................................
'I'()TA I., STATE AiV A,R 1)
... ...............................——----—-------------- .....................................
STA]"F 11NAN(IAL ASTIANCE SUMECT 10 sWN597. F,,S,
--------------------------
PROGRAM 7TH.L 1:1)NINN(i S(H)JR('J,'. CFDi% AN101 INT
..........................
................................................. —--------------
---—------11.11--—--—-------------------.................................................................. .............. ............................................................
TOTAL AWA RU),
CONVII ANC_E REQlARENIENTS A.11'PL1('AB1,.FT() STATE RESOURCES AAVARDE[) PURSUAN'TTOTHIS
C'ONTRACI' ARE AS
65515TANEE;
Secdon 215.97, F.S., Chaper 6945, VAQ ReNreme 6mWe kor SmAxpoWitums, Other fiscal rCCjLnA-d'flCA'V[S Set f(irthi in,
program laws,rules,and regulatimm
Page 37 of 72
RP-2129.2
A'r-FACI I M ENT III
AND AS,SURANCES
11ne ,Al11ancc ,%ill nol a%%m'd this Contiva Milus Hic PRivider c(nnpkics 14cscC'F'R'l lf']("A HONS AN"D
ASSURANCIA in pciAwrimmv of din conuact. Tie [Wider lira vides the 1111a"ing omlincabons ruwl assuNUTOCS:
A. Wbartuent willid Stmmiim,Cer"!aqi� SAFILP a-r")i
.1d S
B.
ULTA_2,L
C% IFR,Qpl 37 and 4
It Q
MIA= AM('
IF, Association O'Continurk Restrktions AsNgivncc
Wto bl J, 11,1-1 17)
Scrtifinizol ..fir ail 'ii 8 F's," MA:
C,, U14,jL1j=i S. C� !�Lqj?jiq n , , I" ( akaa1 LuanyAM!!
Agrvci,pgW§
H, Cel
1, Records ul R
L
Ills wedon of 1,
A. C111ITFIFICATHIN RFWARDINC SUSFJ-,.NS1A),N, AND 07111 IER
RESPONSIB11 III( - 11141 MAR V" (I)VEREIYURANSACAMN.
I hc I,I I lkkrs i;!I�,ed I I 1%:a k i Cie r cc rIoICcs I o t I i c bes t o I'i Is 1,l b"I,v,I o% 'a I 1cl i"Ic I ic 1. k It Kalb!i I s pri I w i ill I s
1, Are not pre"4"1111) OkJxirrecl� susixnidod, propose'd J61,dclxarrllcnl.. deck�ilvcl illohgitdc, or cmJuc1ccl fi%nn
vvvivd WmisulOns Yy a Wood detmintiumm or agawy,
2, f kivc not sm kldn a Twelvar Qml pivuMg dis (ViAmot boon anwicWd cw had u civil #Wmelo imukrvil
uWaimi Owis kwunnnikskm NOW m a ainsinal 4:'Yn6he hwomloclk,m W%ith "iaeulpting h)ohmili, or
pul0winhN a rmblk (I'Mrah Slam (w WO unnsacOon m under '.,I pud�fic %i'ohi,tion cd,
or slaic ar101rusl, sUltutes ()1' COHili6ssion OK'-ft, fmycry, or
dcstruclion ",Ifrc�ocvcls, nialking 151se simonemAm mcivOg suAw pvqYd3:
3 Axc� ni:)l presen11), Khoted cw odwmisc cidininalo or Milly chm ged by a gmcrnnwrn My I Fedual. Slaw o,r
k.w.M) s,Oih ca:)nillljssicm ofarly 'c0l'the cdl�rases c"11HIMA'aled in paraglar"I'i A.2". of[his and"'Or
4, 1:lave as l"4,1'.riod pr000dhig Ods had onQ or public lrallsacfl":ms
Wiodcra'M" State. or QW) wmd wwd Rv cme oNkAuh.
[he und"signed MuH mquim OmHanjivige of dds cnincathmi bu houludecl in IN docauniicnts kpr all subcontracts at
aH AwN Ondming sWicommov vvndmv subgmms and condaus kumor gmints, MIS MW covaahn upVOMMIst
alld Ov.a all sul:) 1-c"'clyems and cmnnaaom Mmll pmvidc dhis cenHWaidni ucconhngt.
Page 38 of 72
R42129.2
W f?U-`X,'A14D1N(; 111HHUNC; - 01ROU'U."ATION
R W i.n was jo wd 11 m v We r cot H es. 0 t h o ban o If W, Li lo,," lecfr�c I rid bei C I`'. I an I:
A Fedowl al;Imprivaed IBM have bonn paid or "i H he paW. by or on behal r of dw wadmKipwdno mi,jerson Ar
i n I I L ia I I c i I) o I,at t o n WA n g I o h Ah a t we a n o Pri mr,o r ea,Isky ce o r C ong N a. or a n o a pl oyce t d"a M c N n bur o I I%gyes S
h i coi-I i wc t W n "i I h the a o a RE ng of a n y Fedor rd a No mz L aw I na k i ng o fa it), 1,od c r;.ir girut I I. �I'ld'. I I I a i I Igo� ,"I I I%, I:ei IQ 4,4 1
room thm, colorinj"". hms of an) coopomrive agmamni , awl We evicatsion smairantim renen M. anlendmni or
llloidflic uiotw tA 'ally Wmd COMMO.Mmitlom OW CMMM16W agmenolt
If at, hinds (Ahcr than IWO appi-op6mM fulds We hem paw sm ""iH piaid to 'an l;,�Icrsc�rt for ittiluclic iris or
manpQ to hHuawo an onka (w empkice or an) vlgerlc-a a cd,Oalgii,uSs., 'Arl officcr or cinployce cif
Cclnz~,Irvss, or cmipk"Ce of a Manber orUnguss in connalion "Ali a Fakind ommmut gram. kam ow ampmalk c
"rp'llro"Illoill" lllk" iII1deI"ignk;xJ, shall olso ccillplele arld sitbli-I4 suinqJ"'Ird I , "DiSOOSLIIrA.' Forrii to R,cporl
I Myha" huicoxchrim "Ali Ks hisInwhys ,
I ho undwoWned shnll diali lanpvqg or tMs coMficalion be inchAdal in Ow chownems IN;H
all lWors ,uhcoraracts° suh-a mms my commos tllldcr,,avallts h-varts and cooperattvo agrecrilents) ,Irld llTl11 alf
suh- rccQlicivs aacl col-immors SIMIJ ,°Cjjtfy mid disclo's,_
1,11i rtili tic,llu is a nmWil ropmsentmOn of No tWow which miance mas phmd m lwn this (Ammel was nurde
or eMovd hot AhnAvion of this ccoNcrokm is a provqKshe for Inaking or enlcaJrIg irt,10 thlis urq',os",,,d,
by 3 t, 1352, /Nny %%ho fails to MY dive ropAmd midbutiort WH he miQl. m a cNA Immky of nol
lea Hmn 5 HMXMond mq nww than S I(r0,000 ,101,c"Wh such 1s61ul%�
C. & EQUi,%L, ovr,(' m,,rUN1T1" ASSUMANWE (29 CAM INUCU 37 AND 45 (114
PAICUBOy -As 11ml it Wll comply W, "ith to nordivuhiinmiori
J,th"I (XILAOI OliJNMIhMit) [-)rovisjolls clfflrc 1611cl"Olng [,'r%%S�
I Sovion 188 4 We WiRme Invomm Act of 1008 (VVIA). L 105-.2210). %%hidl PlOhtbik diSt:r�kInn,1010n
agailim aH WN%Ws W the Whed Sms or trio bads or Nwo., cokq% religion. sex MIAMI OQWL QC_ &MMY,
IMOvil oRiMmi, or belief, ancl apdmt bereniAnks im Me basis ofcid�ici as �r ImOit"IlY
zlclurilak.A irmiliprani 'aulhnril.el"fio -o't:11f ill tht ("mtcd StmesupaAkombon Wall VVIA I RIC 1-010011CWHY MUMCLI
P IxTrats ca-ac 6 A i y,
2, 1 ide VI offfic,,CA 0 Righm Am of 106 11 Pub 1. M-352"I,Lis mnen(JCLIL 1111d Al by orpursiivint
10 1:11C RC C4�l cl��I I ck�
P(AkflkWl OFOW Dqmnmeu orl lcallh smKI I Ultarlll SClN'rCeS'(_1'5CJ�R ll�art 80,1,to the cvid il,mi, in �rc . .
Wh We V1 of divu AV ond the IfegublOn. no pemon hi dw I Whod Walus shulL on dw g"mW ofnon mdor. (or
nutioll"ll be excludecl from panicipion in. he doded the bmietu, ol,. or kC 01.11,CA-VOSC .J]hjlCCICLJ to
cliscri I'll ill'ation irvldcl, aclhly for "hich dre Applic.tril receives Fi"derIlrl llhmll(:IulIl hom
llraw' Deparlow lit
�3 Sec 1:i or m 504 of We R c W W H I m h m i .""act o r 19 7 3 oN h I_.. 9 Y I I a I I I ca,lc l_, al'u I a I I rcclu i ren lc I I I tnlpq Sei] [)_.a or
t-l'ursuant to the kem"rdal.ploun of(be I)cj!�a n nwm of"m hh mull hmmn Sury Ws 0 5 CT R Pon 8", in dw end 0 mk in
mord a ace w ills see oon 5m o r d m t Av L a ad the RegL d 01 W 110 1 A Or"i SO L I LAU I o I'i Cd I I"1.1-Id i,co 111 5e1, i I i d i v i d ii,,l I i 11 1[rk!
l,Inlilud sutles solcl) by reasori of hN hmsdicaR Ivor exclial"I thmil in, he clenied tho belrcrits cwC,
cw be suNeoed to cliscriniarralion undler mV pnWmn"vr adivd) Ow Mich Ow Applbus mmim Moral drumbal
asistanco front the Depaminem.
4. The Age [AscHinkinhon ?W1 of 1975 "WA. 95135), tis lilipow-d 11'w ca-
10 Me Regulation(.11,11re IDq'xAr-UJ`aOA cd kkahh aml,Flurnalt So-Kcs(45 011 Pan 91 L a)Kv end Owt, in acmdmice
"Ali the Act and the Reguln6on, no pumm in le I dial Smics AmIL on Oc bads of Rpi be (Nnkd the boh1h,
or be excluded flown in, tam- be Wdeoed to discriiAmmion WKWr any pnopyin or acthhy for which
reccive; VMS nrrmrci.,ill 'issiskillue fron; the
5MIc Q of 14, Edication AnmAmms of 1972 (Pulm L. 9111 Si. as anwedul- arrd "iH I-CLIUNIVHTCI-Wi iituposcd by
Page 39 of 72
RP-21222
cwpwsrraM h; to Reguladon or TeDepunmn of I bakh and I hnnanSeryinaw (GUR Fort 86), to Towkidul.
hi wcoMmwc vOT We M and Ow ReWilmhon. no Lowmic in H-1c'! Uldr'c'd stales sholl, col the 1'osis' c)r' Sex. tic
excluded Ann poldkipwitni A ho denicd to bcneHB A or [x-, othel-oise to discidialimaic)n any
o1wohn plwWwrn or x6vity Air uhkh We AppFicapm receives 1 edcnfl rin,n,cial assistance 10m die Dopstruttent
6, fire Arricricalt %%hh ilis.�,rbihlrw.,,s Ac,j or 19%) (PuK 1, 101-3361 WWII plx"11'rlbi�"s discrill-nrlotion in-oll
practices- apphcnlion procellores, Wring. fiting advarwoncm, aincl other
lCrrj1lp_" oortcfilicus, ancl Mwisip, wmv, Wyoff, wavo W-lige
lxrrl'o'fi'tS. and all "WOOlies,
Provides W "sums drul. k W canply "Ah 29 CIR Pan 37 and all oQw- ik�gtlk.rnons
lisped rkrmk. I his assul:.'lJ'lCU appp)lik-s w 111'w�ivicler's Operation c,flhc W[A I We I - Am My mskwd pwgrzirn or
acaivily all".] lo"fll c"mmon Mwidci makesiocarD out the AM fAW I - WnWh o"Brod pRipram ormOviy,
Provider Laidetnwk dull Ke Mpadinem mul Ow LIM Smws We the righi to, seck judiciai;
assuraw,,,.
I he WNsWrred shall mxpAv thal hingtrogy,, oflihis asswwxv be Whlxl irt tulle docui�rl.cw for all
A 6011 OMMY M&MMUM MOMN, s4lb-gianis arx! conlnwts Wx graw knurrs ard cwqmnow agmernows)
and that aH Sul!:w fflle'lm:anmalrslk.lm�mr����all'tI1this asstll%-'lllce
D. CERTMCATJON REGARDINC P1 MWEM: ITY C7111NIES,SE(�-'TION 287.133, F.S.
1'rovidu licreby cerlHics tat m.,,ither it, mu any pwom ol"Ailiaw orHmkbi Ws bun colviewd of a Wic 11iQ
as ik"lil.1%,xi in Y 287,133. RS rwwMaced on mime cowkwd vonloi- At,
"llrd 'agrec"s 1h,"ll it is n.'°quired lo infi,%rul Ch,! VX'!pl'onxna ill 1lj"4)jj agj"
circmnlst'alwc�s reg"ar-ding this st.�rk.ks
F. ASSO (,'f,�'j'j4)A; OF COMMUNITY ORGANIZATIONS R)R RFTORM MAN` (A(A)RN) FUNDING
RESTRKAIONS ASSVRAN(A ('lit lim. Is. 11 VA 17).
