Resolution 250-1987
~ - ----,
Louis LaTorre, Director
Social Services Department
RESOLUTION NO. 250 -1987
A RESOLUTION OF THE BOARD OF COUNTY COMMIS-
SIONERS OF MONROE COUNTY, FLORIDA, APPROVING
AND AUTHORIZING THE MAYOR TO EXECUTE
AMENDMENT 1/2 BY AND BETWEEN THE STATE OF
FLORIDA DEPARTMENT OF HEALTH AND
REHABILITATIVE SERVICES AND THE BOARD OF
COUNTY COMMISSIONERS OF MONROE COUNTY
CONCERNING CONTRACT KG-6l3.
BE IT RESOLVED BY THE BOARD OF COUNTY COMMISSIONERS OF
MONROE COUNTY, FLORIDA, that said Board hereby approves and
authorizes the Mayor to execute Amendment 1/2 by and between the
State of Florida Department of Health and Rehabilitative Services
and the Board of County Commissioners of Monroe County, a copy of
same being attached hereto, concerning Contract KG-6l3.
PASSED AND ADOPTED by the Board of County Commissioners of
Monroe County, Florida, at a special meeting of said Board held
on the 22ndday of June , A.D. 1987.
BOARD OF COUNTY COMMISSIONERS
OF MONROE COUNTY, FLORIDA
(SEAL)
ATTEST DANNY L.. KOLHAGE, Clerk
~~NL
ERK
BY
"f
r ~
AMENDMENT *2 CONTRACT KG-6l3
....
This Amendment entered into between the State of Florida, Department
of Health and Rehabilitative Services, hereinafter referred to as
the "Department" and Monroe County Board of County Commissioners
Monroe County In-House Services, hereinafter referred to as the
"Provider", amends Contract KG-613.
...
1. The following Sections and Paragraphs are hereby amended
as follows:
a. Section II, page 3, the Department Agrees:
-.:
To pay contracted services according to the condition
of Attachment I. in an amount not to exceed $43,964.49.
b. Attachment I, page 6, Section C, paragraph 1, METHOD
OF PAYMENT:
1. Subject to the availability of funds, the Depart-
ment is identifying no more than a total General
Revenue dollar'-'$43,964.49.........................
c. Attachment I, page 7, Section D, MATCH:
The Provider's contribution will be made in the form
of cash and/or in-kind resources equaling at least ten
percent (10%) of the actual net cost for a total match
amoun t" $ 4 , 8 8 4 . 9 4 . . . . . . . .; . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2. The following pages of Exhibit I are replaced as follows:
a. page 12 by page 3 of this Amendment.
b. pages50 through 56 by pages 3 through 10 of this
Amendment.
3. The following pages have been added:
pages II to 15 of this Amendment.
This Amendment shall begin on May 20, 1987, or the date on which the
Amendment has been signed by both parties, whichever is later.
All provisions not in conflict with this Amendment are still in effect
and are to be performed at the level specified in the contract.
~
......,--...)
~
.-._,',.,. '
AMENDMENT i1 CONTRACT KG-613
".
IN WITN~SS WHEREOF, the parties hereto have caused this /~ page
Amendment to be executed by their officials thereunto duly authorized.
PROVIDER
STATE OF FLORIDA
DEPARTMENT OF HEALTH
REHABILITATIVE SERVICES
BY:
BY
NAME: Jerry Hernandez Jr.
NAME: Luisa P. Maurer
TITLE: Mayor
TITLE: Acting District Administrate:
DATE:
DATE:
I.... "';::.,:.:!',tl ',....~
AP~R 'ED AS TO FORM~
AtD L GAL ,'SUFF1,:fE^'CY'f-/ /1
.......--<-,~~ (Z ~....../;
8Y - .
AttMney's Office ,
,~
(
APPLICATION FOR PURCHASE OF SERVICE
Department of Health and Rehabilitative Services
....
Face Sheet
CONTRACT KG 613
Date of this Application:
Amendment Proposal
April 15, 1987
Legal Name of Agency:
..
Monroe County Board of County
Commissioners
P.O. Box 1680
Key West, Fl. 33040
Name of Program:
Monroe County In-Home Services
(
Type of Service:
Homemakinq, Personal Care and
Home Delivered Meals
Number to be Served:
Monthly: 30
30
Yearly:
Funds:
Client Donations: $ 840.00
Local: 4;884.94
Federal:
43,964.49
Total:
$49,689.43
L
Beginning and Ending Dates of
Contract Period:
.a--
Contact Person:
Name:
Louis LaTorre
Position:
Executive Director
Address:
Wing III-Public Service Bldg.
