HomeMy WebLinkAboutSeminole County Day Camp Provider Agreement 2014 04 14 DAY CAtiIP PROVIDER AGREEMENT
THIS AGREEMENT is made and entered into this 15th day of Ma
2014 , by and between SEMINOLE COUNTY, a political subdivision of the State of Florida,
whose address is Seminole County Services Building, 1101 East First Street, Samford, Florida
3?771, hereinafter referred to as "CO-LINTY". and the CITY OF WINTER SPRINGS, a Florida
Municipal Corporation, whose address is 1126 East State Road 434, Winter Springs, Florida 32708,
hereinafter referred to as"DAY CAMP PROVIDER".
WITNESSETH:
WHEREAS, COUNTY has received Community Services Block Grant funding in the
amount of EIGHTY-EIGHT THOUSAND AND NO/100 DOLLARS ($88,000.00), hereinafter
referred to as the Grant., from the State of Florida Department of Economic Opporwrilty for day
camp scholarships for eligible individuals residing in Scrninole Comity, Florida; and
WHEREAS, in response to the needs of these individuals. COUNTY may issue vouchers
for day camp scholarships,hereinafter referred to as"Day Camp Scholarship Vouchers", for income
eligible individuals residing in Seminole County, Florida, hereinafter referred to as "Camper",
participating in a COUNTY program for payment of day camp tuition and other specified expenses
for short-term day camp services provided by DAY CAMP PROVIDER; and
WHEREAS,the purpose of this Agreement is to identify the COUNTY approved day camp
programs to be delivered by the DAY CAMP PROVIDER; establish the costs associated with the
approved day camp programs; describe the processes and procedures that wilt be followed if an
eligible Camper receives a Day Camp Scholarship Voucher From COUNTY for enrollment in one
of the DAY CAMP PROVIDER's approved day camp prob sins; and identify the operating
procedures governing payment for the day camp programs;and
Seminole County "City of Winter Springs
Day Camp Provider Agreement
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WHEREAS,COUNTY has statutory authority to disburse the Grant under this Agreement,
NOW, THEREFORE, in consideration of the mutual understandings and covenants set
forth herein, the receipt and sufficiency of which are hereby acknowledged, COUNTY and DAY
CAMP PROVIDER agree as follows:
Section 1. Term. This Agreement becornes effective upon execution by all parties and
terTninates on September 30, 2014, unless otherwise terminated pursuant to the terms of this
Agreement.
Section 2. Responsibilities. COUNTY and DAY CAMP PROVIDER hereby specifically
agree to the following:
(a) COUNTY shall solely determine whether Seminole County residents interested in
day camp services are eligible for Day Camp Scholarship Vouchers in accordance with applicable
Federal and State income eligibility and other program criteria, including the Scope of Services
attached hereto and incorporated herein as Exhibit A. Only those Campers determined eligible and
in need of day camp services by COUNTY shall be issued a Day Camp Scholarship Voucher for
day camp services; provided, however, sufficient funds are available, in CO[TNTTs determination,
to cover COUNTY's portion of the day camp costs. All. terms and conditions of this Agreement are
subject to continued Grant fiend availability_
(b) COUNTY shall not guarantee any referrals, set aside any day camp scholarships, or
budget any fiinds whatsoever for any day camp programs offered by the DAY CAMP PROVIDER.
All decisions regarding the issuance of a Day Camp Scholarship Voucher shall be made on a case
by case basis by COUNTY, taking into consideration the information available, including, but not
limited to the assessed needs of the Camper and any additional costs to the Camper. COUNTY
shall, to its sole discretion, determine whether to issue a Day Camp Scholarship Voucher for any
Seminole County 1 City of Mlinter 5princs
Day Camp Provider Agreement
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approved day canip program offered by a particular DAY CAMP PROVIDER. A matrix of
approved day camp prcgrams is atrached hereto and incoiporared herein as Exhibit B.
(c) DAY CAMP PROVIDER shall deliver the day camp program in iiecordanc.c. � ith
the day camp program description in effect at the lime the C•ampLr enrolls To the particular day camp
program.
(d) DAY CAMP PROVIDER shall immediately notify COUNTY in writing of any
changes in the approved day camp program, including but not limited to the day camp description
and program cost described in Exhibit .l: prior to the enrollment of any COUNTY sponsored
Camper.
(e) DAY CAMP PROVIDER agrees to accept the Day Camp Scholarship Voucher and
bill COUNTY for the agreed upon day camp costs at no more than the total of the Day Camp
Scholarship Voucher or the total published cost of the specific day camp services for municipal
residents, whichever is less. The amount of the Day Camp Scholarship Voucher shall be determined
by COUNTY up to a maxima n amount of NINE HUNDRED NINETY AND Wl 00 DOLLARS
($990.00) of the cost of day camp tuition per Camper to DAY CAMP PROVIDER. COUNTY shall
pay no other costs or fees that are not specified in this Agreement and included on the Day Camp
Scholarship Voucher. Payments for tuition and/or other approved costs will be made only for those
Campers receiving a valid signed COUNT' Day Camp Scholarship Voucher. The Camper must be
enrolled in and receiving day camp services designated on the Day Carnp Scholarship Voucher
before the COUNTY Day Camp Scholarship Voucher is considered valid_ If the Camper does not
begin day camp, DAY CAMP PROVIDER shall immediately return the Day Camp Scholarship
Voucher to COUNTY. COUNTY will not pay DAY CAMP PROVIDER for a week in which the
Camper does not attend at least one (l) day.
Seminole County /City of Winter Springs
Day Camp Provider Agreement
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(f) The COUNTY Day Camp Scholarship Voucher shall he issued for a limited time
h-aine not to exceed a nine(9)week period.
(g) Campers receiving a Day Camp Scholarship Voucher from COUNTY shall be
enrolled by DAY CAMP PROVIDER only in the approved day camp program for the designated
period of time specified on the COUNTY Day Camp Scholarship Voucher. At no time shall DAY
CAMP PROVIDER allow a COUNTY Camper to switch day camp programs or to extend his/her
day camp services at COUNTY*s cost.
(h) DAY CAMP PROVIDER shall provide COUNTY a record of completion of the
day camp program by the Camper within ten (1 0) business days of said completion. This
information shall be released to COUNTY based on Camper's authorization as outlined on the Day
Camp Scholarship Voucher_ DAY CAMP PROVIDER shall provide COUNTY a completed
Monthly Report within ten (10) days of the end of the month. A copy of the Monthly Report is
attached hereto and incorporated herein as Exhibit C.
(i) DAY CAMP PROVIDER shall refer COUNTY Campers back to COUNTY in the
event that the Camper or DAY CAMP PROVIDER is unable to continue the day camp services
specified in the Day Camp Scholarship Voucher, DAY CAMP PROVIDER shall also notify
COUNTY in writing of this occurrence.
(j) DAY CAMP PROVIDER agrees that each Camper receiving a Day Camp
Scholarship Voucher for day camp services shall be evaluated by the DAY CAMP PROVIDER for
all financial aid eligibility normally available to DAY CAMP PROVIDER's Campers. A Camper
eligible for assistance shall not be discriminated against in receipt of such financial aid solely due to
his/her receipt of a COUN'T'Y Day Camp Scholarship Voucher.
Seminole County 1 City oi'Winter Springs
Day Cramp Provider Agreement
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(k) It is the responsibility of DAY CAMP PROVIDER to provide sufficient oversight to
prevent misapplication of funds that results in double payment of any charges or the utilization of
Federal, State or COUNTY .funds when other funds could have been used for the same purpose.
Section 3. Payment.
(a) DAY CAMP PROVIDER shall submit to COUNTY a written invoice in the form of
Exhibit E, Request for .Payment, and all necessary supporting documentation for the approved day
camp tuition and other identified and included costs once a Camper possessing a valid signed Day
Camp Scholarship Voucher is enrolled in a day camp program. This invoice must be supported by a
copy of the COUNTY Day Camp Scholarship Voucher and any receipts, as applicable. Each
CAMPER shall be identified by name and costs associated with each Camper shall be itemized. The
Monthly Invoice. Exhibit E, is due to COUNTY by the 10'i' day of the following month. The
payment request shall be addressed to:
Day Camp Provider Reimbursement Request
Department of Community Services
SeEninole County
534 West Lake Mary Boulevard
Sanford,Florida 32773
Invoices accepted for payment shall be paid within thirty (30) days of receipt. invoices not
accepted for payment due to inconsistencies, errors, or failure to submit supporting documentation,
shall be r&urned to DAY CAMP PROVIDER for correction and resubmission.
(b) The COUNTY Day Camp Scholarship Voucher shall specify the expenses that will
be paid for with funds administered by COUNTY. DAY CAMP PROVIDER shall adhere to the
plan of action established by the Day Camp Scholarship Voucher.
Section 4. Refunds.
(a) The DAY CAMP PROVIDER shall, in conformity with its established refund
policies, refund such monies for day camp tuition and tees paid by COUNTY for Campers who
Seminole County 1 City of Winter Springs
Day Camp Provider Agreement
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enroll in and begin a clay camp program,but drop out of day camp. Refunds due for tuition and fees
paid under this Agreement shall be made payable to COUNTY at the address provided in Section 6
herein. DAY CAMP PROVIDER shall refund to COUNTY any Grant funds used for ineligible
purposes tmder the laws, rules and regulations governing the use of these Grant funds. A separate
email advising COUNTY that a refund is being mailed shall be sent by DAY CAMP PROVIDER
to COUNTY at ocarter"a setninolecounr";t1.--,ov.