AS a L'olldiljoll w�:Jf Ow (Amiusel. 14"M alswvs ths. h "it conifull My milh dw hodend Rwdbg rawictions
1'-wmalling lo 1vC()R"N' alicl per tire Coll';ralicklEcd Aa [)ivisicar F. Sccflon 5111
O"irl) I„ I 11 1 11 7Y 1 1w CINTlinnitV Apprquillow ArL 20 H, SmIkirts 10 1 and 103 W. L H F04 21 pnnhlb;
t1r;o 1-w:11,110 I.. I I 1.-1 17 arm'uv"rilrdlk.' llraller 111c pjrcvided hy L. 1 1, 1 „I 17.
Fbo undoNipped shrall nNuire W lanWayo Wds awamalluc bc hwkKJc(L in m]k)Cllrlrcnts k")r kdl stiih'corl&r"'lcls ,.it 211
lik'!rs (illchl"Hil"p. sull !!lr"rrlts an"d conAnkcl" lindcr groluls" lcow' and 'agrecillcurs) and
r111 "oll") rc'(Jpa'Onjrs t�irli] sh"dA pn'n'idc rhis ussi'll-o'n(%
F, CERTIFICATION REGAR DING S �RLJJ INIZED COAIPANIES ILASTS,SEGF ION 287.B5, u'.s.
H'ihis Cowrocl is in Ow anwwn or a MW or inmv. in ac"wdaimc %vhh dh; RpOranorts w;f s. 28T 131 IS.,
Pirco vicic"r hvreh�'o lh"rt k is nol paiOcipathig in a 1xicou of ImadjA no lkwd on oWwr to Saw0d"Ll,
Compmics "hh US!% in Swi.,in 1-ism or to Souhhzcd (WpInKs wilh AMAins W Ow Imn Ponlorn
Wor Lim. and 1hat it dctcrs ric�l. l'ove [?usincss oper�flions in (7nha �w LIM Ws am ewawd p;HmwM to S,
21&A 71 KS,
Me%ider wx0slands Out LHNNuant a)s. 28T 131 FS . Tic mArrOssion ofa Me suleel Proviclo"o
civil penollk"S' d-HUJ;'Or LOSk.
I f Provider is wwble to coof any onhe siawnwrus. in his Mhurbon. 10wider sUl .attach,mi ejuriMmi to this
(Alwact,
G. CEATIFiCAAA10N REGARDIM; DATA INTEGRIFTY ( ONUILIAN(4] F'OR CON AC-IMEMENTS,
ICI ANISJX)ANS AND UNWRATIVE AGRYDIENI'S
I. 1 hL! Provider a9nd ;'Inv inl7cownwars of nNOws under this nwhorel have WwwWO inalNWenicni s)morns
emmu or pnwidhW!um& hihmnakm, AwWddg: ( I ) aculza:, iAlrrellt. rnd Conq4CW diSCIOSLOfe 01"010
Page 40 of U
RP01212
1-1113vicial resuhs cal, each cr' prograln I'll thc' pi'vsCribetl
mquironew (2) to sotwee and arplimiAm of IN& hor ally mwoo sippowl achwAky and (3) the
comp"trison; of mitlays wwiffi budgeled alrionnis cach aww& Rw inttt-)ility to procoss ill
accordance u idt Me wqVireirrow omdd wsrM in a rown of Pont flind's fllolr havc rlm;?s Iven accOldritt"d IN
twporly.
2, Sm�,Slelrls rised 1)w the P'rcrvider. ()I- arly clrrsidt epllivy cn
wfliich tho Vrovidle,, is dc'tvndent lbr� caul that is to ke vctponcd. ow- have beon assesst.,d
and vedhod WD MMIlglem-Sw depcimho M
kkwHOd wbc nowmnNiarvin Pinviderwill take, inniMaic wkwi toassurechna hltegrhy.
3, 11' Ibis, cowrwr includes 1he pi'mkOn c& hard"kne. sol't"aw. ni-inwac, vnicmwK cm inMoMmi chit)
w1malogy. tho iindoWipwd warivras that Tese pmckwo arc (tau ,a
wXwow", AH versions of thesc, lwo&wx onOwd by Oro 1havIder ovpi-csomod by To Morw4pwd) and
pnchmcd 11 thv swo uHHw veMled IN accipAcy and dMeWA) ordaw Irkw to hwnw1hv-.
I In dw ekelo of any decrease In rcIzacd to nine m-rd, tkitc I-ohrt,�d cozlos and jrll,�"vrral
war KNAC dw harclmw or MA"we pagi-ams hurn opnowng pmpn-] , Ill'o Plvlv1dcr aproes lo irnnicdjaticd�
requirc.-Ll to roshwo VA"MV am! soft"MV pnwMMS ��o Glv saime Iiwicl o'f I`ancticm,'Ait� a's
va"mued howN at no chwVo to die sw and MUM l MWONLOY' l 0) w1c, blo,;JI,un"s of he stare, time
Mw ordw esserwe
5 1he P rk:i v i(]e-r „I 1-1d 'a 11), Sm1lrcumIrIr%Icw a nd Or ve uAms as I'sc I%u cc s tarrwlc r I I l i s c:-nr I r n,kc t, %%,rI r ry 14 11 11 le i r I)o I u cii S "r 1N vJ
r,1C e'd I,I Ire s i r w I t I d e a d kmw r N w vM pn w We R w w In 1 cc d c I i ve ry c o 1) 1-11,10 11, tsc,°i'f a I I 0m m me r !e I w m i i"mc I"N I d i 11,
onmVeilcks King thnn dma immyriq "mokuwc iYaws.
IL VER1111CATION OF ENIMAMAIENT STATUS CTRITHCAMON
M A cuMbn ofemllmody "Ali IS Mpanmok 1100wr Mwes Ow Use Mw US 0"'.-partnicril of I JoInUISIXI
Swof)`s MY 0 ;,wern lo YwAY dw anily mcru cNONMY of all ric" cnljlk.I ccs hired 1)wr 1he'A"I"CA"ider diAriflL2,
the contr;lct (L.1,in to J!Ierlonn elnphi�lilcnl drike� pirr-smun W thin coninwi aml Ow arny sulwoArras irwhAe arm
express mquinavient thai subconn,,.,r.cI= wnMw vcnAmn IwAmmkip work or l°lrovkfint.z S-elviccs" 1"lursomfl. to dris
(),�mtrucl tiffli?c the Mci-PIS—gsion to vNib the mpkyracts cligibill(y of ;dl nou ernploqes hirod 1, 111c°
submwrackw amd/in vendor during 01C (,111,4-e Q0Ilr1,'iAj
4"hic, [he laripinge MMN mriflicalion llo irinicludc'd n-I aH:
ank. l�r� all MOOMMS anvow vetwors "Nttl colirplk:'Ince accordirigb
J Ns colddembn is a niannial rePT=C1nMkM Of ICJ up)n Mch relhowe "as Mmed "hen Th hansvidon mys
inside or cracral intit Subinission MR w0katimlis a pavqVin hm nmkhg or mairg h*o dik Irvinwohm
inrlposc-d b, Circullms A-102 and 2 CFR Pan M wld 215 Mrnwrly ONIR (Ircular /YJ I M.
I. REC70RDS AND
I 1w MGM rigNes 4) Me a%QaMc to Affi'airce and I)C-Ima,tincrit staff av1d;,cr �,uly pmy'ly
Alh�rnce �:jmj I o p�a,l I'll ord ail,% and ".111 CMUM0 related rmorvIs aml 'the Shall 11w
4111d of all pwginim-mbod inAn"ation and Lkwunwnm6nn on an) sudi sysion Mgmed
1W dw 11cpsidn-ims Nbirmamc includes QVI ONPOIS and backips Mll dwa Lind systems "wcorchnz
SwImlards.
J, CERT111711CAITON NEE 114RDING INSPECIMN OF FKBLK? REC(mins
1. In allhion to die rectMonernsof se0ions. IT I� 10 2 o['0w Staird,,,,ud (Aminict- aml 1110704 3) and M M. aml
nny N, Ta Kid action N mmmwed as oNmern;i1and In n 1110701(4), F.4, asx] fli�Aflj,rncc or
die Depannicni is mmwd In Uw civil, avrM IN)vkkr agmes w h0ormAQ and hAd hantMemAw Allivince and Nre
DyaMnaA Rw any costs hwurwd by dw AlhamwAlw%pnmoo, Meal irony aw rig ys lies ismsed or awarwlw]
,,ig 0n6t iticAlliamea1w Delmnmern acwri a Public Records RcqLWS1 invide pirrynnll (c,('11'alliew, 119, F'S', ci�,,ncerrnng
Page 41 of 72
RP-21212
00s covorria; or scmicos perkwivwd
I Stx,"0on I 19 01(3), 1:�S- stau-'-; it 1)11 Illic 1,0 1 ld� 'ar expe I idod b." a I I ""Igerw ili 1:);I; I Ilefil Of dl-[L�', Or HIC113 bQ I'Shi I)
Qolltirihillkq-6 for ally pQrsoil. Wrr,")nathn. WK15n, lrus�, assciw, ialiori. groilp- c1l, (')I her I]. Al tilt'!
kli'alwi,ai,, hll6int�s , aaxl rmotds of swh an euriky"Web pertak VP the palflic agency (Flwkta
Department of Elder Anbuts) mv win rvam saiWn 1ROARS,mmes4Wevoy jxwwi "hohwi,otmN1yoi'
mich as puNk rcawd And pcoWt Ow rmoM OD be iristwood mxl corded by arl, "mon daily to do sv twidor
Aw hufmaArrial mcmhowhys.
PwvWx% sjwuiw hdo" anwis that hN the AlhancemRl
,.�lvaihable l'or
[1y k."w'Villion of this corlln.-wt rrlu�st ill,crlill"k.' 11lc.-:5c in Al sl,lbcoplirak"J (d.
H,� exl�vl6il,�iri 1:d, 1his c0l�ltral,(, nu. o HeWde Woc pw%Rzins (AT W wH rc-hocd agrk"'kniloas (if
apQW),
sipiing b4fk:wk. 1"NoWr ce0ks die reprosunakwis NOOK Ki pmris A lhnmigh J Wo am inw mW wum:l,
11 QQ,�,Jnton(on Street, 2'A Floor
IgIntattku"rve and 11de of authoWed Street Address
N'lonrole (7ounty Board o4'County Co tit lin isskme I-S,
Socia] ServivesAn-Hoate Sez-vices 101 1 Key Wes�t, FL 33040
Provider Natne 1)as City, State, Zjp code
014"signed by James D.
James D. Molenaar Molenaar
Date:2022.10.07 11:19:57-04'00'
Approved as to Form and Legal Sufficiency
James D. Molenaar
Asst. County Attorney
MONROE COUNTY ATTORNEY'S OFFICE
Psge 42 of 72
RP11212
ATTACHMENT VI
ASS�,IR,AN C"ES—N()N-C!0 NSTR(JC110 N 11W)GRA'NIS
Public reporting, bur(kti Ar Mh Kledion of Atimnathin is eshmated to avelage 45 rnhwas per respma, hwhdhg Orne kir
roviolvi,rq;instrucliorls, searching existing data sawres,getthering and maintaining he alma weded and ecarlphling and reviewing
the co I lect ion or in(iniriat i(in, Send axnnnicrus reganling die burden estini ate orari),oihel asj,!wc1 of this collection
Qlathing mygestims IS reduchng this burdelt to Ow Office MAWtagorient and Budget. Paj!)crwcark RedUtt1011 PlrojQcl (0348-
00,11), Washington, DC20503,
PLEASE 1XJ N(Yl RETU RN �Vr(tj I R(,'ONIFLETEI),FORMT(YTHE(WFICE ()F MANAGE 'RE NTAND 131A)CUE F,
SEND rV U) THL AN)RES,S PROVIF)EV BYTHE.' SPOW)RING AGENCY,
Nmo!! Ceitain of"fliose assurances P-nay not be apWicable to your puyjed or Imograny IF you have qpeniontlAcne contact A
awarding agency. Further", QQrt,ann F'edenfl alvnrdfiig agencies rnay require applicants to,cerd[d to addhonal assumixes. If such is
Me Ca.Wj )'OLl wi,[] b utodfied.
L I LIS the log'al auth,orny to apply hr Wderal and the 61S(fllnional, manage dal anA finandal eqpaWlity (AduxAg
Rmds sufficieni lo, pity the iWMACM A=or pll ject Cost)to ensure piroper planning, martagewient, and, Of the
f)rqject deqcrilied in this applieuti4in.
2. Will give dw awalrdhW agency, thQ Conipoi,)Ilcr General offlie lWed Su es., and if appropriate, dw Wate, dimugh any
authodzed access lo and thQ right ft,) oxanifilc, all 1,=x'ds, bi-iiiks, papers., or doctunents relaled to the Award;
and wvjfl establish a proper accouliting syslom in acloordance with general, accepml wainshig standards or qgency
direedves.
3. Will estalflkh, s,awguards to pri"),hi,bit Cruploy(,cs Crimfi using led positions W a propose dtal cmimikoes M, IMSCrits the
aj!q)eiiranee of"personal Or orgallizatiouill Con(lict 01,inleresi, Ca"-persoinil gair"l,
4, Will kfltiaite and compble the woli whWn A aphoWe time Rame after M&P DfWproval of the awardling agency.