Key West, Fl. 33040
Phone: (305)294-8468 Ext. 139
Name: Gwen Rodriguez
Position: Project Director
Wing III-Public Service Bldg.
Address: Key West, Fl. 33040
Phone: (305)294-8468 Ext. 157
Payee:
Monroe County Board of County
Commissioners
Name:
Position:
Mayor
Address:
P.O. Box 1680
Key West, Fl.
33040
Phone:
(305)294-8468
'.
(
STATE OF FLORIDA
DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES
DIVISION OF FAMILY SERVICES
REPORT OF DISBURSEMENTS 1<' Go Co /3
STATE LOCAL SERVICES FUNDS
Contracting Agency:
lddress:
Monroe County In-Horne Services
Wing III-Public Service Buildinq
County: Monroe
Phone: 294-8468
Reimbursement Period From:
Contract Period From:
To:
To:
(
-
TOTAL ACTUAL
DESCRIPTION APPROVED EXPENDITURES EXPENDITURES
BUDGET TO DATE FOR THE PERIOD
PERSONEL: GROSS SALARIES
FRINGE BENEFITS
TOTAL PERSONNEL $43 743.60
STAFF TRAVEL
In Area 2.788.19 I
,
TOTAL STAFF TRAVEL 2.788.19
SUPPLIES:
Misc. Direct Service Supplies 300.00
Office Supplies 120.00
Xerox Copies 100.00
Printing 752.75
TOTAL SUPPLIES 1 272.75
NON-INVENTORIABLE EQUIPMENT ,
Postage 362.75
Professional Fees 500.00
Medical Exams 70.00
Advertising 300.00
Insurance & Bonds 6')2.14
TOTAL NON-INVENTORIABLE EQUIPMENT 1,884.89
INVENTORIABLE EQUIPMENT
OTHER EXPENDITURES - Unit Cost
GROSS COST OF AGENCY 4Q h~Q_ A":l
LESS AGENCY FEES COLLECTED 840.00
NET COST OF AGENCY 48 849.43
PLUS NET COST OF CENTERS
~ESS AGENCY C.P.E. 4.884.94
LESS C.P.E. OF CENTERS
TOTAL CASH REIMBURSEMENT I 43,964.49 I
REVISION 4/15/87
6/30/87
..
l. PREPARED BY:
TITLE:
DATE:
RECEIVED BY:
TITLE:
DATE:
'-I
.. ....:""._.~....:..~~~~~~~i.z~. ._;....~~_..
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J.Yv~!: ~R~~3~04~E
(3051 294,4641
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Monroe County Social Services
Monroe County In-Home Services
Wing III-Public Service Building
Key West, Florida 33040
CERTIFIED PUBLIC EXPENDITURE LETTER
'"
Monroe County Board of Commissioners'
(Donor I s Name)
P.O. Box 1680
Key Wpsr F'l
(Address)
11040
(.".~.
. .-
BOARD OF COUNTY COMM.SSIONERS
Wilhelmina Harvey, District 1
Ed Swift, District 2
,Jerry Hernandez, District 3
Alison Fahrer, District 4
Mayor Pro tem Ken Sorensen. District 5
This will serve as confirmation of cornmittment between the Monroe County Board
of County Commissioners and the State of Florida, Department of Health and
Rehabilitative Services, District XI, of $ 4 RR4 q4
Expenditures representing the following item:
Ten gercent
of $ 48.849.43
in Certified Public
Please note that the above figure has already been allocated from
Signed:
..
Mayor
Monroe County Board of County Commissioners
<-
5
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REVISION: Number of clients and Units of Service to be provided:
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This program proposes to serve 30 clients with 2,650
units of service.
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ASSURANCE OF COMPLIANCE WITH THE DEPARTMENT OF
HEALTH, EDUCATION, AND WELFARE REGULATION UNDER
TITLE VI OF THE CIVIL RIGHTS ACT OF 1964
\..
