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Resolution 252-1987 Louis LaTorre, Director Social Services Department RESOLUTION NO. 252-1987 A RESOLUTION OF THE BOARD OF COUNTY COMMIS- SIONERS OF MONROE COUNTY, FLORIDA, APPROVING AND AUTHORIZING THE MAYOR TO EXECUTE AMENDMENT If 1 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-624. 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 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-624. 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 Jf ~aL~/1J~ ERK AMENDMENT #1 CONTRACT KG624 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, herein- after referred to as the "Provider", amends Contract #KG-624. 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 $5,519.25.......... b. Attachment I, page 6, Section C, paragraph 1, METHOD OF PAYMENT: .. 1. Subject to the availability of funds, the Department is identifying no more than a total General Revenue dollar amount of $5,519.25.............................. 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 amount of $613.25. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2. The following pages of Exhibit I are replaced as follows: a. page 12 by page 2 of this Amendment. b. page 19 through 22 by page 3 through 10, for 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. P. Maurer NAME: Jerry Hernandez Jr. TITLE: Mayor DATE: N TITLE:Acting District Administrator DATE: ( .. APPLICATION FOR PURCHASE OF SERVICE Department of Health ana Rehabilitative Services ...-.. Face Sheet CONTRACT KG 624 Date of this Application: Amendment proposal April 15, 1987 Legal Name of Agency: ""' Monroe County Board of County Commissioners P.o. Box 1080 Key West, FI. 33040 Name of Program: Monroe County In-Home Services ( Type of Service: Home Delivered Meals Number to be Served: Monthly: 18 Yearly: 18 Funds: Client Donations: $ 0.00 Local: .613.25 Federal: 5,519.25 Total: 6,132.50 <- Beginning and Ending Dates of Contract Period: -2- Contact Person: Name: Louis LaTorre Position: Executive Director Wing III-Public Service Bldg. Address: 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 P.O. Box 1080 Key West, Fl.- 33040 Address: Phone: (305)294-8468 ~,-;".z;.& c...:_.;.....__..'-... " -i ( STATE OF FLORIDA DEPARTMENT OF HEALTH AND REHABILITATIVE SERVICES DIVISION OF FAMILY SERVICES REPORT OF DISBURSEMENTS STATE LOCAL SERVICES FUNDS I< Go Co 2.. '-I Contracting Agency: Monroe County In-Home Services 4~dress: Winq III - Public Service Building Kev West, Florida 33040 Reimbursement Period From: Contract Period From: County: Monroe Phone: 294-8468 ( TOTAL ACTUAL DESCRIPTION APPROVED EXPENDITURES EXPENDITURES BUDGET TO DATE FOR THE PERIOD PERSONEL: GROSS SALARIES FRINGE BENEFITS TOTAL PERSONNEL STAFF TRAVEL I TOTAL STAFF TRAVEL SUPPLIES: Home ,Delivered Meals (1,700 @$2.23 each) 53.791.00 Supplies (Thermal carriers to transport meals) 2 041. 50 Brochures for Proaram 300.00 TOTAL SUPPLIES $6,132.50 NON-INVENTORIABLE EQUIPMENT TOTAL NON-INVENTORIABLE EQUIPMENT INVENTORIABLE EQUIPMENT , OTHER EXPENDITURES - Unit Cost GROSS COST OF AGENCY $6,132.50 LESS AGENCY FEES COLLECTED 0.00 NET COST OF AGENCY 6,132.50 PLUS NET COST OF CENTERS ~SS AGENCY C.P.E. 613.25 LESS C.P.E. OF CENTERS TOTAL CASH REIMBURSEMENT 55.519.25 I REVISION To: To: 4/15/87 - 6/30/87 .. l PREPARED BY: TITLE: DATE: RECEIVED BY: TITLE: DATE: - 3- .. _..:_..',~_~ ;:~s-4~~~"':'~'.I._-'."""...:~_ - ... .....~ [ 1KYy~~r~R~~,~2E ..... Monroe County Social Services Monroe County In-Home Services Wing III-Public Service Building Key West, Florida 33040 ~~,,-- - . -----r....-..r ..........i ....,-, ~- 1 \I.--r~" ~ W...:...:.,r.' _~ ~ ~\ . n' ~, ".j~W~\ ~;V.:~ -0 . ~ ''= '_ '!J .' '~ BOARD OF COUNTY COMMISSIONERS Wilhelmina Harvey, District 1 Ed Swift, District 2 , Jerry Hernandez, District 3 Alison Fahrer, District 4 Mayor Pro tern Ken Sorensen, District 5 CERTIFIED PUBLIC EXPENDITURE LETTER ~ Monroe County Board of Commissioners' (Donor's Name) P.O. Box 1680 ( Kpy wP!':t", Fl (Address) 11040 . .......