5--"VHI conlply mifth Ow Personnel Act of 19710 (42 1 VSAI 4 W47(0) relating to prescribed standarck 16l.
medl systems Or progauns tandcd under oiw or We 19 statutes or regulahons specified in, IqVendk A of OfNfs Shindalsk
Ar as Merit Symon ol'I"ersonriLl A(bnAhMmikin (5 CER, M Vibpart Fj,
6 WIH comply %ilh a1.1 Federal, statut,cs refiaGlig to nondiscrintination, These OWN but am not lknhed W: (a) fide vi orwo
Chd Rights Act of 064 (111. 8&3521 whkh pphlits discriminAhn on Me basis of race., color or national origni; (b)Title
IX of Me Elwaahn Amendiness of 1972,as rumended(20 1 10C, 1681-1683.and 1 t385-1686),,which prohibits dkcrirnirtaflori
on the bads of sex; (c) Scuban 504 of Me Rehabilitation Act 1973, as arnended (29 (J.S.C. 7914), which rirdnbil�.q
discrin'titiation,on file basis ofhan&Qajis-, 0)Te Age Dkaknirlatkin Act of'1975, as arm2nded.(�42 tJ-S.C. 6 10 1-6100, whkii
prohibits discrin-iination mi the basis ofam,(e)tbc D,rug Abuse 0iffice and Tmatmers Act of 1972(P.1. 92-255y as amended,
rel,afirig,to non.discrinihokm on Me bail of dmg Own (f)the Compmhembe Alcohol Abuse and Alcoholism Par endnn,
TI-eaknent and Rehabilitatkm Ad ol' 1970 (KI. 910,161 as axnended. rehang to nomliscriminnation an be basis of alcohol
ibuse oralcoholkin;(g)523 aud 527 uric PuNic 14cahh Suvkc Acn�tf'1912 (42 1k'&C 290 d?3 and 290 cc 3h as arnendul.,
relating w confidentiality, ofalcohc'fl: an(I drug abilse patient reco,W Po Thk VH[ of the(10J Rights Act of 1969 (42: IT'Si.C.
360, et seqj, as ammWel Watkig to nomAcriminaiOn in Ve sak, ranch or -MmncWg cW haiming W any odicr
provi'sions, 41 the,specific statute(s) under which for f�ederal, assistance is being rriudc; and ij)
the requirernem of mW nther nondisudahatlion swulte(s) which unary apply lx) the application.
I "All ewnpbq or jixs alrCady calnphc(t %WOVIC nNU101110RIS Of TideS 11 811d III of the Uniforni Rckic.-alk:)n, Assistance and
Real Property Acqjuisitu,)n Policies Acl of 1970 (KI. 91146) whRh pruvide for fair and OLILlit.1131C treannent u,rpemms
dist.flaced (.,)rwhose property isaoTdred as aresult asMwed1ptvgmnm. 11heserqukernmovapplyto all
interests in roalpropct-ty uqWred for laippel purposes regardWs of AdoW pwn[cipadon In pul-cimses,
K Mill cmnpbn as applicable,%vith flic Ixo0sions of Me Hatch Act(5 II.S,C. 504-1508 anal 7324-73281 w1dch DO The polldcal
awkWAS OFCMPWYCQS whose principal enilAloynient activitics maw Wed in mKic tar M pml"Ah Federal haad&
9. MAU eurnpY, as applicableti with the pro0siuWW (Q 10W 27M to 2M*Gj to Cqxbnd Ad (M)O
K&C 276c mid 18 1J,S,C 874) an(t the Cornract Work Hours and Safety SmIrcls Ad (40 t0f! 3271331 rcWwdAg
hart orst"indards f6r I'Merally, assisled construction sub;agreenlents,
10. Will C0111111y, if applicable, With flood linsauramnce purcliase requKinents of Scaki 102Y) of Ve, Hood [Nmster Protechmi
Act rah'"1973 (I'l.93134)which re quhses recipients in a sNchd Hood hazard area to participate in the program and to[mmWase
W Wswwwe if the total cog of insutmble construcrK and acquisition is $1 10,0104(g)an inOTT
I L VKH cmmply%vith enviummuM swidaMs which nmy be prwalbed ptasuant to the Coflowing:(a)institution of environlilental
quality Qonln)l measilres raider the Nalicmmnaal Environmerital 11tiliq Aa of W (RL. 91190) and ExendWe Wer (EO)
I I 51A, (b) notiflca,Ihon of'Violating facilhies purnmW to ED 11738; (c) Irroiection of Wamis ptummi-m to EO I Wad)
Page 43 of 72
RP-2129,2
QVzl4la'lk)Rl of flood lu'vards in floodphins in accordance wah 1"() 11998' (e) wsslil-anc,e of pixiject Collis i Ste 1111cy widl the
approved Mate nianagenient progymn devel:oliecl undor the(I oa islal Z,:,,mA: klatiagenwnt,Act of 19'72 (16 US.C. 145 1 et sLq.)-
0) 04' Federal actians to State (Clear Air) failfleniethlation Plaw� under Svchon 176(1c) ot'the Clean Aix Ac:t oil
19.55,w aLi4ended(42 1 IIS,4- 7401 et se(f),(9)protedio,ti of Li ridergro ou i.d water ill'Ider the Sutf , Dri,rikirig
Wlalu Act sal" 1'974,as alnended, (P.L. 93-523), anal (h) [,)ro eclion of endAng.ervd speclona under the Endangered Species Act
of 19'73, asainenlle(j, (13],, 913-20)
12 %ri I I II P ly w i th (lie W'j Ild and IS cen ic Rivers A ot cif 1968, (16 U.".s.C., 1721 el: seq.1, ry lated to px)tec t i i ig, conipo nents, 01,
PIOti:llti,'I.I�4,)1111)(�)llk.11is ol'the national wjkl and scenic riven,.System'..
1,31. wifl as'dsu thc awarding,ageuicy in assR.Liring olinipliance wvith Section 1,06 of the Mttioiwl HistoriQ Preservation Act of 19166,
as imienclod (16 1, 470), E01 I "1593 (idenfificalkin and protectiol"i Of historic prolwrlivs),, and the ArellIaeological and
I listo'l-ic Prescrv"flk)n A0 of 1974, (16 USXI. 4 69La-I et st cl.),
1 1,- Will clornply with 111,, 93-348 regairding the priotection Of SILIIIJQA2,1S ill%ItAIIII in rcscarQh,, and related
Activities suppor(vd lby thls zw-ard o fass ist"In ce,
15. Will comply 16ul7 the I iboratory Anfina] Welfare Act of 1966 89-5+4,n�arriLnd,Ccl, 7 U-S,C, 2 13 1 et seq.)pertainirig to
flLe care, haridfing,, and treatiiwnt off�w',urni-blooded anfinals held for research, teachilrig, or oflter aoivitics Supported b),-this
wvil rd ti fil ss istan t:c.
16 Wi41 tontlily %kith thc Paint 11(�aisoning, Prevention Act (42 1,II S.C. 4N 1 ct seq.), whi,cil prohibils the use(-d'lead-
Imsed 1.)a i i i t in Q.on s I rkwti o1i i or rebab i 11 i tau i on c)f res i dein ce!sl ruc t Ll MIS
17- "Ili 11 cause uiI be PCI-ilkwined Ifie r equjred flulancial and conlpfirinee alachts in accordance,with the Single Aki,(M as Anien(finents
o 1" 19,916 ai i d(N B Ci i-(,,Lt har N o,, A,-1 3, A trigs t s o f S tw es, Loc a I G o vel-n in ent s, and N orl-Pro(i t()rgatji j zat jolls,
18 A"i I I Col il J)I yI° rnrulII all app I ka b 1v req ii i reviiei it s(i F a 111 (it h er, Fede ra I I am's,e weig t k'e 0 I'diers,regtt I afi o i is areal.pol iv ies go v e rl a[11g
this progr.,,nn.
S I uNATUR Ot,",%I I]I OR IZEI 0 L(1 I[A]N(i 0I:I'l(l I H F
C),
——-------------
I ION PA IT: Sa J3MH-1['"D
MONROE COUNTY BOARD 011' COUNTY C'(1)MMISSIONEIRS,
SO( IAL SERVICESAN-1 IM1111- SFIRAW"I"IS, bD IZ.
-—...-......
James D. Molenaar Digitally signed by James D.Molenaar
Date:2022,10.07 11:20:32-04'00'
Approved as to Form and Legal Sufficiency
James D. Mollenaar
Asst. County Attorney
MONROE COUNTY ATTORNEY'S OFFICE
P,ige 44 of 72
Pm '1' 9
ATTACHMENT T VII
t'ONTRA "f �3t�� t ,' " 1, �N l Ii" ," 1 :°I AND
Maximum
Service Unit Units of maximum
ervic s to be Provided Date Service DoIllairs
Cong regato Mauls MI-TC C 1 9 N
r ate Meals C 4 m ....................................
�Lo,Lgj�qpte Me a S cry, ..,
..................................................................................................................................................Nutrition, Education C1
,,,,,m
° 1u
hm p pilm ssit, mcc CV C 1
1 $30.90
Telephone Re Reassurance c c1 7, 7 1 7. 7
I
i-forme Delivered Meals Frozen 5. 14,769 1 ,
Emergency Horne Delivered Meals C2 $6 53 1731 $1,127,47
Nutritilorn CouinstAingC 7 ,5 1 ,5
NutritN on Ecl�fion c7 1. "I 102.0
„........ ,mm .. ....
Page 4 5 of 7
RP-2129 2
ATTAC"MENT" VIII
ARP
ADVANCT IMSIS(J)NTRACI
Ikeport Nuniber Based On, Su h in i t to A Hia nvx
On Thh Doe
I (Wher Abame* October 25
2 Iovonfer Advance 00aher 2.5
3 Ocwkr EWMurc Rqwrt Novenher 6
4 November ExpendArc Rcliort DeCCIVII)er 6
5 Deceniber Lxporiditury Report JMWMY 6
6 jammy IAPMAHWC RqW11 %rum, 6
7' February L.xpenditure Report Mamh 6
8 KIalthr ['xpenditurc Rqio,rt April 6
9 Apfil ExIvri,dituro Reporl My 6
10 idly Expendhure Report JWW 6
I 1I Junt Expondimye Repurt JuY 6
12 July [-,xperidoure Report Aug, 6
13 Ampst Expenditure Repw: S,epteiiiiber 6
14 Sepembm- E"emlhnv Spoil October 6
15 Fimal ENIMICIALIN Mid C[CYSt()Ut Rell(Ift Amber 3 11
Lqz"CII& Advance based on prqjected casIt need.
Nole ,Y 1: Report A I Ar A h awe B arils A..t pvenvonts cannA be WmWd to A Depmon p&r UAW%221
or umd the agmemem with flue Allian;ee Bias been cxeQijI:e&
NtAcO 2; Relxa-t minken 5 Owmph 141, shaR reflect fin a(�jixainv.ivt ofmiv-lenth r:,fl'the to[A advarice aniourit.,on
Mi ofthe repons, repaying advance� issued the first ni,i:mth offficiagreenient,
Mme 031 submission 0fe"xpeIaditumrqvns may ormAy nW Ffin"'dexpendWe
report refleds fikinds due Nick to the Alliance, dte%vidersha[llsubnijl payrnevit arm vice oi,tipul die
TOP011,
Page 45 of 72
RP-2 12.9.2
ATTA01MEN'T IX
REQUEST FOP.PAYMENT
ARP -FORM 106
AM ERICAN RESC UE PLAN-0,LD ER ADULT ACT F UNDI NG
............ .....................................................................
I YFE OF REMRT
PROVIDER NAME,ADDRESS,PHONE&FED 10 NUMBER
...............................
J�, .....................
Pv,,Mdm Nam o
Pcr
.............
dgf Addm 5
P,rq,40vr T@Wphono
"I',"",..................
.............................................................. ...............
GER11FICA11W
Flvopnvod ...................................... Dale Appi e�m,.�d
............................................................... -------- .................
BUDGET SUMMANY 11"a NCR I,l ffl,,'M2 RPM RRM % IFOTN"
........... .......... ...........................
Nrr maw
.....................................................................................
11--.-...............
cookracl Nnowd W........... -..............................o M
.........................................................
.. ......... "I'll"I'll,.........
000 000 000
.......... ........................ ....................... 0 .............
0 OD 0.00 Ono cl,to 0.00
:q!�nt��� -----11 "1 1111,11-11,11.111,ll,-............... - ......... ......
..............................
Kmh 0mom Mod 0 M, �D D0 0.0of a
........................... ................ ",............. 9,
01
................. . ..............................
ILe� Cutttmil Wrilh Ady P&yb*rA 0 00, C�00 0 0 0 D�010 0 DD 0.00
........... .......................................................--
.......................................... .......................
dforthisMonth W OOG 00
.............................................
PEA 911 AFP Rem RA Owl LXUdwr X521
Page 47 of 72
RP-212 .
EXURRIT I
ARP; uldfiA,Ini Ilia
..... �. ___'___ ,,,,, ,,,: ,, _... __..
R'p M4 .APPREM,x"MEP.AMOLEEIRM EU _ " PERj' r.v,
J,f7iMl't�r# �Pd
rtT r mml rNr.R IY...
____ . .... .,�
nnl"nrl 0
P'v.A at,1.. ... ..
rinfffl.XEmiu�P'!"%L6 I crrr NIV the hest 0mpry�nuWedgD and dnllarthul WNVe mpcal(ar^nn� ude.m 0*0Vlln4N&oualN I4rdri#rl All,par Muse®nnl rar?h Vm
them!"'. Furtel,I cadito that Phundnrhnd mcrNy and V7D®mrAT.,N+ meju rldrwwsi.
prupnrmd ty_....__._..�._._.�..�. i1i,T"I'm;.___w--_._�,. Appravuud fm'y„
r pp g 1rd'u HililYrIg 0.; ...
INCYSFNi�"'1aL�;�+IP'"h'�6 rl rx ru7*�1 IFF`rJggr91 C�, I�,[D7Wn1'I"u+Cnf PMllmmr G`,' lab %pm AW2FWWld$
Far Ibis 1%,11 m Ynnr In 16mtn ... Nu nip Priam'M,,,Rkee is YT'Lh
f'da'FV!filCyl funheN`.A ., $a NOW"
�Cmh kr Ath 11118„4IG1,IIIC2,1]IE)
......._,_.....