Monroe County In-Home Serv'ices (Hereinafter called the "Applicant")
(Name of Applicant)
HEREBY AGREES THAT it will comply with Title VI of the Civil Rights Act of 1964
(P.L. 88-352) and all requirements imposed by or pursuant to the Regulation of
the Department of Health, Education and Welfare (45 ~FR Part 80) issued pursuant
to that title, to the end that, in accordance with Title VI of that Act and the
Regulation, no person in the United States shall, on the ground of race, color,
or national origin, be excluded from partiCipation in, be denied the benefits
of, or be otherwise subjected to discrimination under any program or activity
for which the Applicant receives Federal financial assistance from the
Department; and HEREBY GIVES ASSmt~CE THAT it will immediately take any
measures necessary to effectuate this agreement.
..
(
If any real property or structure thereon is provided or improved with the aid
of Federal financial assistance extended to the Applicant by the Department, this
assurance shall obligate the Applicant, or in the case of any transfer of such
property, any transferee, for the period during which the real property or '
structure is used for a purpose for which the Federal financial assistance is
extended or for another purpose involving the provision of similar service or
benefits. If any personal property is so provided, this assurance shall obligate the
Applicant for the period during which it retains ownership or possession of the
property. In all other cases, this assurance shall obligate the Applicant for the
period during which the Federal financial assistance is extended to it by the
Department.
THIS ASSURANCE is given in consideration of and for the purpose of obtaining any
and all Federal grants, loans, contracts, property, discounts or other Federal
financial assistance extended after the date hereof to the Applicant py the Department,
incluaing installment payments after such date on account of the applications for
Federal financial assistance which were approved before such date. The Applicant
recognizes and agrees that such Federal financial assistance will be extended in
reliance on the representations and agreements made in this assurance, and that the
United States shall have the right to seek judicial enforcement of this assurance.
This assurance is binding on the AppliCoant, it's successors, transferees, and assignees,
and the person or persons whose signatures appear below are authorized to sign this
assurance on behalf of .the Applicant.
DATE
(Applicant)
BY
Winq III-Public Service Building (PreSident, Chairman of Board, or comparable
authorized offiCial)
Kev West. Florida 33040
Applicant's Mailing Address
<-
nRS/PDAA/3-82 74
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Attachment 3
(
DEPARTMENT OF HEALTH, EDUCATION AND WELFARE
ASSURANCE OF COMPLIANCE WITH SECTION 504 OF TIlE
REHABILITATION ACT OF 1973, AS AMENDED
The undersigned (hereinafter called the "recipient") HEREBY AGREES THAT it will
comply wi~h Section 504 of the Rehabilitation Act of 1973, as amended (29 V.S.C.
794), all ~equirements imposed by the applicable HEW regulation (45 C.F.R. Part
84), and all guidelines and interpretations issued pursuant thereto.
..
Pursuant to 84.5(a) of the regulation [45 C.F.R. 84(a)], the recipient gives
this Assurance in consideration of and for the purpose of obtaining any and all
federal grants, loans, contracts, (except procurement contracts and contracts of
insurance or guaranty), property, discounts, or other federal financial assistance
extended by the Department of Health, Education and Welfare after the date of
this Assurance, including payments or other assistance made after such date on
applications for federal financial assistance that were approved before such date. '
The recipient recognizes and agrees that such federal financial assistance will
be extended in reliance on the representations and agreements made in this
Assurance and that the United States will have the right to enforce this Assurance
through lawful means. This Assurance is biuding on the recipient, its successors,
transferees, and assignees, and the person or persons whose signatures appear
below are authorized to sign this Assurance on behalf of the recipient.
This Assurance obligates the recipient for the period during which ,federal
financial assistance is extended to it by the Department of Health, Education
and Welfare or provided for in 84.5(b) of the regulation [45 C.F.R. 84.5(b)].
(, The recipient: [Check (a) or (b) ]
a. ( ) employs fewer than fifteen persons;
b. (X) employs fifteen or more persons and pursuant to 84.7(a) of the
regulation [45 C.F.R. 84.7(a)], has designated the following
person(s) to coordinate its efforts to comply with the HEW
regulation:
Gwen Rodriquez, Project Director
Name of Designee(s) - Type or Print
Monroe County In-Horne Services
Name of Recipient - Type or Print
Wing III-Public Service Building
Street Address or P. O. Box
03-0021-0354
(IRS) Employer Identification No.
Key West
City
Florida
State
33040
iip
<-
I certify that the above information is complete and correct to the best of my
knowledge.
Date
Signature and Title of Authorized Official
HRS/PDAA/3-82
76
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IS-
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