(b) fn accordance with Section 215.34(2), Florida Statutes, if a check or other dram is
returned to COUNTY for collection,DAY CAMP PROVIDER shall pay to COUNTY a service fee
of FIFTEFN AND NO/100 DOLLARS (515.00) or five percent: (5%) of the face amount of the
returned check or draft, whichever is greater.
Section S. Access and Retention of Pubiie Records.
(a) The parties shall comply with the public records laws of the State of Florida and the
non-confidential portions of all financial records, supporting docannents, and any other documents
pertinent to this Agreement shall be available for inspection by any person in accordance with
Chapter t 19. Florida Statutes- DAY CAMP PROVIDER shall comply with Federal and State law to
ensure the confidentiality of personal infonnation including name, Social Security Number, Social
Security benefit data, date of birth, official State or government issued driver's license or
identification number, alien registration number, government passport .number, employer c}r
taxpayer identification number, home address, phone number and medical information of eacl)
Camper receiving a COUNTY Day Camp Scholarship Voucher.
(b) DAY CAMP PROVIDER shall have ip place an official process for investigating
and reporting lost or stolen confidential information. Any interaction or potential infraction of State
and/or Federal laws related to the loss or theft of confidential information shall immediately be
reported to the COUNTY in writing,
Seminole County/City of Winter Springs
.Day Camp Provider Agreement
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(c) The parties hereto shall retain all financial records, supporting documents, and any
other documents pertinent to this Agreement far a period of five (5) years after the termination or
expiration date, whichever is earlier, or such longer period as inay be required by Federal or State
law.
Section 6. Notices. All notices, consents, approvals and required reports which any
party shall be required or shall desire to make or give pursuant to this Agreement, shall be given
in writing and delivered to the below designated persons by First Class United States mail or
Facsimile transmission, proof of delivery and receipt retained by the sending party:
For COUNTY:
Seminole County
Department of Community Services
531 West Lake Mary Boulevard
Sanford, Florida 32773
For DAY CAMP PROVIDER:
City of Winter Springs
1126 East State Road 434
Winter Springs, Florida 32708
Either of the parties may change, by written notice as provided above, the person or
address for receipt of notice.
Section 7. Termination.
(a) This Agreement may be terminated for convenience at any time by either party with
thirty (30) days written notice. In the event of such tciminatian, there shall be no interruption iii
services for COUNTY sponsored Cnrapers already enrolled in dray carnp through the period paid for
by the Day Camp Scholarship Voucher issued and paid. DAY CAMP PROVIDER has thirty (30)
days after the effective date of the termination for convenience to bill for any payments due. DAY
Seminole County 1 City of Winter Springs
Day Camp Provider Agreement
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CAMP PROVIDER shall be entitled to receive just and equitable compensation for any services
performed hereunder through the date of termination.
(b) Either party may terrninate this Agreement in writing; when it has been determined
that the other party has failed to comply with any of the term specified herein or leas violated any
stipulations of this Agreement. The obligation of COUNTY to make all payments due under this
Agreement for all enrollments prior to the effective elate of termination of this Agreetrtetit shatl
survive termination unless.DAY CAMP PROVIDER fails to perform. If DAY CAMP PROVIDER
tails to perform, in whole or in part, COUNTY may serve a tennination notice that shall be effective
as provided in Section G herein. In the event of such termination, COUNTY shall be liable for
payinent only for set-vices rendered prior to the effective date of termination. Final billing for
payment must be received by COUNTY within thirty (30)days of termination date. Refunds due for
any payments made for services that have not been provided must be received by COUNTY within
thirty (30) days of the tennination dale. The obligation of DAY CAMP PROVIDER to refund to
COUNTY any payments made for services that have not been provided shall survive termination of
this Agreement,
Section 8. Indemnification.
(a) Each party- to this Agreement is responsiblc. for ,tIl personai injury and propeiiy
damage attributable to the negligent acts or omissions arising out of this A;r..ement of that party
and the officers, empto_vecs and agrnts thereof,
(111 The parties further agree that nothing contained herein snail be construed or
interpreted as denying to any party any remedy or defense available to such parties wider the
laws of the State of Florida, nor as a ,vaiver of. sovereign Immunity of COUNTY and DAY
CAMP PROVIDER beyond the �ia�acr provided fur ir2 Section 768.28, Florida Statutes.
Seminole County/City of Witter Springs
Day Camp Provider Agreement
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(e) The waiver of a provision herein by either party shall not constitute the fiirther
waiver of said provision or the waiver of any other provisions
Section 9. Assignment and Third Party Beneficiaries. Assignment of this Agreement by
either parry is expressly prohibited. There are no third party beneficiaries to this Agreement.
Section 1.0. Mandated Conditions.
(a) Governin= Law. This Agreement shall be governed by and constnied in accordance
with the laws of the State of Florida and the parties consent to venue in the Circuit Court its and for
Seminole County, Florida, as to State actions and the United States District Coun for the Middle
District of Florida as to Federal actions.
(b) Accuracy of Submittals. The validity of this Agreement is subject to the truth and
accuracy of all the information, representations, and materials submitted or provided by the DAY
CAMP PROVIDER in this Agreement, in any later submission or response to a COUNTY
request, or in any submission or response to fulfill the requirements of this Agreement. All of
said information, representations, and materials are incorporated by reference. The inaccuracy of
the submissions or any material changes shall, at the option of COUNTY and with thirty (30)
days written notice to DAY CAMP PROVIDER, cause the termination of this Agreement and
the release of COUNTY from all its obligations to DAY CAMP PROVIDER.
(c) CounteiIL rts. This Agreement may be executed in any number of counterparts,
any one of which may be taken as an original,
(d) ether_ ations. DAY CAMP PROVIDER agrees to comply with the
Americans With Disabilities Act (Public Law 101-336, 42 U.S.C. Section 12101 et seq.) and the
Florida Civil Rights and Fair Housing Acts (Sections 760.01-764.37, Florida Statutes), which
prohibit discrimination by public and private entities on the basis of disability in employment,
Seminole County 1 City of Winter Sprints
Day Camp Provider Agreement
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public accommodations, transportation, State and local government services, and
telecornmuni cations_
(e) Unauthorized Workers_ COUNTY will not intentionally award pub}icfy-funded
contracts to any contractor who knowingly employs unauthorized alien workers, constituting a
violation of the employment provisions contained in 8 U.S.C. Section 1324a(e) [Section 274A(e)
of the Immigration and Nationality Act ("INA")]_ COUNTY shall consider- the employment by
any contractor of unauthorized aliens a violation of Section 274A(e) of the INA. Such violation
by .DAY CAMP PROVIDER of the employment provisions contained in Section 274A(e) of the
INA shall be grounds for unilateral cancellation of this Agreement by COUNTY.
(f) Lobbjn , Prohibition.
(l) No fmids or other resources received from COUNTY under this
Agreement may be used directly or indirectly to influence legislation or any other official action
by the Florida Legislature or any State agency.
(2) DAY CAMP PROVIDER certifies, by its signature to this Agreement, that
to the best of his or her knowledge and belief:
(A) No Federal appropriated funds have been paid or will be paid, by
or on behalf of DAY CAMP PROVIDER, 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 the awarding of any
Federal contract. the inakino 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.
(B) 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
Seminole County 1 City of Winter Springs
Day Cramp Provider Agreement
Page: 10 of 12
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, DAY CAMP PROVIDER shall complete and submit Standard Form-LLL,
"Disclosure Form to Report Lobbying„
(g) IngQr-poration afLaws. Rules_Regulations and Policies.
(1) DAY CAMP PROVIDER and COUNTY shall be governed by applicable
Federal and State laws, rules, regulations and policies.
(2) DAY CAMP PROVIDER shall comply with the State of Florida.
Dcpartrnent of Economic Opportunity Federally-Funded Sub rant Agreement, &,; amended,
attached hereto and incorporated herein as Exhibit D.
Section 11. Endure Agreement. This Agreement constitutes the entire agreement between
the parties hereto with respect to the specific matters contained herein and supersedes all provisions
discussions, understandings and agreements relating hereto and cannot be changed except in Wilting
signed by each of the parties to this Agreement.
IN WITNESS WHEREOF, the parties hereto have executed this Agreement on the dates
set fortl3 below the respective signatures.
ATTEST: CITY OF Wf-NTT'R SPRINGS
r
At, l,44 -t _ORENZO-LIJACES MAP,[ ES LACEY, \L-,,or
City [ lerk
Date:_Arril 14, 2014 _Y _
[Balance of this page left intentionally blank,-signaw es continued on page 121
Seminole County 1 City of Winter Springs
Day Camp Provider Agreement
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ATTEST: BOARD OF COUNTY COMMISSIONERS
SEMINOLi -D 1
MA1tY,:;NNE MORSE RO ,.RT DALLARI, CI. irmarl
Clerk to the Board of _
County Commissioners of Date;
Seminole County, Florida.
For the use and reliance As authorized for execution by the Board of County.
of Seminole County only. Commissioners at its _ /� 7�a ,�; . 20 /y ,
regular meeting.
Approved as to form and
legal sufficiency.