11 uE1 Wl.KMO arlNlch ... � .. r
IWOM IN
BilimbWUhitC,bM:RmpDrl: 4Y4tdIw,rl bdNkdrl I6NidFe;',g�ni �
9A,} Nffl N-rtl t9':V- Y'F:;G' 'CFp I 9ArM ,9-
sommav conlract 1➢ 1 Rmfi ArlROO MY p 'Imdm1 Y.:T-D °Y-Ti D Lwe d I"»NranIh y"I'lID
Amue.r�nt WrOms This NOW BWIIIAWM O labin �U. dup C'Iwr1s Wu,¢p V„"„SIIWls
m ,
rLlmla rwnsr ;,,aY1 s{WP" o fi°MYnur're'II�(uimrNs Px9r'TIpN
.....
N
� �
...., �yv ... .......
Ik lo.v
__.
�roa�ry�,,;.W, � ����w,��� .... :� Irv.
4Cr � Ni flls ,
,� ..... - _.... , .
... ......... .........TOW
Syr.011,erRP 101 10 r9 rW, 4"FrtivJunr M. 21
Page 48 of 7
RP,,2,1,,29,2
A,rTACHAIENT x
E X 1-1113 IT 2
RECUPTS A,UNIIT COST REPORT
ARP SubITUIv:HOC$
RN F U N 0 1 M M U i i�—WQRT pmm
................
-x
............................
IRLGTM
................................
rw..r.a.......... ............ . .....
............
..............
"I"!............'T
..................... ...................... ..................... IPSA Nil ......................
GEli�DI"14;A1,QN, I coravy W I�n hW,ol rnyl0owledge and bolwl MOM I.Pis*P&I it mmp[dim arid correct and wD oudwp herain mon for p4pos ol got ftw1jr,liw
F,wthat I mff,42i a I.IM a UmChod Morijryord YT13 Jpf4,nt IjfOjsI(4jqjUp d00 I"6j*oiA"rqpLrjt it cul,ect
NOR&MI by ....... A.......... Appiwxl hq .........
............."............ ........................................ ....................
INCOMEMMEIM A Ap�mwmd8u.*pl 8 Ackua�Idal ERMlidig C. Mflal Wilingi %of Apfvvmd
tam Nit Impod Y(Pv 10 Oflike BLA412 Parlor me,Rocelpt0,10
Fedtqtil rui-ds
l"Irciraryl .............................
Ca5h Malon IIllb, MUI,1111IG2,,RIEM
SLIPTOTAI Cash RoceirAs
....................
L.Dool W ................... .......... ............
TO TA L 8 E,CC I P f S SG 00 OUVO
BIMI able Uhrim Cast Report WidulpUraN d Clio is Serwod
84mros Go serf RflPaNe UrA Hale Ambo).IEiolm d Y T,rj YTO C'mud PAwAh Y.:T-D
Ampum Lklils Th[8 pellwj, Billable, 0M.-OAR Utwlup,U(mils Jrwl4i Clisms
................. ................... ..............
—7-7— .............
............
...........................
. ......................... ............
-------
-----
............... �,
amp
..........
.... ................. ...................................
....................
$
.................. .......... ......4�
........................ ........................... ............... ...................
.................
...............................-—-----
.......................
.. .................................................
-------------
I.......... ..................... ----------- ..........................
%A 011 ARP IOXIFemm,4,M1,31m,2021
Page 49 of 72
RFC- 12' ,
A'I'"I'ACH6"' ENI
EXHIBIT°
RECEIPTS&UM T COST RE,PORT
ARP SM,Mblilde IIIICZ
....., ........
�PRPY1"R A 9,APQ lhJEOS a[nd IDS _ � �I m WQR' QMD�, .,. _................
ra r, -_____ _.-,,,,-
�.0 1'b
AIW1 pore x
... .......
.................... k6"iV6�i
_ h� I
........
ME Gsy�ak.•.Y, llrr OI w�Nrer tl ✓Inra h!rurae?d@r,uu r,zrouP knra�uwal,tlY i,n0.GNaeir�iva uh uw;�u'amd,iYerc�V¢V�aun¢tN UG�'mi aril w,udk'�'G �, yh Uryr. ,.„ r rr r .. ........._
V 'rr4 4uVy�ppC Y Ld. qc�.r � u�u �r d�Mifw��#4'er G'��'�I�rrowSw r��r Frau tlto irn
wlv�.rrmrnlr�ti�Ctf rurWvtrwr.Ub:.�.,pu^[Gy RY'u�M9,hNdq�ti iisd�irN.Vovti�'u'oV".rreMl Vi6 iwoVP:O"Y"V"L1,rrrurm',;w�u.irxitllLY�momlu�uga0ii�r�Pra7:po�smfx"m:�r,�,vn¢�;rr.,�reu�rV
Frury7W'¢ml by 08M'.. A. _ ..._ ......... Alyps^"`"ty N.hxe G
_
IINCC+r'G ................................... _._ .._..-,.�.,..,� ,r,„r .._.
...._____.
CCEIIRTS A dyryl"UrtvUwrad�'uuJ:«4 iB dh.vml'llVcwl OlUng E�,. T'A"vd Wfing "r'd'A,pw'.'RR V
YVw.w I a pa nr llhwbvjul mrr>Mor Mo
ro l paw . .... FPC' �6ClI
lPHU'-m15 ba°�)DWIr�m .. ,W m�rr J .._.._._ ......_.._..
__................ ........ ���mm� Wr.. W w ,........................................._..
(.Am h,Makiii g IVffl,lllC I HIM 111F�r � ;�
SIUG�t(JW.. f,1V� r'�Vs'C 0,0��n � T
I_:ua:xrll jh,Kird rowlaW6v:Pn
I�.apV"�l hg"'pl Illrlf�" �'ba'D > .. � 3kVp +Sd;N�i
._. .......
VAN ar'd;tl (G; o°I,sk, Er'� ViG'jl 1',V'N �lA'i o'rlN'
�;lgrVres X.ryMInwl D"llrable UN kMVp Arr•,ujrA,kilMr'I'arl V.p"'.D Y-"n D Cxurrreil p&mflh "W-V:'.�M
Arnoll.urol lh pgviry., 1BIBOabllNs Hu7A':re I.A,6j 0iY:Ms LAti.p V;yllis:m,.
Ov', h S+ h d y.au wu ,.&Yve 6r.. > M'VkSr'N'TA•d�uwr Aa RrlVrr`f71CY:
,
.. ................... _... -1
mm��mm� umumm��wwwwww` ��.�r��w�rrr
- ,,, ,
m��u
_....... ....., ..... .._,..,.... .. ..._, vvnmmfwr mro�w,�d owwwwuw.uwiw' .r mmr+mmmio mm�,nr ru rvry
.,.,,um ummm rewmmreu mum;�wuw
..rvmr9g ii _..____ ____..._�.......... -.....+n..+.:.b.,�i.ry w�ri��. r�� ���nrc ter.. ..:. rvrya�. rrrrrrmmWi.iri
rw .,
V�Jra pV V�^yl 4ry VY$tl�s 0%urnv�w O'club wr 292
a, e 50 of 7
R P-2 1.29.2
ArIPACIIA1EN7FX
Exbibit 4
RECEIPTS&IJNIT CQST PfPORT
ARP Sub7nde IMID
................. ...................................
Mlt$W2-9 BI EEMOU
.....................
.......................
0
........................................ ....................................................... ..........
...............
.................................. -—----- Dar7AwM;;C4"
... . ...... ...........
certf&tile bes 1:uV my knam4dqa and,balleftlat dus PaPrA 4� r.gnlPf*b@ Ond wryea and*1 001affi ho*in W6 bi,PWposlft ilel bill u�n
HlecomIlan
Prepim,ed Uy Dime, A Arorcimd rjy� Oiw*
........... ................. ............................
INCOMORECEIPTS �A hopm*d Budgtl I aw BlIfing C 101M Bwl dUrigLa , Appra*d
Budget PrIam Ma"'I nell,,,
Federal Fw4s MDrVffi�
.............
PrOPM,ij
...............................
SUBTOTAL CWKnrG#s
... .................................. .......................................
...........................EJ AL ............ TNT.......................
100101P Unit Opia Report, C11P,nIm Suvad
Serlxura r-WAsad. BlIOMe Urvi Rate Arimuil r,,ammi y TO 'Y-T-D Gamit malh YA-D
Ammot LhL Dig Period Bjh o Billadwi Woup Glivro, Jrdw Cliamg
Lk4b.L Cum $anmd Sid c—viT-D—,$
wet m
...............
............................_J........
................
-- -------- ...... .......................j.............
.............................. .......................
.............
..........................................
....................................
--------------
MRA V
RAC" ...............................
........................................
.................
.... ......... E.............. .....................
FN4 0 Of,10130 himn,(NArmbar�92 1,
Page 51 of 72
RP-2129.2
ATTACHMENT X
Exhibit
RECEIPTS&U hMT COST REPORT
ARP' rahTllaW WE
PdTNfIaMP. N�aE rE
C ABzrl P�XOu
i rro
�TT'r
I `,a' Rit 1
CLRJEQUMJ lcasbf�lmffm 0+1+&lril wmi Ia An�rm�carwd Oil rllliayyi%N-ro4n !tW.AdvA
ft caarrrd# Fri#ra vn,I r xmrr.�r,,mnar ��r�omXfirey�r:a!'1�r02.r�r^m. ari�A'dArurtygadYbll:la hl raL n�:"w+ Ewa,ka ®rnezxt, j
@iwadrej by IIIJw rur .................._......... A4'�4wr by .... ,,,,, ..._
...... _...__ .,,,,,�� ,
ilNCX')�JP,IN',ECEfP'7". A A vp DW,gral 8 t'4cueW 161al DIMIlim,x� i�; Taal IMI111Nng, �4fhyF��„iw„V+
i,ahisr ._......... ......... ...,._.�...__� �w,.e.��, �Y"��� et!",VSao..
�xawf Yew I L:4�trdr� I�u.. I T��aMaa �.�il �'MTf9
IFe �sl Fuma& _ ffi 3� .. �a[�iT�"a'r�l
_........................ _.._..____....__�� a vww+.w.................•---
`
C;wh Moth(1118,Ce U RE9
..
SUBTOTAL
.
local lin-KindlmalrV + ...,,,, AJN6�
TOTAL Rf�CEIP'T'S �,5. .....__. '�� .. � �DMY�",, �
�,�,
.. . . .
f NSI3TR,Unit COE9,IRapod gJma@uplixautpad ChantsS�nrvad
(A) 1M Is' f B (E) QFI '&I (A) M
13eo-cma , ..
m m'
T,T.Da Ta Jwtl dn ua a a
Amauuw9 Uri s this Pedoo BillOb1h aillable UrS4p Cherilil Jrcdup Llw rra
Ca3s1 sa
.,...
.. . ....... _......._
ON
F°rr r^ro°TfAwu�N aRiar'd'T[5
"
TT RAf J
.�._.._.._.__ ..,,,,,
... ._. ......
a~cY i.deeue.rb
„ ,,,,,,
_ � r
_.........................._. ....__ �„
---
MA C rW:W V05,3C FGwlid,0Gwdw 20 a
Page 52 of 72
R P-2 129,,2
tte"do you playa to
How vAll thp.w Kinds ka ep rtnwy„wr ar.tivitiiws
trMluace 47r israrapit i'r'rerat wital no seirvices Des cribe imw FIO"w^a"Wu I VOU be Ofter
r urrent 0AA servdres, dry yc'ju lalailr On tedinblogy will tie :addressirig nwl Major grans and ARP fuili fing is spermt,
r"-WQ j. acNices? iiM136ernvnt n�'? q,ased �'Iealltll?' m3t�mtwWoes ttarrau lr�
ftlr^ #3 , �.. ..
....,._ ......... .....
...., ............. ............. — - __-..._...
�,.......
tt,l3lp3
If" r,
r eruurruirr Rescue IPtan ll Quarter y RePrrrrt w Quarter
mr,5va do you Ipl arm to
How witlres, f,urd keep these actdwutks
C-rwttarwwr.�aaa m;wmlatalanrment What new s..wrwicaz..s. Ill r'in�°ww Maw Willi ywrat,a l'm srasrainatxde after
t:,;lp;CN'tY'Vt OAA a{ wl,r"{„ pfr,5 You plan r ra teclamrralcst.,V mlI The ad rw=,�Cpiinp,rnenraE Itid'ajor pracaIs a ilmf ARP fundiri Rs spent
Title
Eacticps'? ....... _ implernnnrsorta;~ usmmd' ._.._.. healrNrw,,,,,,,, ._...m ....rrwrrxr ?
Iettw:I '2
rtMC2
mmm. ......._ ._....-- ......__. .....�� ......
LNf";f
EtM E
�r rcat Rescue Man(ARP) u ,��riyI sort- airt r
m���.��m� �.�
......
�Hcauar fir&you piaarw to
HOW W Nu these ftIMIm
entrnnrp r)r si)pplerrw nt what lie"liew Sw lvices 1')estri mru tNm HOW will!yuu he sru"Mr;amablwrm after
Wr'rw"nt OAA services, dies Vowa pLan orw tec Ianrrlogy w'wN ibc. anddil,rim mtal Ma°ajarl and ARP fending is spent,
No ra a iut�u auswr9 , tn'.altlwx rh"i "times tt'�r�tu dro7
� � :� , ...- . ...........
17n3E
................................ _ _ __.........__ ..... �mm
MID
eWF1 I:
American�C,�'�cauu�Pura��� � >a�rt.rUy Rummprort-Quarter 4
....._......._.__...._._._._..r._.... .__ .._._.._ ..........._....._.._. � ��,,, ,, ,.,, , ,
I-low afu You rAin to
l wwuuli these,f unr'V;M keep rlae,t ac"O'vitia's
(armi'larmor:Or NYIujplj1eL rienl What new svr-Oces IDezrri,aP.how How"II Vogl fed '-stainable after
n'ft,l dW,A wroces�,„ do,
$,r�remwrawwri on I�iV�rPi,� "RwiN be far�alt ing me a1Or m l and A7rN'fatrudun�is Spent
rw�nrnnr�� gml
lsract yes f ? o'uat,h?
dtE tId
It rb,3C t
_. ....... ......... ......... ........ .._..
ft113C
........................... _._.._._ ..
