Item C19
BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
Meeting Date: __5-] 7-2006
Division: ~ Community Services
Bulk Item: Yes -K- No
Department: _Social Services
Staff Contact Person: _Deloris Simpson
AGENDA ITEM WORDING: Approval for Mayor to sign the Match Commitment of 10% for the
upcoming Community Care for Disabled Adults (CCDA) Grant, for Fiscal Year July 1, 2006 through
June 30, 2007, and to submit unit cost information to the Department of Children & Families.
ITEM BACKGROUND: Approval ofprevlous CCDA Contract on March 16,2005.
PREVIOUS RELEVANT BOCC ACTION: Prior approval granted to the CCDA on March 16,
2005.
CONTRACT/AGREEMENT CHANGES: NIA
STAFF RECOMMENDATIONS: Approval
TOT AL COST: Unknown
BUDGETED: Yes -K- No
COST TO COUNTY: unknown
SOURCE OF FUNDS: Ad Valorem Taxes
REVENUE PRODUCING: Yes
No X
AMOUNT PER MONTH
Year
APPROVED BY: County Atty. _ OMB/Purchasing_
Risk Management _
DIVISION DIRECTOR APPROVAL:
SHEILA BARKER
DOCUMENTATION:
Included X
Not Required_
To Follow
DISPOSITION:
AGENDA ITEM #
ReVIsed 2/05
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ATTACHMENT 0
Certification Regarding Lobbying
CERTIFICATION FOR CONTRACTS, GRANTS, LOANS AND COOPERATIVE
AGREEMENTS
The undersigned certifies, to the best of his or her knowledge and belief, that:
(1) No federal appropriated funds have been paid or will be paid, by or on behalf of
the undersigned, to any person for influencing or attempting to influence an
officer or an employee of any agency, a member of congress, an officer or
employee of congress, or an employee of a member of congress in connection
with the awarding of any federal contract, the making of any federal grant, the
making of any federal loan, the entering into of any cooperative agreement, and
the extension, continuation, renewal, amendment, or modification of any federal
contract, grant, loan, or cooperative agreement.
(2) If any funds other than federal appropriated funds have been paid or will be paid
to any person for influencing or attempting to influence an officer or employee of
any agency, a member of congress, an officer or employee of congress, or an
employee of a member of congress in connection with this federal contract,
grant, loan, or cooperative agreement, the undersigned shall complete and
submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance
with its instructions.
(3) The undersigned shall require that the language of this certification be included in
the award documents for all subawards at all tiers (including subcontracts,
subgrants, and contracts under grants, loans and cooperative agreements) and
that all subrecipients shall certify and disclose accordingly.
This certification is a material representation of fact upon which reliance was placed
when this transaction was made or entered into. Submission of this certification is a
prerequisite for making or entering into this transaction imposed by section 1352, Title
31, U.S. Code. Any person who fails to file the required certification shall be subject to
a civil penalty of not less than $10,000 and not more than $100,000 for each such
failure.
Signature
Date
Application or Contract Number
Name of Authorized Individual
Name and Address of Organization
ATTACHMENT E
CERTIFICATION REGARDING
DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION
CONTRACTS/SU BCO NTRACTS
This certification is required by the regulations implementing Executive Order 12549, Debarment and
Suspension, signed February -18. 1986. The guidelines were published in the May 29. 1987 Federal
Register (52 Fed. Reg., pages 20360-20369).
INSTRUCTIONS
1. Each provider whose contract/subcontract equals or exceeds $25,000 in federal moneys must
sign this certification prior to execution of each contract/subcontract. Additionally, providers
who audit federal programs must also sign, regardless of the contract amount. The
Department of Children and Families cannot contract with these types of providers if they are
debarred or suspended by the federal government.
2. This certification is a material representation of fact upon which reliance is placed when this
contract/subcontract is entered into. If it is later determined that the signer knowingly
rendered an erroneous certification, the Federal Government may pursue available remedies,
including suspension and/or debarment.
3. The provider shall provide immediate written notice to the contract manager at any time the
provider learns that its certification was erroneous when submitted or has become erroneous
by reason of changed circumstances.
4. The terms "debarred," "suspended," "person," "principal," and "voluntarily excluded," as
used in this certification, have the meanings set out in the Definitions and Coverage sections
of rules implementing Executive Order 12549. You may contact the department's contract
manager for assistance in obtaining a copy of those regulations.
5. The provider agrees by submitting this certification that, it shall not knowingly enter into any
subcontract with a person who is debarred, suspended, declared ineligible, or voluntarily
excluded from participation in this contract/subcontract unless authorized by the Federal
Government.
6. The provider further agrees by submitting this certification that it will require each
subcontractor of this contract/subcontract, whose payment will equal or exceed $25,000 in
federal moneys, to submit a signed copy of this certification.
7. The Department of Children and Families may rely upon a certification of a provider that it is
not debarred, suspended, ineligible, or voluntarily excluded from contracting/subcontracting
unless it knows that the certification is erroneous.
8. This signed certification must be kept in the contract manager's contract file. Subcontractor's
certification must be kept at the provider's business location.
CERTIFICATION
(1) The prospective provider certifies, by signing this certification, that neither he nor his
prinCipals is presently debarred, suspended, proposed for debarment, declared ineligible,
or voluntarily excluded from participation in this contract/subcontract by any federal
department Of agency.
(2) Where the prospective provider is unable to certify to any of the statements in this
certification, such prospective provider shall attach an explanation to this certification.
Signature
Date