County :%ttomey — - - -
Attachments;
Exhibit A - Scope of Services
Exhibit B - Day Camp Program Matrix
Exhibit C - Monthly Report
Exhibit D State of Florida, Department of Economic Opportunity Federally-Funded
Subgrant Agreement Community Services Block Grant and Modification of
Agreement
Exhibit E - Request for Payment
Exhibit F - Day Camp Description and Program Cost
M('C'/Sjs
3114!14
P'IL 4eNlLsgal Srrtt[ary(",8%L.I.—L14 i t❑ti--,L -1 AV,—nl-R'mw 5pr,aen dor
Seir31 nole County 1 City of Winter Springs
Day Camp Provider Agreement
Page 12 of 12
EXHIBIT A
SCOPE OF SERVICES
Generalll,-
The Community Services Block Grant - (CSBG) includes a $411,271 appropriation for Seminole
County through the Department of Economic Opportunity (DEO). Of this funding $88,800.00
has been approved for a Day Camp Scholarship Program. The purpose of the Day Camp
Scholarship Program is to provide s safe environment for youth to enable working parents to
maintain employment during the summer months. Additionally, this program will enable youth to
avoid risk-taking behavior for a defined period of time.
The funds under the program are intended to target families that meet the following criteria:
■ Household must reside in Seminole County; and
■
Household's income must be at or below 125% of the Federal Poverty Limit (see chart
below);
In addition, the household's children)must meet the following criteria to be determined eligible:
■ Chifd(ren) must reside in Seminole County (at least 50% of the time); and
• Child(ren) must be between the ages of five (5) and fifteen (15).
125% of Federal Poverty Limit (Effective 4!412014)
1 Person T 2 Persons 3 Persons 4 Persons 5 Persons j 6 Persons 7 Persons 8 Persons
$14,588 $19,633 $24,73$ $29,813 $34,888 $39,963 $45,038 a $50,113
Specific Obligations:
1. SUBRECIPIENT shall reserve at a minimum the amount of spaces for eligible campers
as specified in the inter-Agency Day Camp Agreement, Exhibit B — Day Camp Provider
Matrix.
2. The SUBRECIPIENT will provide services listed by their agency as outlined in the Inter-
Agency Day Camp Agreement, Exhibit 8 - Day Camp Provider Matrix, for the equivalent
of a Day Camp Scholarship.
3. COUNTY shall ensure that the households receiving assistance meet all of the following
conditions:
a. Households receiving assistance meet the program eligibility as described
above.
b. Process invoiced payments within 30 days of receipt.
4. Administrative Costs, There will be no Administrative Cost reimbursements connected
to this agreement.
5. No SUBRECIPIENT board member, employee or any related family member of either
shall receive or obtain gain, profit, or benefit in the form of a commissions, fees, or
payment for any other related product or service funded under this Agreement.
6. SUBRECIPIENT shall submit completed monthly reports for the months of June, July
and August of 2014 in the form of Exhibit C to the Inter-Agency Agreement to the
1
COUNTY by the tenth (10"') day of July, August and September for the previous month.
The following categories apply_
a. Number of jobs created or retained.
i. Tracks the jobs created or retained because of the receipt of CSBG
Day Camp Scholarships.
H. Track the amount of hours each job (position) worked on a weekly
basis.
b. Number of campers receiving a Day Camp Scholarship for the month and
how many completed the program.
L Measures program success in contributing to parent's maintaining
employment and youth avoiding risk-taking behavior for a defined
period of time.
2
Exhibit R-Da Camp Program Matrix
Numher of Value of
Agency Scholarships Scholarships Weekly Charge Scholarships include Camper Ages _location Oates of Tamp [amp Hours
City of Allarnuata Springs 10, SS Dfknu $500/summor Camp and sale;a Held trips C:0 12 Iye't me Pa,L hu.^2,2014 August 1 ?019 7:DO Amt.5 001'M
Camp and s'elecr Held i1 13 to"15 7eagNei(ItJle SchUOI Jur,e 2,2014 Augu511,2019 7.00 AM L,(30 NO
F_ntcrinh ISL Er:n+ring
[ity�t Ca. alperry _ 25'
$7,L 00 $9Elwaek Camp a d i trips_ _7th Grade C issclbc,i Flemenr;ry lone r,2014)r V 25,1014 7 i J AM-6:00 I'M
Entering 1st grade
City LV Sw Oad _ 10 O2iSS.(i!j 59./Weak (,arrp,tield trips and t shirr Sth gi t- yw[ii,tl El,-en l Schual lucre 7,2014 AL;uSt 1.2014 7.1Q AM.u:O'PM
L lementa ry and
4 riddle
City of 4vieda srhoo_} t1_309.[T] 51301weeF=Y _ Carnp,1,=Ids mps and I-;b, A,,L,Lt o I R 7e Par F 2014-AuguV,8,2014 730ANI-6,OOP�7
f?sldent Fee
City of S-10'd 10" S.575.111r $70/—,Wv Camp,se!i ia!d gips and Li_ vro 1? Rlvenvalk Acaderrry June 9,?Ol!-August 1 told 7.30 AM-5 40 PM
-_..._ — fields trip;{3s/wee o-.�,rampt shirt,lunch
Ci iy of Winter Springs 1V' S990.Oi} ;110/weak'.y Ilxlweek} Entering Grades l-b Winter Springs 17—Center June?,201,-August'1,20'14 7.-30AM-5;3npM
__. -- Jun?2-0.'_914
June 5-13.2(`14
Iona.16 20,21
ne 11 227,3019
July 7-11.t014
fuly 14-'t8,2014
July 21-25,201.7
_minnle i:nimry Leisu re July 28-August 1,1414
Services 2weekly4 :2 3-,2 j141/wpei Iv Camp 11u 12 Ed Yarborough Nal ur=Canter 7_-10AM S�OPM
$IOr/weekly, _,rnplered
Seminole Caumy Pohce Athletic Soy kindergarten Lp 8th
1^ague IPirl,l n0" 5Y65.00 reyistratinv Foe Cam and an occassianel extra 11141 trio grade Juvenile`enrorcemenl Center June 2.201�AiS st 1,20119 7:00 Ali 00 PkI
rted[tug take Elementary C1ysral
3127/weak+ Eake Elemi Stn:astrum
s7,, riindergarLen-5[h E:emenlary Sp Lake
Se on,,W County School Finard 90` 51,155.00 registration fee Camp,lunch,and fvld taps Grade Eielmentary T ?urie 1._019--lurgust 1,2074 7.00 AV-5.170 PM
5..5+7/weak Jor June 2 11,2014
_week I,in!'lE 27,2014
sasslnns .lu rte 3CJ uiy it,201.4
5125Jweek
for July 14-25,2014
Cry m La-Mly 9" 51,1;5.W 1 weel:scssinn Camp,field to s,and hutch it field irip days h to 11 Lake Nla Cmroi Center Jul 22-cii 1,7.014 7,30 AM ;'M
.1p to the number of schclarshlps ava ilah!e FOi each camp depending upon d,,-,,d and h,ndina,availaihihty. If reservod spots are not filed with County appri campers by May I.,2014,
_�eacri,lay curnp provider rrrsarvts[lie right to open r;le sloes m rho generai public. _ - _
EXHIBIT"C"
MONTHLY REPORT
CSBG Day Camp Scholarship Program
Report must to submitted to Seminole County Community Assistance Division by July 101h,August 10e and September 10h.
Number of Jobs Created and Retained due to Day Camp Scholarships:
Month:
Total Weeks
Attended
Week 1 Week 2 Week 3 Week 4 Week 5 During
Child Name Aye 1 Weekly Rate I T I Month
Dates of
Week June 2-6 June 3-13 June 16-20 June 23-27
Number of
Days
Attended
batesoi - - - -- -
Week _
Number of
Days
Attended -
Dates of
Week _
Number of �,
Days
Attended
i Dates R 1
Week
Number of f
Days
Attended
Dates of �- - -- -
! Week
Number of
Days - - - - —L -
� , Attended
II. Campers and Day Camp Scholarship Information:
Month Number of Campers Receiving Day Number of Campers Completing Day Number of Campers Not Completing Reasons for Campers Not Completing
Camp Scholarships Camp Day Camp Day Camp
June 2014
July 2014
August2014 -- ------ — — I ---
W. Employment Information:
Month Number of Jobs Created Number of Jobs Retained
June 2014
July 2014
August 2014
Program Representative Signature: Date
EXHIBIT D
STATE OF FLORI134
DEPARTMENT OF ECONOMIC OPPORTUNITY
CFDA#� 193.569 Contract Number: 14SB-0 06-69-01-425
FEDERALLY-FUNDED SUBGRAN`I'AGREEMENT
THIS AGREEMENTis entered into by the State of Florida, Department of Economic Opportunity,
with headquarters in Tallahassee,Florida (hereimfter referred to as DEO),and e f t Dunn, rich,
(hereinafter referred ro as the"Recipient').
THIS AGREEMENT IS ENTERED INTO BASED ON ME FOLLOVTNG REPRESENTATIONS:
A, The Recipient represents that it is fully qualified and eligible to receive these grant funds to provide
the services identified herein;acid
B. DEO has recci,:ed these grant fluids frorn the State of Florida,and has the authority to subgrant
tlsese Funds to the Recipient upon the terms and conditions below,and
-C. DEO has statutory authority to disburse the funds under thia:Agreement.
THEREFORE,DEO and the Recipient agree to the following
(1) SCOPE OF WO
The Recipient shall performs the work in accordance with the Attachment A and Armclunents I-M
of this Agreement
(2) INCORPORATION
The Recipient and DEO shall be governed by applicable State and Federal latws,rules and
regulations,including those identified in Attachment B.