_... _ �,,..................., ....... �nme
Ra,gc 53 of 72
RP-2129,2
A"I.".l'A CII NfI I^"„mr
STATE OF F'LOIUI;:A DEPARTMENT OF I'HI"rl,]ER F IR:
CIVIL RIGHTS
COMPLIANCE
QIE LIST
Nmlgm°aan ITa cilmt Vma.raay Monroe County Board of County
Cornmissionem, Social Se(vices/InAome Sewdes.. conly: Nkneve
ciclmm II a t t;omrnMr tcd By
CRY state,Zip Code " .., 3 I'�,ut�a� � " III Ialarlla
PART L
READ THE E ads."0,"FAC ED INSTR1,1CTIONS, FOR ILLUSTRATIVE JAMO]�RMF "r im vvincH
NVILJ. HELP VO U IN 111E (,'0MP1,ETK)N OF THIS F0 RM..
1, BAR), b Awpvpwm"°hciilKy arvd the ype ni'suvkeprovicle&l-� ^ge rr., R awck
11.
fMMA V"T,ON M AREA SERVE[
IW11w." Mad, ,ry � ,X I'<��:�'�3rk119�' �"�'�i�t,�lltl��.l` 'u",��FL,"II ale Dis,,,JflQd
t. t°t.tt N 1 S r."til,rRE'N I tX ENIR ,ta,t.1 D OR RI TIS HT D Mohv:'dwc
%�'11 ` Black � Hispanic 16 t't1�I A
,
t�ematl rt "lath,° "I Mack t amllcr qk I �°Inal �,°M]fit,at,l ry,l
PART IL USL ASI^;IPARA'IT tlEIEI"M MEN FOR AKV EMANATIONS 10,,'OrNtRtlNG MORE S'PACE.
h aaaa a"Cmramm e mrI`Corra lhnm on lilmm %Al"r t e Dela«mu•Irxmaat".' V" A mmr°' G:t,," NON US N0
al'a, aw'9�Ialmrra
7" Compare the staff a mMammaptasmtk ma:to,tlw 1:aopwauum Is smo,r0lmvsentrwtiive oI 11ho poln1lalAnt? If NA
tau , I,S r "
S. Me Ali ul"all, ryrairm:armrts 1)r smrwbes trnAed tra chm s and ' nAkar;ts Mom regard to mace, colmr, NA MS N
rraatimantrl origin, sex,age. rdlglaamr or mlisalbilky? IMA m'rr O, �xIr1,1Imm. El
Page of 7
RP-2129-2
9. Are all benel'i Is, servico and fiwi I Wes avail'able too,applic ant and Palo 1pam's nh V.1n eqmly c Rid Nt mmma regaigen cry !rwe,
sex,cohr, age, nadolml odgW, mbgWn or disabOy? NA YES - N0--" lFNAocAK1cxWaW
.......... ...........
.................. .............. ............
.............................
.............................. .......................
10. For in pal le n t Sc ry i ce s, are roo or am ignments mAdc ",it hout regard I o racc,coh-tr,nat iona 1,o ri gi n or d!i sabi I i ty"! N A
),'l-.',S NO If"NA are N( expInin.
.........
.....................................................
............... ...............................
11, Is Me prx ramtfacd ity as a, on ic tar n -English slue chen I I'N N(,.)A or ,12xplain.
lien
..................................-
.....................................................
...........................................................
12. Are
exam
y % licvrili lmuli . holo-Imed of111e ll- k"ctio'll ills:(di scri Ill i natk'm?phpmpa
Ifyvs, hOAV? vatall w5OCA or NQ cxNak
.....................................................
.................... ..............................................�ll,",-,.,�,�Ill""I'll""I'll"-'ll""I'll""I'll"I...............
11, (3 i Ve Ill e a]Utllbel MIXI c u tren t sultus of al ly d iscri i it i n ati oncoinp laints n2gard i ng surd ces or vin p kpintent
filed agai,nsl [lit
... ...............................................................................---
...............................................................
................... -—------".................................................-..................................................—
11'' IS the p granvi'mility physically access6le to mnWhy lmmh, md sighwhydi-ed indiJklumN? KA
A /N(k, If INA or W.expWn,
.......................................................................
.......................................... .................................... .................
................-111-11111-11................................ --------------,-,
PARTUL THE FCHJIM"N(;QISSntMSAPMXYOPRO(.RAII,S,' Nt) FAXILmrsmim 15OR NUMEEMPLUIVES
14 1 bs a BOOM% bmu cmducted to idenfify any bl:lrriers to SICI'Villg di1','A1)lCd illdi ViCkjals, aild to nrakt-- any
HuQcssajj)" U'N(), explhi,
........................
............................................................. ............................................
16. is mhQrc anid emahl aM griev,ance pmcWwv 11ma bcorponims due pmons hi Te resMution of
coniplaims? if W explah
.......... .......... ........................
Page 55 of 72
RKQ1212
It
17, 1 bs a pmson bemi dedpwwd M comhnute Sedion, 504 contpUmice activitios'? YESwlkh, If NU MWal,
...................-
18, Do recruArnont and nkncadun mawri& advise applicants, cinIflbyees and, participan(s of
nondkcrindnation on (he basis ol"dis-ability? lfN(),,, eNphlill.
A;
--
..........................- ............................... ..........
1-111-111�1111-111�11111111...............-,--................. ..................................
19. Ary auxiliary aicd aWe to amme of su6ms to hearing aml sWW Apaimd
inlvkluak? Y[ No If NQ exNah.
........................ ...... .........,.......................
.................................. ..................... .................. ..............
-—----------............... .....................
..............................."I'll.........................- .................. .............
PART IV'
FOR PR,()(;'RANI S ()R FACILITIES Wl'I'll 50 OR MORE EMPLOYEES AND FEDERAL CONTRACTS OF
$50,000 OR MORE
M Do )an have a written, plan? YES- 'ZN0 If' 0, ex pb irt.
............................. ..........................
................ .............. ............. ..................
Page 56 of 72
RX21202
=wc USE ONLY
Revlwcd By NO" 0
Pt-ograrn oHke NO We o f Awreel i wc,A ci imi.1S",cm X
Dale felephone 1311tv
On-Sile 0 Desk Rveckvkt
INSTRUCTU)NS FORTHE CIVIL RRAITS,C()N11UAN(,,'F ('HE(,KLjS'T
4. Dcscribc ihe gwgrapk semwe area such as a distria, CMMY4 dty or otho. locafily% 11"the prograillifiwililty
serva a sfecific MWO pVuWhn nwh as Mewmits, desahe Me MMO pqmhM A No detirte die q pre
of se nice IvovA dod.
- [hQ percient of% puphUon sawd by rue aml wK W pqxdmWn senmd iricktdn pmwoiz A the
area lbr whicliso"vices are ImMed such as a city, courity or whCT Fegi()1181 d[C21. l"OPILdAti(Al
9AWks emi be obuidied bvm heal Waribmi c9cmu mvmw libraths or any publicabon from Me 1980 Anvils
containing Florida pop pulMion statistics. Include dw swame of you papWadan matistics, (�"Other"races include
AsWVN6Ac IsLindQrsavid Anwrican Natives,),
3. EnWT Af MAI aUflAbeir OffLd 1-6me staMlmd Wr pinvertl ly mce, sex and disability Include the eff Live dwe
oll"your swruiulry�
T Urder the total number of cHents ulm mv mwWd. regisemd or mmago :saws:d by dre pwgr,am or %Hty,
and Hsi lick perccid by mce, sex and disability. friclude flic dme INn enw1hawn was cminted.
5. Enter Ow total munber of achjsm)r bouni vwrnbers and, their,perceng by nact:, scx, and disabi.]ity. Ifihere is
no advAmy or g=Tning bowd have this section Wank.
h, Eadi reciMcni ofAbdend financial assistance must liavc 4,-),n file an amurarice that Ifiv, pro,gr'ani kv ill be conduclecJ
hi cornplince w1h A nandherimbatoy pmvkimrs as mVdmd A 45 CFR 90. 1 Ids is ksual to stmidaul pri of
die contracl language nir Dulnirtmom recipienis md dwh sukgrawcesA5 CFR SU 0).
it Is the race. sm and MAW odgin of the MaR Mot& of Me 9weral lummUkat? Fm emmVk, if I WS at"'
the p(iliulat[on is I fispanic, is 111-tcre as cmrpmilik percentage of Hispank smffl
%bere durre is a Mp%nun vadwhn bowmn die race, sex or edinic conipisido,n ofthe chentq and flwir
avedabiH, in the popuhation, tlw prograirilk0hy has the respon0blo to Mmike die rnsms Rw sum h
vuriatkni and action may"be necesawy to comea any Sonle [egiflinaw wqmrilies
nmy e&M ;Men pvgmms am sanctioned to serve tnigel pqwhitims such as Wrly or dkabrlod 1aw.mmu, 45
CFR
9� [)o efigibility roquArnenn; unhwRA%; exclude perscuis in protected gr0,L1j,)S froni t1w pri�)visiion ofservices or.
Fvidence of such isay be indined A MaRand cheat represeritation(Quiestions,3 and I)mid also
Mmugh onshe recW anaysik of persi)iks wi() j1pphed No were dmkd scakies or eml!)kWnimj 45 CFR 8113
(o) and 45 CFR 80,1 (b)(2).
10, Pa Nciparns or Mils nwm be pa0deld scivices such as medical, nurshg and doi,lal care, labor,"atory services,
Page A of 72
RP,Q12R2
physjctIl all(] recre-afional therapi,les, coun,.whng and qociaf services ovkhout regarDa ince, sex, coloqnmional
o6gin, religion, age or KabUity. Away titles, appohioneni scheidulling and acturacy (if record keej)bg inust
be apj!Ified urriforinly-and wiffiou( regard to rarce, se,w,c, lor, national otig[n, refigion, age or KaWlity, lEnt-ram,es,
waking ivanv roceptJon awa&reqwonis and odwr fa Uhies mmm aWAv vVialty—awiflable Um all clients,45 CFR
au (1),
I L For hImIlent ser0ces,residents must be assigned 0 romns,%vads,on,wilout regard to race.cokiq national
oHgh or disability. also, videivs must not be aAW Ndela-dwy are willing to with
persons of a different race, color,national origin,or disetbifity,45 Clf,'R 80-3 (a).
11 T1w pnwrownWity and A services must be accesdWe to particitiants and apNkanm includirig dwse pemons
who nmy riot spnkbingl6h, In grograflAc areas where asigriifiicant popula6on of non-Englisle spealdng people
14,proWum amnsibly noW NeWde Te onMoyamit of bilingual Staff. III,officr alrv-as, if is sul llk!Ient to Iuave
a paid ie,y or 1!flari, for serxice, such as a clarmflif H9 ol'james and teleph,cww nuni,bers of I)i lingual individuals who
w i 11,ass Ist In the [I,rov is On o AwO cm 45 C FR W 3
13, PwWvmsJNdWks mum imke inforitial io,ri regard hig A nwWWW1 ina(my pmv.Ismns, of"I'itle VI available lo
thed par-ticipnt . bendkhriesor miy odwr hmmvsted pat liev This should include on their right w,
hk a cwrionAM cWdkcrhAnatWrI w1h cWtei-the Florkla Eklimirrimt of Elder Ah"airs or flie US. f)epiiiliaient of
HHT The wnwraafloli array,be Supplied verbally or in wrlitig w evmy W&W or may be mVplied WWI Ae
tMe of ail URMI opporuindy Po[iQ), poster displayed itia public area.ofthe 1'.1cility, 45 ("T'R N.6,(d),
IC Rvpmi nunber of disaluKtion contphits filed apiw flee.pmgmmaheili, IndWe die bask,c.g, racq odor,
Creed, Sex, age, 1,1ational otigiri, disabifity, relafi,.�Aion;, Nae ksaws hwohwah e,g,, services (w e2tiployruent,
pluvinetA, etc, Indicate the cNU HWAs hwAw poky Acged to have, been violated along with, the
narne and allrms of be Waal„stater,w hodetil agency%vhh whom to comphho Nu bwn MW hAkme be awrvra
Awfus, ej,WWI,no I'vilsorl'able cause found, failure to crane dlate, f1tilme to cm1wnde, undeinvyiew,0,
15 The firograni/116h, mum be physically awossible to di abled inclividuaK [1hysi,cid accessibility inckides
cleignmod pvibgareas, curb,carats or level approache% ramps and,adekjaa(v widills to entrainces' 'The hobby;
public telephone, I-CS11,001VI facilities, watvr 1butitains, in1brination, and a(hrlissians offices s4ould be
acccsamlmlc. Door widihs, and traflIc amas of adwArdowbe cofOerias, restnwnts, wreatian areas,
counleis ancl sorvirtg be observed Ar accessibdity'. Elevators shoal,d,I)e obtrved f6r(h)or ividRi,
'Alld Braille or raised nttn,ibers. Switches and Conams row Hght heat, ven6lation, hre Wants, wrid other
esseiWak AwuW be inmal led at an npprq�spdare height f6r,rno'bility, 4ti1xiited individuaf-s-.
16 ScctR�iti 5(d')4 of"Ow RdwW HWWn Act of N73 reydires fluat a recij)ient of WernAl WWI assistance conduct
at self-evalumion to identiff any amemdAby Was, Wcvinlulatiort is as fbur-slep process,°
whh idw amistwice or a dhabled enluaw cwtvrit jaraelites and 13oh6cs which dI�i�
not cmmWy with SUN 504.
Modif), policies and pInackas Out do not iniele"t Section 504 roquirelTients.