~.. This will serve as confirmation of committment between the Monroe County Board of County Commissioners and the State of Florida, Department of Health and Rehabilitative Services, District XI, of $ 613.25 Expenditures representing the following item: Ten percent of $ 6,132.50 in Certified Public Please note that the above figure has already been allocated from Signed: r Mayor Monroe County Board of County Commissioners L . '. L" ~ ~ ___'.. ! . . i.. _ .. . fl... - ~'.r... .- ~- .~~--.. ~ _..... ...J'::-", , - Date: /~ .,,", ---:' '. '~~,...3~_}- ~ ',' ".;,_,', ,-" ~ .,..,.,., >:..:,."," ;':'::"k~:,~i:~~~t,.f:<:",-.~,~ :~t.~~':'''t'\)!#~Zi.i~.:'~W~J'&l,~.i.\t?~~ ( .... "=l' N \.0 ~ 0 0 0 0 0 0 U"l U"l 0 U"l 0 U"l U"l 0 N N E-i . . . () .-i .-i 0 N N 0 M 0'\ iil 0'\ "=l' 0 M M .-i .-i r-- 0 M .-i .-i \.0 U"l Eo; .. .. .. .. fS M N \.0 \.0 U"l (I)- ~ (I)- (I)- () E-i Ul ~ ~ Ul ::J E-i tIl 01 13 .-i ~ III ..... 0 ~ dfl f'C 0 ~ ~ .-i ::J 0 +J ::E: ....... Z ~ ~ E-i 0 ~ H r-- 0 ~ () :I: l:Q CO 01 (9 Z () f'C "- tIl .. g H ~ Ul 0 ~ ~ H M III l:Q E-i ::E: ~ ( 0 "- ~ () fS \.0 (9 ~ Ul Iil ~ ~ ~ Ul t-) ~ 0 H 0 E-i ~ @ () Z ~ Ul +J III 2 S ~ H r-- .c: (9 III (9 ~ ~ co U tIl ~ ~ "- III ~ 0 U"l OJ OJ ~ () .-i 'M "- M ~ Ul ~ "=l' N ~ ~ E-i III ~ H N () ~ (I)- :I: (g) .-i ~ ~ III 0 ~ 0 l:Q () r-- .. OJ .. Ul.c: (9 .-i ~E-i Z H H Ul H E-i ~ r:4 Z III H ~ ::J ~ ::E: Ul III .. ~ i Ul Ul, ~ H (9 f'C g ~ ::E: l:Q L - 5- ( REVtsION: Number of clients and Units of Service (Meals) to be provided: This program proposes to serve 18 clients with 1,700 units of service (Meals). .. ( c - ~ - ( . ( l I ! ASSURANCE OF COMPLIANCE WITH THE DEPARTMEhi OF REALm, EDUCATION, AND _w"ELF ARE REGULATION IDi1)ER TITLE VI OF THE CIVIL RIGHTS ACT OF 1964 -.;. Monroe County In-Home Serivces (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 CFR 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 ASSURANCE 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 invol~ing the provision of similar service or benefits. If any personal property is so provided, this assurance shall obligate 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. the . -..........; ".- mIS 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 by the Department, including 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 r.ight to seek judicial enforcement of this assurance. This assurance is binding on the Applicant, 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) Wing III-Public Service Building BY (President, Chairman of Board, or comparable authorized official) Key West, Florida 33040 Applicant's Mailing Address ...-- ,..........."'''',''"' 0"'" ..,. - 7 - ( .. ( L Attachment 3 DEPARTMENT OF HEALTH, EDUCATION AND \<.'ELFARE ASSURANCE OF COMPLIANCE WITH SECTION 504 OF THE REHABILITATION ACT OF 1973, AS Al-lEh'DED The undersigned (hereinafter called the "recipient") HEREBY AGREES THAT it will comply wibb Section 504 of the Rehabilitation Act of 1973, as amended (29 D.S.C. 794), all requirements 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 i~ binding 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 t~e 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, proiect Director Name of Designee(s) - Type or Print Monroe County In-Horne Services Name of Recipient - Type or Print Wino III-Public SF!rv;C""p Rnilning Street Address or P. O. Box 03-0021-0354 (IRS) Employer Identification No. Key West City Florida State 33040 Zip \ I certify that the above information is complete and correct to the best of my knowledge. Date Signature and Title of Authorized Official HRS/PDA.:i./3-82 76 - ~- .- tr. - '-:l C :> :> - w I 00 N ~~ .....; l/) ~ ,... ..... ~ n c..,< l/) ,... ..... - w --.J t-' ~ .... ~- tl t"t> ..... .... ::l .... 00 tIl t"t 0 ='~ tl "1 t"t n I'D tIl o ..,.. t"t =' I'D '< tl "1 n I'D t"t n ....."1 < ~ I'D ..... ....t"t '< S ~ "1 ::l I'D " n "1 ~ c:: ..... ..... .... " .... tl 0'" ::l I'D c.. ..... "1 :l I'D .... ....0 I'D "1 "1 S I'D ~ c.. o :; 0 ~ "1 ::l tl .... tl .... ... '< c. = ::; ::l .... c.. ::l o ..... "1 :l .... ,... '< ~ .... n ,... = .... ::l c..oc ..... c.o t: '"" ,... r:: ,... tIl I'D .... o I'D "1.0 .... tl S; ..... .... ~ I'D ~ ::; 0"0 tIl .... ....0 l"T'< ....= o r.; ... ::l u: ,... c..n .... 0' u. ::l "0 ,... -"1 tl tl '< n It' " C. n ....0 ::l S I'D ~ - ~ .... o .... 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