(3) 1-FjU0D(7F AGLLLNMN3'
This Agreement shall begin upon execution by both parties or Octol 2(ji whichever is
earlier,and shall end 5cptZMbg 3 ,unless taminared earlier iri accordance with the provisions of
Paragraph (12) of this Agreement.
(4) Di CA N S T
Either party may request modiEcation of the provisions of this Agreement. Changes which are
agreed upon shall be valid only when in writing,signed by each of the parties,and attached to the original of
chis Agreement.
{5} R�C3RI7KFEL'II�IG
{a) As applicable,Recipient's performance under this Agreement shall be subject to the federal
"Common Rule, Uniform Administrative Requirements for State and Local Governments"(53 Federal Register
8034) or OMB Circular No. A-I 10 (now 2 CFR Part 22 5), "Grants and Agreements with Institutions of Highex
Education,Hospitals,and Other Nonprofit Organizations," and either OMB Circular No-A-87 (now 2 CFR
Nrt225),"Cost Principles for State and Local Gorcrnments," 0A1B Circular No.A-21 (now 2 CFR part 220)
"Cost Principles for Educational Institutions," or OMB Circular No. A-122(now 2 CFR Part 230), "Cost
Principles for Nonprofit Organizations." If this Agreemenr is made With a commercial(for-profit)organization
— - - -- -- ---- -- - Page 1 - - - - - --- -- -
on a cost-reimbursement basis,the Recipient shall be subject to Federal Acquisition Regulations 312 and
931.2.
(b) All records perraining to tht Agreement,including but not limited to, supporting
documentation and records sufficient to demonstrate compliance with the teams of the Agreement including
personnel and fm mcial records and reports related to the jobs,wages,and cumulative investment required
under thin Agreement,shall be retained by the Recipient for five fiscal years after completion of the project,
which includes satisfaction of all repottiug requirements and teceipt of all pagments due under the Agreetn=r,
provided applicable audits have been released,or five years after the date that an audit report is issued,
whichever is longer, The five year period may be extended for the following exceptions;
1. If any litigation,claim or audit is started before the five year period expires,and ext(nds
beyond the five year period,the records shall be retained until aU litigation,claims or audit findings involving
the records have been resolved.
2. Records for the disposition of nou-expendable personal property valued at$5*00(}or more
at the time it is acquired shall be retained for free years after final disposition.
3. Records relating to real property acquired shall be retained for five years after the closing
on the transfer of title.
((;) The Recipient shall maintain all records for the Recipient and for all subcontractors or
consultants to be paid from funds provided undea this Agreement,including documentation of all program
costs,in a form sufficient to determine compliance with the requirements and objectives of the Budget and
Scope of Work and nil other app)icsble laws and regulations.
(d) The Recipient,its ernplo)rees or agents,including all subcontractors or consultants to be paid
from hands provided under this Agreement,shall allow access to its records at reasonable tines to DEO,its
employees,and agents. "Reasonable"shall ordinarily mean during normal business hours of&w a.m.to 5;00
p-m,local time,on Monday through Friday. "Agents"shall include,but not be 16)ired to,auditors retained by
DEO.
(c)The Recipient may,per Rule 1 B-24.093(9)(a),Florida Administrative Codc,allow its public
records to be stored through electronic recordkeeping systems as substitates for the originsi or paper copy.
(6) AUDIT REQLMEMENI'S
(a) The Recipient agrees to maintain ftnaacW procedures and support documents,in accordance
with generally accepted accounting principles,tv account for the receipt and cupenditure of funds under this
Agrcctnent
(b) These records shall,be available at reasonable times for inspection,review,or audit by state
pcxsonnel and other personnel authorized by DEO, "Reasonable"shall ordinarily mean normal business hours
aF 8:00 a.m. to 5:00 p.m,,local time,Monday through Friday.
(c) if the audit shows that all or any portion of the fiords disbursed were snot spent in accordance
with the conditions of this Agreement,the Recipient shall be held liable for reimbursement to DEO of 0 funds
not spent in accordance with these applicable regulations and Agreement provisions within thirty days after
DEO has notified the Recipient of such non-compliance-
Page 2
(d) The Recipient shall have all audits completed by an independent certified public accountant
[IPA),either a certified public accountant or a public accountant licensed udder Chapter 473, Lt, The
IPA shall state that the audit complied with the applicable provisions noted above. The audit rnust be received
by DEO no later than nine months from the end of the Reaipien is fiscal year.
M Rl f'9RT5
(a) The Recipient shall provide DEO with monthly reports,quarterly reports,a close-out report,
and the yearly Information System Survey report as set forth in Attachment C to this Agreement. These reports
shall include the current status and progress by the Recipient and all subrecipients and subcontractors in
completing the work described in the Scope of Work and the expenditure of funds under this Agreement,in
addition to any Other informatona requested by DEO.
(b)Monthly reports are due to DEO no later than the twenty-first day of each month following the
cod of the reporting month in which funds were expended.In the event the twenty-first day of the month falls
ou a weekend day or holiday,the monthly report shall be due no latex chart the next business day.
(c) Quarterly reports are due to DEO uo later than twenty-one calmdzr stays after the end of each
quarter of the program yeaz and shall be sent each quarter until submission of the admi6strative dose-out
report. The ending dates for each quarter of the program year are March 31,June 30,September 34 and
December 31.In the event the twenty-first day of the month falls on a weekend day or holiday,the quarterly
report shall be due no later than the next business day.
(d) The close-out report is due to DEO no later than forty-five calendar days after termination of
this Agreement or Forty-five calendar days after completion of the activities contained in this Agreement,
whichever first occurs. In the event the forty-fifth day falls on a weekend day or holiday,the Close-out report
shall be due no later than the next business day.
(e)The year end activity report is due to DEO upon notification by DEO to the Recipient that the
required activity report is to he submitted.
(0 If all required reports and copies are not sent to DEO or axe not completed in a manner
acceptable to DEO,DEO may v&hhold further payments until they are cosnple"or may take other action as
stated in paragraph (11)REMEDIE5. "Acceptable to DEO"means that the work product was completed in
accordance with the Budget and Scope of Work.
(g} The Recipient shat]provide additional progtarn updates or inforruatian as tnay be required by
DEO.
(h) The Recipient shall also provide the additional reports and information identified in Attachment C
(S) 14i�NIT�RING
The Recipient shalt monitor its performance under this Agreement,as welt as that of its
subcontractors and/or consultants who are paid from funds provided under this Agreement,to ensure that the
Scope of Work and other performance goals are being achieved. A review shall be done for each function or
activity in A tachment A to this Agreement
In addition to reviews of audits conducted in accordance with Paragraph (6)zbovc,monitoring
procedures may include,but not be limited to,on-site visits by Department staff,firnitzd scope audits,and/or
Page 3
other procedures. The Recipient agree_< to comply with the mast recent monitozirg rrsdnt121 provided by DEOP
and cooperate ufith any rnonktoz7ng procedwedpxocrsms deemed appropriate by DECD. Ir, the went that
DEO de;ermincs that a lirrtited scope review of the Recipient is appropriate, the Recipient agrees to comply
with any additional instructiam provided by[)EC)to the Recipient regarding such review. The Recipient
further agrees io comply and cooperate with any inspections,re-,riews, investigations or audits deemed iicctssa Lry
by the Florida Chief'Financial Officer or Auditor Ger_eraL In addition, DEO will=monster the pcxforrttance.
and Em2ncual manag,:n-rent by the Rc�ipiert throughout the contract term to ensaxe timely completion of aIi
tasL--
�a) Unles3 the Recipient is a stage agency or subdivision,as defined in Sc-ctacn 768,28,Fla.Stat.,the
Recipient is solely zesponsib[c to p=es it dens)x-ith in taming 0111 the terms of this Agreernent,and shall hold
DEO harmless against all cairns of whatever nature by third parties arising from the work perforraazcc under
thus Agreement. For purposes of this Agreetnmt,the Recipient agrees that it is not an employee or agent of
DEO,but ra arf itidepertdent contractor-
(b) Any Recipient which is a state agency or subdivision,as defined in Section 768,28,F . fi „
agrees to be fully respomible for its negligent or tortious acts or omissions which result in claims or suits against
DECD, asfd agrees to be liable for aay damages laroximately caused by its acts or omissions to the extent set forth
in Seel on 7GR.48, Fla-_Stint- Nothing heton is intended to serve as a wail er of rover unit,by any
Recipient to which sovereign imrnuuity applies, Nothing hcremi shall be comtmcd as consent by a state agency
or subdivision of the State of Flonds to be sued by thud parties in any matter arising out of any contract.
(1(7) [}EFALIZS
If any of the following events occur{"Event,of Default'),all obligations on the part of DFO to
make:further pa}-inert of funds shall,if DEC)elects, temuuate and DEO has the option to exercise any of its
remedies set forth in Paragraph (11). However,DEO may make payments or partial payments after grly
Events of Default without waiving tie right to exercise such remedies,and Without becDMwg liable to make wiy
further payment
(a) If any warranty or representation made by the Recipient in this Agreement oz any previous
greemeut with DEO is or becomes false or misleading in any respect, or if the Recipient fails to keep or
perform any of the obligations, tcmns or covenants in this Agreement or any previous agreement with DEC)
and has not cured them in timely fashion,ar is unable or unwilling to meet its obligations under this Agreement;
(b) If rnatrssial adverse changes occur in the frnarncial a-ndition of the Recipient at any titre during
the term of this Agreement,and the Recipient fads to (Mre this adverse change vAffiln thirty calendar days from
du date written notice is sent by 1710.