Take reniedial dWs W elim two any chscritninatk)n that has been identi ficd.
Maintain wlr vvahakn on W, (Ilds checklist may be used to WIWI this mquimmom I'Mme Rwr
sleps ha%o been lbllowcd,),45(71`R 84A,
17, Progimms or Wilides Mat empty 15 or nwm perscumniuM adopt grWance prackures dwt hworpow
appropriate due process stanclarcls arid [,!r,rovhc Rw A pvinpt area cquitabb resalwAn of wmph% allegirig
mV awkn pWIWWd by Section 504,45(1,R. 84.7 (b).
18. 11rograrns or facilitis Mat ernploy 15 or more persons must desigrtate at least orw perscuri
to comply, kvith ',wctimt 504A5 (.`R 84,7(a),
19, Continuing steps must be taken lo notify employees and the publk m:rf tyre po[Jey of'
nonchhuhuhtation on dit bash of disaWlAy. This lead des reaSmovt aura erit noders for hearings,ne"spaper
Page 58 of 72
RPA1202.
ad,and MY apRoprime whan ummwrdcmAnA5 CFR BCH
20, thktt ernploy 15 or mwv pemms must provide app,ropriate auxAliary ,aids to Im-sons will
jrnpaired sensc��ry, inanual or spt�iiking skills wherc niccessary. A.Miliary aick inay h1cluck-", bw rIrc 114"It huylited
I'm-hearing inipaired in,dNkluals,uaped orl3railk mmerlhar mw ahnmdw rmmmms Im crab
be used ko pmvi4Q.cqu,'adly efficrive services, (45(I III 84.52 (d)
21. WguimMeMes widi 5() or inove enip1c)),ees and S50100 in Wmal contracts must develop, impleinent and
Wnwh a whuen afErnmOve acOun comphance pmgmm in smordmut w3h ExecuUve Omler 11246, 41 CFFR,
60 and TU W V I n f 0 ic (:N 11 Rights A 0 o f 19644 as arn ended.
Page 59 of 72
RP-212.9,2
A"ITACH NIENI' 1)
1,11-111)1�,'JR AFF"A
F!�dlp'J P�u,Iwn,
ATI,4�0� IT(c"TPN'��A
BACKGROUNDSCREENING,
Attestation of Compliance - Employer
.............. ......
AU 'HORITY: Th,s form is,required annualIly of mill employers to comply with Vie
attestation requ i rements,set forth I section 43 5.05(3), F I orida Statute S,
................................— ———-----------
)o the term "employee' means any (person or entity required by law to conduct background
screenings, irtdIudmng but not limiled to, Area agencies on,XjIi,,iig,`I and Disablikly Resource
Centers, Lead Aq(encies, and Serwce Prov6d,ors fl,ifai contract' direcVy or ridirectly with, the
Department of Eldof Aftirs II and any offier person or entily whilchi hires employees or
has volunteers in SrQfVjcP,who irrweet the (lOfjnitiion of a dkecl service provider See 4 5. 2,
3 0
430 0402, Fla,Stat
> A direct service provider is 'a plemoo '18 years of agie or older who, pUrSUant to a program, to
provide selvices to the elderly, has, dinact, face,1o,tace contact with a client while providing
services to the client and hias access to, the dients, Ilivtng area, funds, personal properly, or
personal 1dentificaboin Harniation as defined in s. 817.565 The jerm includes foordlrrators,
managers, and supendisors Orr residential f adliifies and vol unleers,' §430,04021 F I a s II
AIMIADQ1 :
As the du[y authonzed representative of
Gwt
Fam*v to,Wow
located at j(),0
MqmV
11, 's 4�At ............. hereby affirm under penalty of
Name ear Repre,�enrahve
pI thal the above named employer is in compliance with the provisions of Chapter
435 and section 430.0402, Fforida Statutes, regairdlirligi(level 2 background screening,
ell-,,
L................
Signature of'Replesentative Date
............
Wf;'A Ft)(ro 7 A Of GcVflfAWIC@ Eorjrjkjyor,EIIAI Anwary V9, 202 Sezinon 435,0.5(3j,
F S Form avaAab(e ar t 0 0 ra a�5
.1�22�2� B..0
James D. Molenaar Digitally signed by Jarnes D.Mulenaar
Date,2022.10.07 11:21:36-04'00'
Approved as to Form and Legal Sufficiency Page. 60,c)f 72
James D. Mollenaar
Asst. County Attorney
MONROE COUNTY ATTORNEYS OFFICE
R41129.2
A TTACII NIENTF
AWane Mr AWn* in,
HusWess Amsodak Agmemod
Tbk Bushms Associate Aglvorwll is alga ed in I I I QZZ, . by be AHW=e An-Aging, Inc, ("(-'overed Endq"')
and Nbaroe Coumy Board of Counq; Cainnihsiahrj Social ServiveOn-flonte Services,("Business Associate!), a not-
for-j!)rofit Florida corlxi,ratiori..
1.0 Ekickground.,
IJ Nvord Entity has elgered into one or roore conulds or aglvorienis with Bus�iness Asm)ci are that involves,the ttse of
Protected 11 leIll III I 111161111art�it)11 (1111').
1.2 Covered Entity rempdas Te rquircrnents of tho I Icaldi Insurance Poirtabifilly and Accountability Act of 19196
(1,111"A,A)and haws indicated its intent it) comply in the County's Policies ivnd Promi"res,
13 HWAA mplitions emablish, sj!)ecifie CC)II(fitions on Shen and, how Covered cnfl6cs 111"13, shary n1l'onlaalian Ivilh
f1rov iders whoa perfiirrn flumdoris Rw be MW Entt/.
14 IAPAA mqlireS the Coverod [Enthy and dle flusineso., Asso6alc It) cntcr into as conir,,jct Or agreement containing
specific requirennients,to protect die confidentisfity and seetwity ol'patie"Iss' 111-11,as sa fi)r1h in,but not himiled,to the
We or Fedaa[ Wgudmimn spocifically 45 MR. §§ 16150ley 16410qej 161308py and 1613 14(a-
bX 2(:t 1 W (a s nmy appNl)a nd col ita ined in this agreement..
L 5 W OWN Infactnation IhAnology for Ecorionde and OWN Health Act (20,09), the Anivrican Recovery and
pa rl I— FIF-o I,is ions and Scow Ry pnni si on s loc ated'M 42 Uniwd,Slales
Code(IISQ §§ 17931 and 17914 (20110)roquim bushms amciatesokovoW MhWsto comp" %W thus MA
Suu&y RW,asset RmIh in,bul imi Mad too CrR. §§ 164301 16431M 1643IZond 164316(3M9)mW nwh
sections slull, appN to as bohess am")ciate o4'a covered, entity in the sarne niarum- Ola( such sccjl*�ins apply tci the
lmvmvd emit,
The par 6es 1herdbre EWree as lblluxws�
2,0 Minitions. For purposes ofdds agrennent,the fbHovvhW definitions aprdy:
I I Access,
ally,System resource.
22 AdudinhimiWe SaRguards. Me adininistrative actions, and polkies and procedures, to inanage the selectiol'i,
Cleve Ix)lm'n ent, and, m aim onance of security rnuam= to prouxt Oectronic F'nitv,cled Health
Infortnation.(0111)and to manage the conduct of the eovcmd entity's workforce in relation to the protection oftliat
in forty out ori.
2.3 ARRA. The Anterican, Recovery and ReinwstrnmA Ad QM)
24 ArflflIcIIIi4tati0FII. I IIC Upr-roboration that as person, is Ow,,onQ
2.5 Availability. Tbe finmedy that dam aw hAWWon is ammsible and useable ash danmd by an maMrimd poson,
2A Mach. The unawfij(.67,,d acquisi;tjon, acccss, ilse, or disclosure cff Pill Nvhich contprornises the sccuti,),, or priViLCY
21 ComprumuhtstimSvcurity, PosAg asiWAMM Ask oUlalwMI, mpiWIWW,or(xherhaxrn to WKWIMISr
2.8 Cunflidentiality. The properly that dabi or inAmaximi is neat made available or"disclosed for PUIMM Or
promssQs,
Page 51 of 72
RP01212
19 Efedriarik. Prateclul I lea!Uh Infurnation Ql'"[), I le"111111 in(brinalk),ri rls slieci fied in 4 5 CFR §100.1103(1)(ij Ili,
(I)(ii), filt'l ited to the inflornialion creawd or reQdvW by Basken Assockle flom ororl kywif of Cavelred Fradi,
2JO HITECIL 'Me Health IlMmnatimi IWrlofogy R EammPic aW Clirlical Health Act (2009)
2n 11 Information SyMem An imerconnectod s'el of in R)rIll-.16fin resources under the same d1va rmmmgelnm9 consul
that shares conimAn furtuionahl. A symmm mmnAy Ncludes hardwas,solhvvam inthnnation,dhik applications,
'and pe(qfle.
2,12 lutegrhy I'lie jin�lperty That d1la or inkinafion hav�not l-.wen a1wred or destroyed in all klllautlu�)rized 11,11allnel'.
2,13 Mallicious moCtmi", SoRwmw 17(!rr exanlij!i1e,as v krus, c4signed to(hunqge or Asnipts a system,
2,14 jlaj°r( 1, Part I— hmproved F'rivacy Pnwisimis anti Provisions located at 42 United Sulles C'ode(U.S.C.)
V79,31 aud 17934 (20 1 0)
115 Fasswulrd. CONdakai authetakation hKaWma con-spned of a MOW of chwaaem,
116 ITyskal Safeguards, Ile physical mmstwes, 4ua4i6cs, an(c] procMures +lam protect a Covefed, entity's etectrollic
WJ`Rmm*vn looms imd relawd bWWhVs aml equipment, drum nahwfl and mvivnmental hazw1s, and
1,111'authorized intrusiolk.
2J7 Privacy Ruk, The Smildwds Q Nhaq of hdividualb, Identifiable Hva.11h Inkwimation at 215, C]"R flarll 160 arid
Part, 164, subparts A and E
2.13 111rotecteld, I%Nh IuMmul% (MIQ With inkswinn as deMwd in 45 CTR. §160.101, lfini,med tcl, []to
Wwadan cmared or rmeNed by Makess Aswelke 10ront or wt behairof Covwvd NOW.
119 Rwp 1 md By Law. I las the sanae nwmd ng as dw telvai "required by I aw" ill MI5 CFR § 16 4.1,01
Z20 Sec m to n% Ile Seae ta 1,o f th e Depa meluom eal th and I I uman Scry i ces cn,Ira is or I wr des igri ee.
2,21 ,(] aocQss, usc, dis,closure, modi1katiol; or destnwharl
- sevill-fty hwident, The anernped Or SUCCOq'ifid LlrjatVj[l,orrjZ1C
offill,6R-lmalk)n or inlerf6vwe %hh *Yem oNra.kml; 6 an Mnwhn Ustalm,
1-2 SeCUP-ilry or Securhy ineasures AH of Me QUO, and meclvnical sklfi�guar& in an infill-l"lliti(Ml
sy swan,
223 Security Rulle,,The Security"Stand'ards for[Ile protc 0 i an off"IQCtrank! Protected I lealth Iriforntation at 45 Cl-'R part
164, subpart , andamendtneg'as t1wreu'p-
214 TabWeM Safeguards. Ile ter hnMogy and A pWky mm! procedures Or itS LlSed'Ifll pl'Otftr electronic jlrotwcd
heahh AlWitatki and colurol acces;to it.
2,25 Unsecured PHL Protected health intbrinaflon (hvit is not smwel WOUgh dle USC Of or itieffiodcflogy
spe6fiecil by the Secirctary in,gnndwico issucd un&r 42 USIA sedion 1793jhX2),,
226 AU otha ternis toed, but nut Whenvise WWI W ME ASlvmiar WH hue the salne nwaning as Owse tarms in
the Priucy Rule.
3 0, of Business Ass,IxJaW
11 BLISin,ess Aswchw aVves to not use or dkelose PHI odwr Wn as pendued or required by (hisagrQownt or as
Rupdred by I aw.
Page 62 of 72,
RP11212
3.2 Htisii,-icss as ssocjate aprees tw
WTIOnmit pokciQs ovid. proccdures to, prevent, deted, contah, and correct Security violations in atcordance
mriK45CFR§ 164306;
(b) Prevent US C Or 0110mue of A P1 H oTer tan as pmvided Or by UWAgreeinent or kkS required by law;
(c) Rca-v;onahply ammact appsoprialey timucs the confidentiafily,, integriq, and availabil-ij, of the ePIH that the
Business AsmOste creatm,, mcmhe, rinkWhivortransmitson behWofTe(.'overed Endy and
(d) (7cnilply wi.th the Smurity Rule requirernents inAwling the Administrati'Ve &1J7egUar(IS, 111y`SiCkd SE[kgUards,,
,I echniical 'Silfcgi'lzlrds" 'lnd poticies and procerlures and docunieguatic)n requiretnents set fbi'th, in 4.5 O"R
116,4.308, 1,61.310, 164.312., ancl 164-316,
13 Mahn Aiswcialu agees to Wig= to die exlvit pmoicalile, any WWI effbel that is known to BLISKCSs
Assochtc of are use or dimclumov of P!H by Busihem Associate in, vi,c)htic-in of the ralukemenm of his Agreemem.
14 MaMns Assochte apen k) pwiliptly report to Cbvvred Wit� any use or Isdomue of Me FIB itot provWed, Ar
by this,Agreevner,,°it of'which it bocoiiws amm, Ibis &Wu&s;iny re(Ittests, Ow inspeoicin, copying or arviendnient (A'
W hAmmin mid hwhdhg ap"ecurity AM hvolvisig PHI,
31 Maiiiess Amseive agrees ro, notify ("OVQred Entity Witlx5ot ltnreasonablc (Jelay of any security breach jxrtairiing
to!