(r) If any reports requited by this Agreement have not been submitted to DEO or ha're been
<Amimt d with incorrect,incomplete or insufficient information;
(d) If the Recipient has failed to perform and complete in timely fashion any of its obligations
under Chia Agreetnent.
—— — — — Page 4 — —
[I1) RIyMED1E5
If an Event of Default occurs and DEO provides written notice to the Recipient,DEO may
exercise any one os more of the following remedies,either concurrently or consecutively:
(a) 'Terminate this Agreement if the Recipiect has not cured the default wit}min thirty calendar days
of receipt of written notice of an Event of Default,
(b) Begin an appropriate legal or equitable action to enforce performance of this Agreement,
(c) Withhold or suspend payment of all or any pant of a requesr for payment,
(d) Exercise any corrective or remedial actions, to include but not be Iinnited ro.
1. Request addstiomd information from the Recipient to determine the reasons for or the
extent of non-compliance or lack of performance,
2. Issue a written warning to advise that more serious measures may be taken if the situation is
not corrected,
3_Advise the Recipient to suspend,discontinue,or refrain from incurring costs for any
activities in question,or
4. Require the Recipient to zcimburse DEO for the amount Of costs incurred for any itetas
determined to be ineligible.
(e) Exercise any other rights or remedies which may be otlierwise available under law.
Pursuing any of the above remedies will not keep DEO from pursuing any other rrsnedies in
this Agreement or provided at Jaw or in equity. If DEO waives any right or remedy in this Agreement or fails
to insist on strict performance by the Recipient,it will not affect,extend or waive any other right or remedy of
DEO,or affect tlse later exercise of the same right or remedy by DEO for any other default by the Recipient.
(12) TER11+1NAT1 N
(a) DEO may teurmate this Agretxner,t for cause with thirty calendar days written notice Cause
includes misuse of funds, fraud,lack of compliance with applicable rules,laws and regulations,failure to
perform in a timely rrmanner,failure to cure an Fvent of Default within thirty calendar days from receipt of the
notice,or refusal by the Recipient to pertnit public access to any document,paper,lettet,or other rrfaterial
subject to disclosure under Chapter 119,Fla. Sta t,as amended.
(b) DEC►may terminate this Agteement for convenience or when it detcmdries,in its sole
discretion,dut continuing the Agreement would not product beneficial results in line with the further
expenditure of funds,by providing the Recipient with thirty calendar days prior written nonce.
(c) The parties may agree to terminate this Agreement for their mutual convenience through a
writterm amendrmcnt of this Agreement. The amendment shall state the effcmve date of the termination and the
procedures for proper closeour of the Agreement.
(d) if DEO issues a notice of Event of Default,the Recipient shall not incur new obligations
during the thirty day cure period. If DEO determines that the Recipient bas mired the event of Default within
the thirty day cure period,DEC)will.provide notice to the Recipient that it may resume incurring new
obligations, Costs incurred for new obligations after xeccipt of the notice of Event of Default will be disallowed,
The Recipient shall not be telieved of liability to DEO because of any breach of this Agreement by the
- Page 5 ---- - --- -
Recipient DEO shah,to the extent authorized by law,wi�hhold payments to the Recipient for the purpose of
set-off until the exact amount of damages due DEO from the Recipient is determined.
(13) NOT7 QF,a 1qD CO 'Z
(a) All notices provided under or pursuant to this Agreement shall be in writing delivered,by
standard mail or electronic mail,to the representative idcnt fled below at the address set forth below and said
notification attached to the original of this Agreement.
(b) The name and address of the Division,contract manager for this Agreement is:
Paula I. mmo,Bureau Chief
Department of Economic.Opportunity
Division of Community Development
Bureau of Housing and Community Development
Community Assistance Section
107 East Madison Street,MSC-400
Tallahassee,Florida 32399-4120
Email: Paula.lemcmo(crdeo.myflorida.com
(c) The name and address of the Representative of the Recipient responsible for the
ad.roitustration of this Agreement is staged in Attachment H of this Agreement.
(d) In the event that different representatives or addresses are designated by either party after
execution of this Agreement,notice of the name,tide and address of the new"Presentative will be provided as
stated in(13)(a)above.
(14) S[7BCQNTRACTS
If the Recipient subcontracts any of the work rtquixrA under this Agreement,a copy of djhc
unsigned subcontract must be forwarded to DEO for review and approval before it is executed by the
Recipient. The Recipient agrees to include in the subcontract that(i) the subcontractor is bound by the terms
of this Agreement,(ii)the subcontractor is bound by aU applicable state and federal laws and regu]atio,,,and
(iii)the subcommctor sW hold DEC!and Recipient hattnless against all claims of whatever mature arising out
of the subcontractor's performance of work under this Agreerncnt,to the extent allowed and required by law.
The Recipient shat]document in the juartedy report the subcontractor's progress in performing its work under
this Agreement.
For each subcontract, the Recipient shall provide a written ststement to DEO as to whether that
subcontractor is a utinority vendor,as defined in Section 288.703,ML StAt.
(15) URMSS ND GQND!nQNS
This Agreement contains all the terms and conditions agreed upon by the parties.
(15) A
(a) All attachments to this Agreement are incorporated as if set out fully-
(b) In the event of any inconsistencies ox conflict between the Language of this Agreement 2nd the
attachments,the language of the attachments shall control,but only to the extent of the conflict or
inconsistency.
— Page 6 —� -
5--Unvle Ccanty,Mnrda
(c) "This Agreement has the following attachments (check d that are applicable):
® Exhibit 1 Funding Resources
® Exhibit 2 Special.Audit Requirements
® Attachment A Scope of Work
® Attachment B Program Statutes and Regulations
Attachment C Reports
® Attachment D Property Management and Procurement
® Attachment E Statement of Assurances
® Attachment F Warranties and Representations
® Attachment G Ccttificavon Regarding Debarment, Suspension,Ineligibility and
Voluntary Exclusion
® Attachment H RecipientInforraatitm
® Attachment I Budget Summary
® Attachment j Subro*ent Information
® Attachment K Budget Detail
® Attachment L Secondass Administrative Expenses
® Attachment M 2013-2014 CSBG Canvnuaity Action Workplan
® Attachment N Justification of Advance Payment
(37} �„IND,}�G1CDN5��E��TTON
(a) This is a cost teimbursement Agreement. The Recipient shall be reimbursed for costs incurred
iA the satisfactory performance of work hereunder in an amount not to exceed 51Z510Z,subject to the
mailability of funds and appropriate budget authority. Until DEO provides further notice to the Recipient,
however,the Recipient is only authorized to incut costs in sn amount not to exceed $1Z.`+�2$2. As funds and
budget authority are aw@21ble,changes to the costs the Recipient may incur Will be aecornphshed by notice from
DEO to the Recipient by written notice to the Rrespieat's contact person identified in Atrachmeat H. The terms
of the Agreement shall be considered to have been modified to allow the Recipient to incur additional casts upon
the Recipient's receipt of the written a0dee from DEO.
(b) Any advance payment under this AgTeetrsent is subject to Section 23 5.161(3 fi),Fier ind is
contingent upon the Recipient's acceptance of the rights of DEO under Paragraph(I 2)(b)of this Agreement
The amount which m2y be advanced may not exceed the expected cash needs of the Recipient within the first
three months of The contract term, Any,advance payment is also subject to federal OMB Circulars A_87 (na"2
CFR Part 225),A-110 (now 2 CFR Part 215),A-122(now 2 CFR Part 230) and the Cash Management
Improvement Act of 1990, If au advance pa)nent is requested,the budget data on which the request is based
and a justification statement shall be included in this Agreement as Attachment N. Attachment N coil!specify tlic
amount of advance payment needed and provide an explanation of the necessity for and proposed use of�hese
funds.
Page 7
(c) Alie: the initial advance,if nay,payment shall be made ori a teunburscment basis T'he
Recipiem agrees to expend funds in accordance with Atrac-� ,vm I,Aaachment K.and Attachrrieat l� of this,
Agreernen t
If the neces5a-_,y funds are not avail-able to fund this Agreement as a T-alt of ac-tam by the United
Stites Co.-bless, the federal Office of Management and Budgeting, Mae State Chief Fmi g_Ftcial pfftces 4f under
Subparagraph (i 9)(h) of 1is Apieemeva A obhgatons on the.part of DEO to make any further payment Of
funds shall terminate,ir_d the Recipient shah submit its closeout report widhin fom-five cajeadar days of
-ecei"ig notice from D1=-+O.
(1 Hf AEE YMENTS
All.refunds or repayments to be trade to DEO under ribs Agrecracra.t ate to be made payable t,a the
ordrz of"Dcpi-mrcrit of Economic Opportunity„and mailed directly to DEO at the following address:
Department of Econorruc Opportunity
Divisioa of Corrtnu uty Development
Office of Housing and Corranurnty Development
Cormmimity Assistance Section
107 East Madison Street
MSC 400
Tallahassee,Mr-dda 3.231)9-4120
In accordance with Section 21534{2), tat-,if a check or other draft is rerumed to DEC) for
coflection, Recipient shall pap to DEO a service fee of Fifteen Dollars (115.00)or Five I'caccnt 0%)of the fact
smount of the*emrned check or draft,whichever is greater.
(19) MAN-QAT•E.D CONDITIONS
(a) The validity of this Agreement in subject to the truth and ao- iva--y of aU the irifotrmatior.,
xepresentsdons,and materials sub nutted or provided by the Recipient in this Agreement . any later subzzussicm
,or response to; Deparimernt request,or in any.submission or response to fialfil3 the requirements of this
Agreement. 111 of said imfomaaeion representadans,and materials afe incorporated by reference. 'Thc
inaccuracy of the submissions or any marestal changes shall,at the option of DEO and with thirty days wiitte.2
notice to the Recipient,cause the termination of chic Agreement and the release of DEO from all its obligations
rc the Rccipicnt-
(b) This Agreemert shall be coriattued under the laWS of tbC State of Florid;,and venue for an❑
araons;'nsrng out of this Agreement shall be in the Circuit Court of Leon County. If any prov sion of this
Agreement is iu conflict with any applicable stahitc or rule,or is unenforceable, then the provi5ian shall be null
and void to the extent of dLe conflict,and ahaE be severable,but shall not invalidate any othei provisio,,of this
Agreement
(c) clay power of approval or chsapproval granted to DEO under the terms of this Agreement
shall survive the terrn of this Agreement.
(d) This Agreement may be executed in =7 number of countezpa ts, ally one o E wiaich may be
taken as an ofiggtnal.
— -- Fagea3 - -- ---
(e) The Recipient agrees to cctnply with the Americans With Disabilities Act(Public Law 101-
336,42 U.S.C.Section 12101 gt are . and the Florida Civil Rights and Fait Housing Am sections 760.01 –
76i1,37,Floii&Statutes,which prohibit discrimination by public acrd private entities on the
basis of disability in employment,public accommodations,transportation,state and local government services,
and telecommunications.
(0 A person or organization who has been placed on the convicted vendor list following a
conviction for a public enrity crime or on the discriminatory vendor list may not submit a bid on a contract to
provide any goods or services to a public entity,map not submit a bid on a contract with a public entity for the
construction or repair of a public building or public work,may not submit bids orQ leases of real property to a
public entity,may not be awarded or perform work as a contractor,supplies,subcontractor,or consultant under
a contract with a public entity,and may not transact business oath any public entity in excess of$25,0()0.00 fora
period of 36 months from the date of being placed on the convicted vendor list or on the discziraM rory
vendor list.
(g) Any Recipient which is not a local government or state agency,and which receives funds under
this Agreement from the federal government;certifies,to the best of its knowledge and belief,that it and its
principals;
1. Are not presently debased,suspended,proposed for debarment,declared ineligible,or
voluntarily excluded from covered ttznsacdons by a federal department or agency;
2. Have not,within a three yrar period preceding this proposal been convicted of or had'a
civil judgment rendered against therm for cornrnission of fraud or a criminal offense in connection with
obt6a g,attempting to obtain,or perforsrringa public (federal,state or local}transacdon Or contract under
public. transaction;violation of federal on state antitrust statutes or coa=aission of embezzlement,theft,forgery,
bribery,£aLsificatioo or destruction of records,making false statements,or receiving stolen property,
3. Are not presently indicted or otherwise criminally or civilly charged by a governmental
entity(federal,state or local)with commission of any offenses enumerated in Paragraph 19(6)2.of rho
certification;and
4. Have not within a three-year period preceding this Agreement had one or more public
transactions{federal,state or locaD termimted for cause or default.
If the Recipient is unable to certify to any of the statements in this certification,their the
Recipient shall attach an explanation to this Agreement.
In addition, the Recipient shall send to DEO(by standard mail or electronic methods)the Completed
Attachment G for each intended subcontractor which the Rccipiexrt plans to fund under this Agreement. Such
form must be received by DBO before the Recipient enters into a contract with any subcontractor,
(h) The State of Florida's performance and obligation to pay under this Agreement is contingent
upon an annual appropriation by the Legislature,and subject to any modification in accordance with Chapter
216, a. t.or the Florida Constitution.
(� All bills for fees or other compensation for services or expenses shall be submitted in derail
sufficient for a proper pmaudit and post-audit thereof.
-- — Page 9 -- - —
0) Any bills for travel expenses shall be documented in accordance with Section 112.061, t.
(k) DEO reserves the tsgbt to unilaterally cancel this Agreement if the Recipient refuses to allow
public access to th documents,papers,letters,or other material subject to the provision's of Chapter 11 Fl,
5Sgtt.,which the Recipient created or received under this Agreement.
(]) If the Recipient is allowed to temporarily invest any advances of funds under this Agreement,
say interest income shall be returned to DEO-
(m) The State of Florida will not intentionally award publicly-funded contracts to any contractor
wbo knowingly employs unauthorized alien workers,constituting a violation of the employment provisions
contained in 8 U.S.C.Section 1324a(e) (Section 274A(e)of the Immigration and Nationality Act("INA')).
DEO shall consider the employment by any contractor of unauthori2ed suers a viO-"On of Section 274A(e)of
the INA. Such violation by the Recipient of the employment provisions contained in Section 274A(e)of the
INA shall be grounds for unilateral cancellation of this Agreement by DEO.
(n) 717e Recipient is subject to Florida's Government in the Sunshine Law(Sectiau 28fi.011,
,5�)with respect to the meetings of the R.e4ieat's governing board to discuss,Yeceive recommendations,cr
take action required pursuant to this Agreement or the meetings of any subcotmrn tree making
recommeadations to the governing board regarding matters pursuant to this A�Fe=mt. All of these meetings
shall be publicly noticed,open to the public,and the minutes of al!the meetings shall be public records,
Available to the public in accordance with Chapter 119, .�StaL
(o) All uarna nufactured and manufactured articles,materials,and supplies which are acquired for
public use wader this Agreement must have been produced in the United States as required under 41 U.S.C, IO2,
unless it would not be in the public interest or unreaso=ble in cost.
(20) LORMaNG EROEMITION
(a) The use of funds under this Agreement for the purpose of lobbying the T.egisisture,the judicial
branch,or a state agency is prohibited pursuant to Section 216347,P.S. Federal grant funds provided under
this Agreemmt may not be used by DRO or any Recipient or Subrecipient to support lobbying activities to
influence proposed or pending Federal or 5tste legislation or appropriations. This prohibition is related to the
use of.Federal grant funds and not intended to affect an individual's right or that of any organization,to pEti6on
Congress,or any other level of Government,through the use of other resources(See 45 CFR part 93)
(b) The Recipient certifies,by the authorized representative's signature to Ibis Agreement,that to
the hest of its knowledge and belief:
1. No Federal appropriated funds have been paid or will be paid,by or an behalf of the
Recipient,to any person for influencing or attempting to influence an officer ar 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 arny 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,
page — -- —
10 - -
an officer or employee of Congress,or an employee of s Member of Congress in connection with this Federal
contract,grant,loan or cooperative agreemmt,the Recipient shall complete and submit Standard Form_LLL,,
"Diselasure Form to Report Lobbying."
3. 'T'he Reciplent shall require that this certification be included in the award documents for
all subawards(including subcontracts,subgrmts,and contracts under grants,loans,and cooperative agreements)
and rhat all subrecipieuts shall certify and&.sclosc.
This certification is a material representation of fact upon which reliance was placed when this
trartsaction was made or entered into. Submission of this certification is a prerequisite for making or enteting
into this transaction imposed by Section 1352,Title 31,U S.Code Any person who fails to file the requited
certification shall be subject to a civil penalty of not less than$10,000 and not more than$100,000 for each
such fidure.
(21) COPYRIGHT.PATI,NT AND TRADEMARK
ANY AND ALL PATENT RIGHTS ACCRUING UNDER OR IN CONNECTION
WITH THE PERFORMANCE OF THIS AGREEMENT ARE HERESY RESERVED TO THE
STATE OF FLORIDA. ANY AND ALL COPYRIGHTS ACCRUING UNDER OR IN
CONNECTION WITH THE PERFORMANCE OF THIS AGREEMENT ARE HEREBY
TRANSFERRED BY THE RECIPIENT TO THE STATE OF FLORIDA-
(a) If the Recipient has a pre-existing patent or capynght,the Recipient shall retain all rights and
entitlements to that pre-eidst ug patent or copyright unless the Agreement providers otherwise,
(b) If any discovery or invention is developed in the course of or as a result of wont or services
performed under this Agreement, or in any way connected with it,the Recipient shall refer the discovery or
iovention w DEO for a determination whether the State of Fioitida will seek parent protection is its name. Any
patent right~accruing under or in connection with the perforrrauce of this Agreement are reserved to the State
of Florida. if any books,manuals,f-ilrns,or othez copyrightable material are produced,the Rec ipieet shall notify
DEO. Any copyrights accruing under or in connection with the performance under this Agreement at=
transfeued by the Recipient to the State of Florida.
(c) Within dtirty calendar days of execution of this Agreement,the Recipient shall disclose all
intellectual properties relating to the performance of this Agreement which it knows or should{mow could give
rise to s patentor copyright The Recipient shall retain all rights and entitlements to 2n}'pre-rxistingintelleetual
property which is so disclosed. Failure to disclose will indicate that no such property exists, DEO shall then,
under Paragraph (h),have the right to aU patents and copyrights which accrue during performance of the
Agreement.