(a) Idenfificalion of aargyr individual whose unscQui-ed 111.11: lins been, or is revisi�inablv believed by^ the Business
Assoc iale to have fleeli" "'ECCCssed., acquilvd, or dis'ch)sed during stich secitrily breach', and
(I'm) All infim-n-mucni roquired for fli,Q lo Our oo/ ffl-15 q/ Rrcuc°h 11ca"Ith
hommawn.
16 IONAms Aswelte agives to sumv that mW art etv hwfu(fivip a subc4:nnractor, to ivIto'ni it jvq�nides 1111t recei'ved
ftorn,,or created c')r rewhed by Mnbve is Assmiale on behalf of Cbvovd Enfiry, agrees to flte sairte restrictions and
conditions that apply 1hrough his Aymonervt to Businem Assockae with respect to such inthamathn'.
.1.7 1 N-hisiviva;s As,wociate has III[I in as Nsignaled R"ord Set:
(a) BuNess Assodaic agnes to pmvido avms at Me mqmm of Onem.] Entity duting regular bUSineSS IlDltrs' 10
PHI W a Designmed. Recorcl SQt,to Covered Wily or, as diremed:by(7,civered, Entity,,to an iri,dividual 0 omkr
to riwo be rewdminents under 45 CA §1 64,52Q ond
(W Whom Associate agivu to md,e any, amendment") U) PHI in a Designated Record Set that ffie Covered
Entity circus or agrees, (il pursuant l�o 45 CFR § 161,4,,526, at the requem of Avemd linny or an IWANIA
Wifflill 10 6ys ofivceivillg flan:requeW
3S BmAins Anocime aVem to make imemal pqmctkeq books, and rcci:irds, jincludIg policies and procedures and
PI 11,relafing,to t1w,kvsQ and dkiclosure (li"PI It rcceived ftoni,or created or received by Business Muchate an bdtMf'
o4'(,'overed Entity-, available to the Covered Adq, or to the Sevremy upon reqwm of dther party in pw-pwas M'
doambAg Covered �nfity's compliance with the Privacy Rule.
.0) Business A!jg)ciaW agrees ten omarwrd suh dischswvs of PHI and inforniaticm rellated to sucl�i disclosures as would
l�ic rcqoirQ.d f6r Entity to respond to a re�,Iuest b;y an in(fividual for an accounting ofelkelusum;ofPIH in
;accord.anQQ with 45 (J'R § INJ28,
3.H) Rushmss Assnciate agrees to pi,ovide to C.'overed Entity or kin, individual, upoin request, ini'61-111a0i'lin (-'011lected to
permit Covemd Way to rcspcmd to a requiest by an lndividw'd for an acumm1bg alAkelosures o4'PH1 in amondalwe
3A I Businoss tin social spe6hully apves to use sentrity riwasures dlt,a rcasooa.bly and appropriwely protce( the
conNenliNdAy, huegriAy, and availabAity-of PHI in electronic or any other fi'm-ni,thal it civalvs,rceeives,niahitains,
ortralasmits onbehalfofthe (',)vend Entity,
Page 63 of 72
R421212
I Q Takem Associate agrees to iniplQnient -wcurily nwamuvs to secure pass%vids used to auto eM H dult it ucmws,
nla[luains, Glu trvinsrnits as part of Mis Agmanult from nialicious soth,vare and other Irlan-i-nadQ and nalural
vulnerabilifiesto assuxethe availki1xility., SUCh information
3A3 Bushen Amochoeaivies to impl riser usecudly Illeamtresto safiguam emu
as parr of this agreeinlent fmrn In"dicious softwarc and other niaxi-ntildc and natural vidnerabilifles it) Assurc the
i11 U I all 1111
W Bushess Associale agirees,10 cc)rrlp1,Y IV ilh:
(a) ARRA 113404 (Appficalion of Knawledge will)Contracts),,
Q) ARRA § 1306 Qmdlons on QMW Comach as Paul of IN% Cam Qrs6mm),
CD 19rmHUd Un+ s and Dkdosums lay thiMmess Assochite. Excqt as oWnSe hmited in IS Agmement m any rdared
a�,rc:onii.,n t, Business Assvwk,te may we or disclose P1 H to perfonn RMOWnsq actKiHeN or services 1br, or car behalf of,
Covened kof as spedHed in any and aH commas wkh CmuS EnNy PWIN that SU,Ch Use or discl.clsure ",vould not
vilubte the Wag Rule if clam v by Cmvmd Emil, or Me mWinuin polkies an(i pvoceduivs of the, Covered
why.
5.0 SI)ecific Usv and Disclostim 1-1rovisions.
5.1 Except as oth,erwise hahted in Oil agreemewAv any rdated agmen-leM, Bashem Assuciale may use MY I& We
proper managernetl and admirtistnWn Of Me Whas Aswchte or to canj out the legal responsWdes of the
RUSincss Associate,
12 INcelm as oiflenvise SAW in thl agreeman or any relmed aptervicnt BuNnas Assovia,te nuay disclose PHI for
Hie pruper management and admKinvati(rn of the flusinc s Asmiciatq prodded dut dUc6sums am ReWAS, By
Law or Businns ?"mcklm DW-iins reasonable iissurartcc,.,; fi-cnrl the permni, to kvhon) the is dis'ejosed,
that R ;00 remain con 5deuthd and used or further disclosed onY as Req0red 13y Law v or liar the p,urpose ftn vvInch
it ,was disclbscd to the persm,arid the pawn riviks the BuskiessAssoiciale m)f any instatrees of'wvhich i isam,arc
in %killich the Q011fidonfia,lity of(ble initirrmatiorl has beeli breacho(J.
53 Totem Aswchte nmy, um PHI W pmvMe dwa anrymbn sta,vices k�o Covered Entity as petrAtted by J5 CFR
§16?5D40X2XJ)(Bj only when specifickdlyi atilhorizod b�,Covued' Fittity,
5A Hwhess Associate may we Mt to repal dohnions of law 10 appn�lpriate Federal arld !Slate tonsis(clill
W 45 CFR §M150YX Q
6.0, Obligations of(7(overed Enfity.
6.1 Cmvmd Entity Miall lioiil`y Businns Associmte Mny Wationjo in its, notice 04'j!)riV`kLCy/ PTI'lCtletS
Enhy in accordance with 45 CFR § t64.520,to the Mont that sitch liniftafion tnay affect Busitiesr,Associate's use
or disdomuc of PHL by pteviding as copy of1he most civ,rent Novice of Pdvaq,, Praeficeq (N311") in, Busin sib,
Assodatm FWure Notices antUor modifications to the IT shall be posted on Covered Emity's webske a(
62 Cmvred Enthy QmR ncitify of any reWdion to the ime ordisclomee ofPHI Owt&Nwed Entity
has agived to in acco,rdance wAh V CFR § JK522, icj the exlerlt that SlAch resiriefion may affi,,,v Business
Associate's use or dk,closure of P1 U..
7,0, Permissible Requests by Covemd EnMy Euq)t Ar data aggivgation, or matiagernent and adr-ninktralive activities of
Buskem AMD60e, COMAI Eftlity Shall not rv,qwvHhnW*s Assochte to [AW,or dis,close Ill 11 in any manricr tharkvou,k]
not be perm IM N e under the Privacy R ul Q i(donc by(71overect En t i ty,
Page 64 of 72
RP-2129,2
8.0 EfR.,Ojvv Date and Terminalkiin,
SA 11w Parties hady agree fli-at dtis aglvemern amends, restates and mpla.ces my oTaTuArlem 1"michm Agrewitent
cturren'lly in Qff" ct between COW EnOry and Noiness AssocWc amithat to pirovisksis of Ws aglvemmu EMW I
be effbobc as Rd Wws;
Me BwOwssAssociato A,greeinmv pixivisions, with that.e=ejnion, of the electronic security prcivisk-ins and
the providons rnmidabod by ARRA, FUIECII and Pan I shall be cKinake upon the hicr of April 14,2003, or
the ellfu,Ctivc �,Jatv of Me e'll-liest c(11,111-act enlered, intcj, bletween Whess Associate and (Avemd FANg dwt
invo[vos the ilw 4")j,pf R;
The elecounic socurity proviskm heradshaR be effbaNe Ow tauter of ApHI 21, 2WO to to eNctive daW of'
be c0lbst cowned clitercd Willa bomwi Bushess Aawdate and Covelvd End, Wrat Nvokes A ine of PHI,
and
(c) Provisions her nmndAed by AR RA, Part I shall be efftelive ffiv [ater ofFchru,ary IT, 201()
or [Ile efi'&flve date of we sLOWA Columo emued, into between uweired entay and business a.smi,6,we that
involves this use of,111 11 or VPHL
82 WSW% Mr Camv. Upon Covanxi Elilrtjcs knawledge of am mrstanial bireadt by (7o,velvd
HE, shall Kim
(a�) Prow,idc kin ofiporwnhy for Business Assochte Xx cure the bttktch (�Pr end ffic vi,,Lflaflon arul (Qu-minale fitis
agroomera W Business Aawdate does not cwv die %wh or nd dw Wobtion SMS dw Inv spedhed Q,
Covmvd Why,
(b) Orned6tey taintinute thIs rip-eement if Busirims W"sochte has Im,eaelled a inaicrial terin o['01is Agreenlent
and cure is not possible, oi-
Q) I f neh1wr tenninatkni nor core is foasible, Covere(f Entity sliall report 1110 viol'ation,to the Secroary.
93 Effeet OfTeirlinilliltioll. 1,',xvcp(as Iwovidai in subpart gmWi(b)of Wk, uion,upon iennina6an of Ws agreement,
for any ivasor;Business Associate shall rdurn,al 111 Hand ePH1 receWed fimm Covacd Ewhy or cimpled or nxeNed
Blindness Assucimc on Emiiy
(a) This proNision shaill appQ to PHI wd WE that is in the possession of or 'agents ('14, Business
Assochic. Business Assrru raw W mlah no copies of Me P111 and eM IL
(b) In the evvni: that BusinQs,.,,,,AssociMe or Covei-ed Why determines that rQuarrinw, (ho PI If or QPI I I is infi�;,isible,
notification of the CaLInd4ions fliza nialw rNum of PHI or eM H inihasibb Bad he 1xvvided to Ow other pug,
Bwitwss AsubWe OwH exlend die ImmectInS DfMiS Agremmew to ,,Lich retained P111 and dap HI and INS
Rurthor uses and retained PHI and ePHI,,for a nflitiniumt ofsk yvain and so long as Hostess
Ansocime mAnWns W M U and ePM, Wn nD Nss thmi six (6)years aNcilhe lumhmthn of Wis ggreemem.
9.CJ Regulatory Rekrences. )% in[ ffiis agj°eerjient to a sectiol"i ilk Me Privacy Rule or Selcurily Ride me�ans ihe
Sectil"In then ill 01,Q0(ar as ina), beanteiuled in the f6ture,
101) Aniendins= The Parlics agme to We smh adon as 1 necessary to ansend d6s Rgremsent forn time u) We as is,
riecessary (b]. F".111tiLy lo Cornply VVkh the requirvatew of Me Privacy RuIC, [he sv'curky Rule 'and we Heald"I
Insurance Poj1-.-,ibfl4y andl Account-abifily, Act dal' I 9,96, Pub. L No. 10449 1.
11.0 Sur-sival. Any taunt, condition, covenant or obligation whidi isquOs poSmunice by either party herem subsequent to
the lernainadon (if Cris agiventent shaill irems,in e03vable against such jimly subsequent to such teirin ination
110 Interpretatiom. Any antbiguity in this agreenkent shAl be reslAved in PeW CovaW EndW to comply inith he PWQ
Rule wd SmuRy Rule,
Page 65 of 72
RP-2129,2,
13.0 Incorporation by reference. Any 1111WE-e changes or deletion(s)enacted in federal law wbich creii,ry
new or difR,rent c6ligations with respect to HIPAA privacy andA,11, Security! sh'all lv aulonn"Lflc.ally incollionaled by
rel4cnce tua this B usiness.Asmw i ate Agreerrient on the rcspiccfive effeclive dale(s)..
1 11:10 Nnfices, All Pio,fices and required, nox5sary oir 4Icsi,rvcJ to be given pursuant to this agr"nuov,
including a change ol' address (br purlXmes all such notiQQ",-. "Ind, Shall he in wvriling and delivered
Personally to flie other or sent 1 y exf)ress 24-hour gixaranwQ.41 courier air delivery service, or l')y Certified In ail 4fl`
the tHfiruilcrl stales Postal Service, posuW jarel)ai.d and rourn rmcipt reqwsted, addressed to flw offier pnrly as follows
(or tar such offier plm-e as any Party 11,11a.y 11*'notico to the othcl.'s specify);
To covered Fnhty�: Allianct fioir Agirig, hic.
Attenrioni: N11IN Rcllhnian
760 NW 107 Aventw
M imn i, F I ori d a 3 3 17 2
To Business Asscwljillc: Monroe (70111,11ty Board, of'Ciliunty S(�)Cial
fit:rviQes
li 100 Shnonlon StrQct 2""' Hoor
Ke)� Wcst. [.1, 130410
Arn)-mini nwice shall hiedecraed delivered upon actual rwcipl, Kanv 11(�aIice cannotbe delivered or dchvery lh(reof'is,refiised,
d(dj%Pcii, will be deenwd to have r�)ccurt'ed on flie thato such delivery was zilgenipted.
15-10 GIoNwrilin,g Law. The la)vs of'the State cd P'kwida, without giv ink; el:T C( 10, Principles ol'conflict or laws, govenri a H
jm,ufers aXisirag under this agreetnerit.
I(I'M severatoilil)% If'ail ly provilsicm in this agrecinciv k uvwn lbrceable to any ex(enti, the relnain&r of this ag,reelnent, or
applicatk)n of ffiat provislon to any or Qircums,tc,111"s OdIVI,thall 0.10se as to which it, k held 1111clijbiwable, will
not lie affected by that unenfc)reeabi l.ity avld kvill bevilbrceable i:4�) the lkllliest exlent pertri itted by law.