(22) LEQA1,.&MMZA ON
The Recipient certifies that it has the legal authority to receive the funds under this Agreement a.nd
chat its governing body has authorized the execution and acceptance of this Agreement The Recipient also
certifies that the undersigned person has the authority to legally execute and bind Recipient to the terms of this
r�greetnent.
Page - —
11
(23) SSURAI�ICFS
The Recipient shall comply with any Statement of Assti iarnces incorporated as Attachme-nt E.
Page
12
STATE OF FLORIDA
DEPARTMENT OF ECONOMIC OPPORTI NNITY
FEDERALLY FUNDIED.5UBGR.ANT AGREEMENT
SIGNATURE PAGE
IN WITNESS W-MRFOF,the parties have executed this Agreement by their duly authorized officers
on the day,month and year set forth below.
RECIPIENT STATE OF FLORIDA
DEPARTMENT OF ECONOMC OppoRTUNITy
Seminole County Board of County Commissioners
(Type Lc& f c
William B,Kdliugsw rth,�icector
I�o3ert A� ark,_ C#airman_ Division of Cornrn, n t} Development
(Ty
pc Name and Tide Here)
Date: + 1 ? Date- `
596000856 Approved as to form and legal
Ftdcral Identification hlurnbcr sufficiency,subject ody to fuff and
proper execution by the parties.
D67834358
DUNS' Dumber Office of the General Counsel
Department of Economic Oppornan p
rData Universal Numbering System
Approved Date,� �3p 2� o
Page
13
EXHL131T 1
FUNDING SOURCES
FEDERAL.RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO TILLS AGREEIMEE-NT
CONSIST OF THE FOLLOWING:
Federal Program: Community Services Black Gran:Program
F'edetal Agency: US- Department of Health u,-d I Iutr:ara Services
Federal Award Identifier: G-I 2M2'LCOSR
Catalog of Federal Domestic Assistance Tide: Ccmmumt} Sen-ices Block Grant Program
Catalog of Federal Domestic Ncunber: 93.569
Recipient;Serrmoie Counry,Florida
Award Amount: $175,282
COMPLLANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED
PURSUANT TO T141 AGREEMENT ARE AS FOLLOWS:
Compliance Requirements ]Program
t, Firr raqrriFrrrew(e.g.,eligihh cdrvatvci rewires orzomnio&irr) Community Services
Black Grant
The Recipient shall use the CSBG funds to provide a range of services and
activities having a measurable and potentially major impact❑❑poverty in
the corimiunides where poverrg is a paruculady acute problem. These
funds will be expended in accosdanc:e with Attachment A,Attachment B,
attachments I-M,applicable OMB Circulars,and die FY 2013 -2014
CSBG State P",
2 Socnnd applxable mmpliara rrrfurirrmerst(r g, El,r ihz#DF irqurrementr fornrytiarxl3 a)' Cornmurtity Services
fideral rdwmmi) Block Grant
The Recipient shall comply with applicable 01vM Circulars acid eligibility
realuiremenn as set forth in the U-S. Departrnmt of Flcalth and Human
Services regulaiions codificd in Tide 4$of the Cade of Federal Regulations,
part 96—Bieck Grazsts,and Title 31 of the Code of Fcdecal Rcgulations,
Part 205—Cash Management improvement Act of 1990.
3_T'brrd applr'ea61t.'arnptiance rrgidrrmenr(e g_,rlane of rhefa funrlr wilt be raid for C ornmuaity Services
mrecrchpurpo.rer) Block Grant
NOTE:Section.400(d)of OMB Circuln A-133,as revised,and Sccdori
215,97(5}, Flocida Statutes,zequire that the information about Federal
Programs and State Projects included in Exhibit'1 be provided to the
R.egpient
STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS AGREEMENT
CONSIST OF THE FOLLOW[NG: None
MATCHING RESOURCES FOR FEDERAL PROGRAMS_None
SUBJECT TO SECTION 215,97,FLORIDA STATUTES:
State Project:Nonc
COMPLIA,NCE REQIAREMENTS APPLICABLE TO STATE RESOURCES AWARDED
pURSUWr TO THIS AGREEL► ETN r ARE AS FOLLOWS: None
Pege 14
EXHIBIT 2
SPECIAL AUDIT REQUIREMENTS
The administration of funds awarded by the Department of Economic Opportunity% Division of Camtnuraty
Development(DED) to the Recipient may be subject to audits and/or monitoring by DEO, as descxibed in this
section.
MONITORING_
In additien to reviews of audits conducted iii accordance with OMB Circular A-133 and Section 215.91, F.S.,as
revised (see "AUDITS" below), monitoring procedures may include, but not be limited to, on-site visits by
DEO staff,limited scope audits as defused by OMB Circular A-133, as revised, and&r other procedures. By
entering into this agreement, the Recipient agrees to comply and cooperate with any monitoring
procedures/processes deemed appropriate by DEC. In the event DEC) detem-lines that a limited scope audit
of the Recipient is appropriate, the Recipient agrees to comply with any additional instructions provided by
DEO staff to the Recipimt regarding such audit. The Recipient hrrthet agrees to comply and cooperate with
any insperrious, reviews, investigations, or audits deemed necessary by the Chief Financial Officer (CFO) or
Auditor General.
AD-0-115
PART I. FEDERALLY FUNDED
This part is applicable if the Recipient is a State or local government or a nonprofit organization as defused in
OMB Circular A-133,as revised.
9. In the event that the Recipient expends $500,000 or more. in Federal awards in its fiscal year_ the
Reupiect must have a single or program-specific audit conducted in accordance with the provisions of
OW Circular A-133, as revised. EXHIBIT 1 to this Agreement indicates Federal resources awarded
through the Department of Health and Human Services by this Agreement In determining the Federal
awards expended in its fiscal year,the Recipient shall eomider all sources of Federal awards,including
Federal resources received from the Department of Health and Hun n Smices. The determination of
amounts of Federal awards expended should be in accordance with the guidelines established by OMB
Circular A-133, as revised_ An audit of the Recipient conducted by the Auditor General in accordance
with the provisions ONO Circular A-133,as revised,will meet the requiremems o f this part
2. In connection with the audit requirements addressed in Put I, paragraph 1, the Recipient sbdl fir a
the requiremexsts relative to auditee responsibilities as provided in Subpart C of OMH Circu}sr A-133,
as revised.
3. If the Recipient expends less than$500,000 in Federal awards in its fiscal year,an audit conducted in
accordance with the provisions of OMB Circular A-133, as revised,is not required. In the event that
the Recipient expends less than$500,000 in FederaI awards in its fiscal year and elects to have an audit
conducted in accordance with the provisions of OMB Circular A-133,as revised,the Lost of the audit
must be paid from non-Federal resources (i.e., the msr of such an audit rnust be paid frozrt the
Recipient resources obtained from other titan Federal entities).
d. If not otherwise disclosed as required by section .31*)(2) of 0M3 Circulat A433, as revised, the
schedule of expenditures of Federal awards shall identify expenditures by contract number for each
contract with the Department of Economic Opportunity in effect during the audit period.
5, r? web site that provides links to several Federal Singe Audit Act resources can be found at
http:l/harvester.ernsus.gnvJsacl sainfo.htxnl.
--__ Page
i5 — —�
PART- II: STATE FCNDED
This part is nppllcable if the Recipient is a nonstate entity as dcfmtd by Section 215.97(2),Florida Statutes
In the event that the.Rcap_mr experds a total amount of state frrrancial assistauce c911al to ar in cccess
of$506,000 in any fiscal year, the Recipient must have z State single ox project-specific audit for such
fiscal year in aecordancc urith Section 215-97, Florida Statures,- applicable rules of the Department of
Financa2J Services; and;and Chapters 10-550 (local gpvcrnrmental enttttes./or 10.650 (nonpzofrt and for-
proft organizstzons), Rules of the Auditor General. Exhibit I to this i'gretment indicates state
futancial assistance awarded thxottgh DEO by this 9greemcnt. In deterrrnining the State financial
assistance expended in its fisca] year,the Recipient shall consider all state 5naucta3 assistance; including
state financial assistance received from other state agencies and other nonstate entities. State fin',ncrai
assistance does not include Feder-al direct or pass-through awards and resaurces received by a nonstate
entity for Federal program matching tequitetnents.
2 In connection with the audit requiretnents in Part 11, paragraph 1, the Recipient sijall ensure tttat the
audit complies wid} the requirements oaf Section 215.97(8), Florida Statutes. T hi s includes st>brtvssion
of a financial rep os-t ng package as defined by 5ectioo 215.97(2), Flanda Stag}ter,, and Chapter 10.550
[1cxa1 governmental entities) or 10,650 (nonproEtt and for-ptofit orgarnizatsons). Rules of the .Auditor
General.
3. If the Recipient expends less than $500,1600 in stare financial assistance in its fiscal year, as audit
conducted in accordance wth the provisions oC Section 215.97, Florida Stanrtes, is not required In
the event that the Reapimt.expends less than$500,000 in state financial assistance in its fiscal year and
elects to have art audit conducted M' accordance with the provisio*_ts of Section 215.97 Florida Statutes,
the cost of the Audis must be paid from the nonstate entity's resources (i.e,, the cost of such an audit
must be paid from the Recipient funds obtained from other than State enritiess).