VTO Sumessors. Any suc,cess(�n,u�p Busine .i M;(w,iatc (w1wther b)", (firect Of irldirC0 011r 13� I.Xlrrchan;Pc,Incrg"er, co,nmflidatk)n,
or offierwise),is required to assurne Business A.s'soQiate"s obligations under this agivernera and agrec tu porform them, in
the same manner and u.)the salrit ex,tQrlt flu"il Busine�s Assock'ne would have L)COIA rOLILLilVil 10 H'tklt SLICCO'Sk9n,had ri,(x
taken place, This ass,uniptlon by the SLICUSS01- (A the Business Associates obligotions sluill has by written agreement
&Wkfi(40c)ry to Covered Entity.
18,0 Entire Agreentent. 11lis agreenlQjlt corNtitutQS 01,Q eni:ire agreemcnt tffdw parties relating to dw, ject niamr
Orrid, gupersedles all, other c:wal or writwn 'a, reenlents, (n, Policies reklitirig therdo, QxCq1t that this agreienielt�
diiies n(�rl Ifin it the aaraaeuatllaaerrt (it'this agrccliwlit in accordi'Ince with Section 1().0 oi,thk agreement.
Enfity AlIlianet Nlar Aging, 1w,
y.
Date
(Signature),
Rusfitess Assatiate., Monirov ounty 1131(mrd of Comity Commissioners, Social Servivestin-Hone Services
B)" Date:
Digitally signed by James D.
James D. Molenaar Molenaar
Date:2022.10.07 11:22:23-04'00'
Approved as to Form and Legal Sufficiency Page 66 of 72
James D. Molenaar
Asst. County Attorney
MONROE COUNTY ATTORNEY'S OFFICE
P.' 1 ' .
. � µ ar
Rage
RR2129,2
Al ITA(31M E N T G
Alliance Ibr Aging, Inc.
Aging and 1..)isabifity Resource Ct;WQrff`lder 110,131,ine
AGING AND DBABILITY RESOURCE C'E"N'TE31 (AIMIC),— OUI I SOU RCED FUNCTIONS
11"applicable, the provideragrees,Co the (611trwing:
A. Perforin A,DRC outsourced, functions in accordance with theAlliance's policies and procedures,
i. Policies and Pro cc&rts fior 01ursmjrQcxj Function-Screen 1"ng
i i. PoliciQs an'd For Outs,ourced
di. Pol4cies and Procedures f'or Activation froln Waitfim- Client & rvjQQs
iv flolick,,s and Procedures 1'(�)rlcrminafion from Waiflist- Client Services
It. Maintainwait I ists in Cl R1 S in accordance ww ith DQpartmew raluirements.
Ad[lerc to prioritizatilon and Uargeting policy as sot lorth in the DOEIA Progran,is and Sorvicos
1,1 a nd book, a s a pt)I ic,,a b k!
D. Enmim (be Prcovidcr's, Disasteil- PIan reflects, ADR C, Or (sourced Functions, annually or a.s needed
to hworporme ADRC omscurced fbFtctions
F:. E`Asure agaimst coninios of'imertst and il"vapproprilate sd f-j-Q 1:'errak by reflerring consuniers in need
o r options um Ilse I i ng or long-terni care services beylond thie provider's scople ofs'ervices, to the
A,�jt)g aind Dis�a,bility Resource Center.
V En,surc that services provided are in (fie clients' best' interest,„ are the most cost OTeclive, of high,
quality, and ari�, rk:sponsivc mid appropriate tauthe assessed needs,
,rhe Assemed Priority C.onswuer List is maintained when serviees funded by the Dqx1rtinew oltc not,
;i v,. oflable. ("ontracted Providers of' rQgisWriM scrvi'Qcs for Local Services Progran-i (LSP) a,:md 101(k.-J, Americans
Ao (OAA) ajul ARV must naahltain waiting gists in Ote CIRTS dautbase ffir registered service,"
n,ot available-
Page 618 of 72,
RX21202
Affianve for Aging, Inc.
AWng and DQUity Resource Cenfet-/Flder 11elphoe
Policy and Prwedwe hor Oubowed Amwden—Scmening
Creation Date: Marchi 5, 2008
Rt'),ision Date. (ktober 2019
Review ll)afe: Oct otie r 2 0 1'9
(MqeeHvw To ensure that it corm nrchertive lit ofcHenN in need of's�rvices is n,iainuiined in CIRTS by
appaWrime timiding swiNc and dwU Q ADRC� is 1hereby able to efkctively gaugQ thQ, level ofetider
service need in NArrdDmk and Monme CoWls-
Policy: Tio obtain necemary I hiformation. froar Olients it) (�)rder lo assist in deterimining dew elofnetA and
c I ig,i b i 1,i iy for ro 1 M ewd s e ry ic e s fun de d th ro ugh 0 A A a nd L S P am! A R P p ro gums
I?rocedure:
I Pro,viders will colko infornt,ation firom callers and conduct a 701S, assQssnrvnt, Ahcru.,,'ifively, if as
701 A03)assesstmental ready exist or is lamps ed horn anoMer Pr(mricler t[re, inibrination froat the 701 B
can lug wilize(t
2. 'Hie Provider will delennine the sawices needed and the appophle (briding source(s) that provides
th,e needed services.
Ifthe ,at is in need ofa serviceo) thm is not provided by the Ptovidk r,, die Provider wilA refer catler
to the A[)RC ['lc er HeQine,aswcl I as, to other c(mmActed Providers and communhy
3, 1 be caller wd I be provicied %A geneml informnation regarding the .4 DRC as "N os We AINK7 E Wei-
Ile W[Ine contact number.
T Ile caHer Nvill be iril"ormed ot'1J,t(,, services am! Mndkg smums 11hat bey am being Qood (m The wait
list fi:i r in (A RIS
I fir npn-case managed4rograins, the Provider "IR umme as chent relcorcl in CJ RTS (if' there is rto
ex NOng rowAwl) arid enler the services needed for the caller by hKing mmns amh savic, [H We is,
an exiMing rmord K C Ili I&JI'tc, apfrrt�)priatie flickis WilA 13C Updated�j,
6, If Me %vidQr dai,rmines that Ow caHer may qualif), Ir more tan one progmm NY which the Provider
is firrided, the Provider 0 encornagond to enter the appropriate hiffirination under trr,di(i)[e furlding
sour,cQs. [If lire is an existing Aent record in (AR Is, the client record in CIRIS will he updated whh
appropiare inktrmadon],
7. 'Ile Provider will hihnn CAR At they vvill receive an omual based on Departnient
Wait IN Reassessmim Standards and encourttge caUer to contact tlx AD RC 110pjfljne with any,
quesAns,
Page 69 of 72
RP
AUWacwWr Aongjnc.
Aging and MaNfily Rewume ( ejtWr1Ek1ez- lielpline
Policy and Procedlitre for
Outscou'l-ced function - 'J'J"iage
Creation Dast- MarcI4 5, 2008
Revision Daw: Ocuk,ep'20 19
Review lhtfe; October 2019
01,�jecflve. TO ernwe Al dknh in nQed of DeparhnwH huxled services rQuive sery in based on the Idghosi
lQv<J of rtced, first, as flumling twecornes avaHaWe,
!'oficy- To assist A= V obMiNng Departmwo Rinded services as funding, Ncxpnics zwaflabie, baqed on
level (�,ifneed as� dewrm hyd by a CARTS pdoHq scm,
Procedniv:
I� The NONONVill C()11(Jjr1Cj annual wassessnwnts bmed on l3cparmat Wait list SUinx1tirds,
I If there is no cunvit 70 1 A or d3 in C'IR:FS, the Provider wild condurt flic anninal (701 s) as,
-klltre� 131 11PI)f0pl Mied on the Ubtrna%i pmvWed A the 701 S,/A(B) assesslINC111, the Provider wi I I opdate
the Client inf7ortn'auon hi CIRTS spedfically as U JIM& to He! ofneed Or by frunding soUrce,
3. Ift P"Adder will ensure that the (A RTS' prjorifiz',rifion scorc is accuriatoly inainta.4nect, ,iccordintg to
Departnient Standards, If a Q00cm change has ocoumod pod or to die 1HIffital re-scrQeriiag, the NovAr
HIM te-serconi. Defrinitioin and examplos of Agnificarn ulna ige ms docunicriAcd in he DOE A Progronris
& Semicq Martua I C"Impler 2.
1 If to cMler is in neect of as service(s) that is ium provicled by the PUnker, The Provicler = refdr caHer w
14i[e A[3 RC: Elder I k1jiJ ine. as well as, to o1her amyncMd Pr,ov Was and ummmmity oqpnhU Ons. 'rhc
calki- %vilI be inlbrined of the services and AmUng sources hat he wah Ust A andAr have been romoved
J)'O"ni th� wvail lim lbr,
5. 10 Provider will remind client of"tl,)Q ADRC Elder I lelp Line contact numbor and to contact the A[)R('
Elder Help Line xvidi vow queslAmis w converns-
6, 'Ns ful"I'dirig becomes awdLabl, Me Provider will nui CIR1 S Norhizakn Repon and activate dAms
accordifig to, DepailrnQnt StandmAs (mIr to ADRC! Cheni Activ,;�aion PoNchs and P=duresy Ile
Cmmwd PwvWcr wHI appi lammAng KwHj as appoprian to prioritized Aents U) onMHV aCHMMUS
ineet pro,grarntnatic rQquireniew,
Pagel of 72
RX1129.2
Alliance for Aging, I ne,
Aging and, Disability Resource Ccnter/Elder 1-telpline
Poficy antl Procedure foi-
AUNWon War VAR Usl --Men ts/Sem ices
C1.4-asion Date M'a rc It 5, 2 GO 8
Revision Date: Ociobk r N)19,
Revie", Mae: October 2,019
Objecth'e� Far snum tWH elders in need of Deparnment funded services in Mrrn-Dwk awl Monme Commks ruNd
on Te CIRTS mlai,t list beghi to receive scrvioes a'ts fundin,g becomes av idable,
pohcy: ADRC MU ivork NOW ProvWms in ensure that OEM waiting Ar Mpartnicuit Funded services [,)egin
U3 receive those mvices as 1"unding lea coiries availabIc%,
Ili-coceduj-e-
I I . The NoN,'idor M aukaw A= on ORTS %viait list based on I)epartilwat piolices. and
RHWWg availlbilij.
2. 1"he Provider %vill upd,'Oo (.71R.1"S slaWs by %ding scmlve -and Service f5or any, sere,iels being activated, Ibr
1he chcril usingappropriale CIRTS Codes"
3° Chent aria), be leh on wait 1W (if as dMient Aiding source An Ow (mm bekg WNW it tiara Pmvkkr
dewrinines t1tzil it isappropri.ate.
I (Tom omy An be WR on wak 141 in CIRIFS ifdwy acre beNg actNated by the Provider under a temporary
non-Departn,wn� funding source and the Provider dehormines, that the chertt's need vW11 pasht sher the
tonporary funding saumc is exhaustal,
5, Ile PmAder%viii 011irm the Witt of mV savizesMIMUng Some Al Key am heing amNewd Aw as "Ol
as We serNkes and fundhig sources that they MH cominue to be vah Hmed hr.
6, IS Provider wHI NAnn Chent to coulact die /VDRC Elder lklpfinc, i1l'dwy We any quenkms or conouns
r�,-,garding Clue stalus ofalr,), ot,11wir.si:�rvjoes
Page 72 of 72
RRA1202
AHWnce For Agin, Inc,
Aging and Disability Resimiree Center/Elder Helj)fi"e
PWky and Prmedum for
Termination from 'W� Iit LiNt -CIiCntS/SeJ-%iCtS
("reation Date. Nlirch5,, 2008
Revision, 1)ate: (ktober 2019
Review Date: ()ctober 2019
Objective: I)o ensure dwl Me mmpvhenMve list of chents in need ofserviccs in (AM,'I'S is appropriately
nmhMhwd by bunding m-mmQ arl,d rhal die ADRC is thereby able to effkfivelly g'auge ftw cor-rant level
of Oda service need in AA And-Dade and Mome (homdes,
Flolliol. ADI (` will mairimin an accurate and, current [it of,elims in neml of Ocler services in Ndiand-Data
and Monme Counties widt the assistance of theADRC Contruled Proviklers,
l2nmedwre-
L Ile 1'rovk1ler will re-screm Am which the Provikler WhIfly pbeed on A CIRTS wah lim lams semkcs
bowd on Depavrnwd Reassemmertt Stundards.
I Tfio re-screening ripy be in Ile Mcm of a phonc screening or a honve visit depending on the clii,ttt s staurs
(j,Q,- a L,t i v e/�e,n d i n g),
3, The Provider%vi H determirie if the c Hent is nxi, Onger in need Ow eliWble) A any of die services they were-
"wit-li0ted We-
4- ]"It( [Ir(vvidcr will lermimale fliv cfiiejit 1`roii.i the wail list (vwfi-ely or by specific service) using the
appropriate CIRTS terrifina6on code for aiW saKes or RnWhg mmme lbr whieh ik clk,,nt is doermumd
to no longer be eligiWe A or no Ong or in need of'.
5, 'The Provider %viH !nMrm the client of any semimOhmXg smuce that they are behig removed 1'rom Ac
WWI list for,
6, Ile Novixier"111 inAm clim oftleir ability to be rmadded to At mah list if their level of need should
change,
7. The Prodder = iwMrm, chmo to cont,act thin ADRC FJdQr Ife4dine if the have any questions or concems
regarding their wed Hsi status,
8- Releren,eQ DOITA Programs awl Serxices 1-fandbook as applicable,
Page 72 of 72