4, The Recipient must include the record keeping requirements found herein m subrmpients, contract;
and subcontracts entered into by the Redpient for work required t1ndet terms of this Agreeement In
the executed subcontract,the Recipient shall provide each subreripient of state firianctal assistance t}te
information needed by the subrecs cm to comply with the requirements of the 5in$le Audit Act,
Pursuant to Section 215.97(7], Florida Statures, the Reapient shall review and mormoc subrerdpient
audit reports and perform other procedures as specified in rbe agreement with the subrecipient, w}liar
may include onsite visits. The Recipient shall require subrecipients, as a condition of reserving state
daaricbJ assistanct, to permit tkle independent auditor of the Recipient,the state awarding agency, the
Chief Fipancial Officer, the Chief Inspector• General, and the Auditor General access to the
submapient's records and independent auditor's worldrtg papers as necessary to comply "with rye
requattneats of fire Single Auclit Act
S. For information regarding the Florida Single Audit Act irtcludwg the Florida(;a�]dg of State Financpal
Assistance (CSFA), the Recipient should access the website for the Florida Department of Financial
Services located at h s: a d s.ca fsaa for assistance. In additiao to the above website, the
following websires IAay he accessed for additions_ information: The Florida Legislarure's website
l www.] ,state.Q_ s and the Florida Auditor General's website sea e. I.u, a n.
u 'lie CSFA ntnnbex for this project is: aon--applicable.
PART 111, OTHER AUDIT REQUIREMENTS. non-applicable.
— — — Page --
PART W. REPORT SUBMJSSION
I. Copses of reporting packages for audits conducted in accordance with(DMB Cirettlar A-133,as revised,
and required by PART I of this agreement shall be submitted,when required by Section.320(d),0,M5
Circular A-133,as revised,by or on behalf of the Recipient directly to each of the Following
A. DEO at the following address:
Ms.Paula Lemmo,Buaeaa Chief
Departmeut of Economic Opportunity
Division of Community Devdopmcar
Community Assistance Section
MSC 400.147 East Madison Street
Tallahassee,Florida 32399
B. The Federal Audit Clearinghouse designated in OMB Circular A-133, as revised (the number of
Copies required by Sections .324 (d)(1) and (2), OMB Circular A-133, as revised, should be
submitted to the Federal Audit Clearinghouse).at the following address:
Federal Audit Clearinghouse
Bureau of the Census
1241 East lath Street
Jeffersonville,IN 47132
C. Other Federal agencies and pass-through entities in accardance with Sections.3ZO(e)and ({,pM$
Circular A-133,as revised.
Z Pursuant to Section .320 (f) OMB Circular A-133, as revised, the Recipient shall submit a Copy of the
reporting package described in Section.324 (c), OMB Circukt A-133,as revised,and any management
letter issued by the auditor,to DEO at each of the addresses in paragraph 3 below,
3. Copies of financial reporting packages required by PART 11 of this agreement shall be submitted by ar
on behalf of the Recipicnt d>Y 19 to each of the followings
A. DEO at the following address:
Department of Econornic Opportunity
Office of the Inspector General
Community Assistance Section
107 East Madison Street
MSC 130,Caldwell Building
TaUshassee,Florida 32399-4120
B. The Auditor General's Office at the following address:
Auditor General's Office
Room 441,Pepper Building
121 West Madison Street
Tallahassee,Florida 32399-1450
4. Any reports, management letter, or other ioformauon required to be submitted to DEO pursuant to
this agreement shall he submitted timely in accordance with OMB Circular A-133,Florida Statutm,and
Chapters 10.530 (heal govemmerstal entices) or 10-650 (nonprofit and for-profit organizations),Rules
of the Auditor General,as applicable,
- ----- Page _ ��
S. The Recipient, tither) subcairting financial reporting packages to DEO for audits done in accordance
with OMB Circular A-133 or Chapters 10.550 [local governmental entities) or 10.650 (nonprofit and
for-profit organizations), Rules of the Auditor General,the Recipient should indicate the date that the
reporting package was delivered io the Recipient in corxcspoadmce accompanying the reporting
package.
PART V'RECORD RETENTION
The Recpient shall retain sufficient records demonstrating its compliance with the terms of this agreement for a
period of five years £roan the date tl]e audit report is issued, and shall. allow DEO or its designee, CFO, ox
Auditor General access to such records upon request- If any liti bon,claim negotiation, audit,or other action
involving the records has been started hefore the expiration of the five year period,the records shall be retained
until completion of the action and resolution of ag issues which arise from it, or until the end of the five year
penod,whichever is later. The Recipient shat ensure that audit working papers are trade available to DEO,or
its designee,CFO, or Auditor Genera]upon request for a period of Five years from the date the audit report is
issued,unless extended in writing by DEO.
- Page ,
FY2014 CSBG AGREEMENT
ATTACHMENT A
8 f,,OPE OE Wj2
A. DEFINITIONS
(1) "Con=uniry Services Block Grant'—CSBG
(2) "Federal—Law"-tualess otherwise specified,the Community Services Block Grant Act of 1981,public
Law 97-35,as zmcnded and 45 C.F.R.farts 16,74 and 96.
(3) "Recipient"- the qualified applicant that receives funding pursuant to this Agreetoent for an
approved program and operating budget for delivery of eligible.services.Recipients include eligible
entities,migrant and seasonal farmworker organizations,and local gaveraments as defused in the
following paragraphs(a)-(c),provided such Recipient is in good standing or has not been determined
ineligible,
(a) "Eligible entity"• any organization,public or nonprofit,officially designated as a
community action agency or a community action program under the Federal Legieiative
provisions of Section 210 of the Economic Opportunity Act of 1944, for fiscal year 19g}
or established after 1981 in compliance with federal taw to-serve azeas uvt served by an
existing eligible entity. If such community action agency or Community action program
lost its designation under Section 210 of such Act as a result of s f0ure to comply with the
pxevisiaas of said Act or who has been dctenniued ineligible,a replacement community
action agency will be designated in accordance with provisions of Federal Law.
(b) "Migrant and seasonal farmworkes osg nization"-an organization funded to provide
direct services to a targer population of'rnigmot and seasonal farmwotkers under the
CSBG Program and having a'Board of Directors composed of at least 51 percent
representatives of rnigzant and seasonal fazmworkers.
(c) `Local governtnmt"or`local governing aathorit�'-the governing body of a county or
municipality.
(4) "Administrative expense"- those costs that refer to central executive functions that do oar directly
support a specific project or service.Costs that ate'incurred for common objectives that benefit
multiple programs administered by the Recipient.Adman zuative expenscs relate to the general
management of the organization,such as strategic direction,board development,Executive Director
functions,accounting,budgeting,personnel,proeuremeat,and legal services. (Informatics,
Memorandum from the Office of Coutrstnity Services for the United States Depwmcnt of Health
and Humans Services,IM-37(Match 12,2013).
(5) `Program expense" program costs that can be specifically identified with delivery of a particular
project,service, or activity undertaken by the Recipient to achieve an outcome intended by the
funding program Program expenses can include expenditures on some activities with administrative
qualities,including salaries and benefits of program staff and massagers,equipment,trti Mg,
conferences,travel,and contracts that expressly relate to the delivery of an individual program or
- f Page _ _
service Forded by a specific grant source. (lnfoxm2don Memorandum from the Dffice of Coununiry
Services fox the Ut ited States Department of Health and Hums-zi Services,1M-37 (March 12,2013).
(G) "Secondary admiaistrative expense"-an administrative expense to support eligible activities as
defined in Paragraph(1 Q)below,but whose program activities are directly funded or governed by a
source other than CSBG.
(7) "Community Action Plan"–the CSBG Community Action Workplan, Attachment M,of this
Agreement.
(8) "Household"-an individual or group of individuals living together as one economic unit.
(9) "T*ble participant"-those individuals whose total countable household income from all household
mcrnbers does not exceed 125 percent of the current Office of Management and Budget poverty
Guidelines.
(117) "E4ble activities"—include,but are not bmited to, the following.
(a) A range of services and activities having a measurable and potentially major irapact on
causes of povuty in the comrnuniry or those areas of the cormunity where poverty is a
particularly acute problem;
(b) Activities designed to assist eligible participants with low-income to.,
E Secure and retain mean+,gfW employrnenr,
2. Attain an adequate education;
I Make better use of available income;
4. Obtain and maintain adequate housing and a suitable living environment;
5. Obtain emergency asii tanec to meet itwmediate and urgent individugj and farrdy needs,
including the need for health related assistmcc;
G.Remove obstacles and solve problems that block the achievement of self-sufficiency
7. Achieve greater participation in the affairs of the community,and
8. Make more effective use of ather programs related to the purposes of the Community
Services Blocks Grant Act.
(c} Provide,on an emergency basis,for the provision of such supplies and services,nutritious
food-stuffs,and related services,ss may be necessary to counteract conditions of
starvation and malnutrition among individuals with low-income;
(Cl) Coordinate and establish linkages between governmental and other social spices
programs to assure the effective delivery of such services to individuals with low-income;
(e) Encourage the use of entities in the private sector of the community in efforts to
ameliorate poverty in the community.
(f} Other activities which may be approved in writing by DEO.
(#1) "Population"means total number of residents for each county,excluding inmates of institutions,as
extrapolated from the latest official State esti nrte of population by the University of Florida Buseau
of Economic Research and Development. For limited purpose agesmies as designated under title 11
of the Economic Opportunity Act of 1964 for fiscal yeu 1981 whiCh served the general purposes of
— _ page
9 commurury actrou agency under title II of such Act,"population"zoeam the total estimated
number of residents fox each county or service Brea raeetmg the def rlition of that limited progzarn.
B. E C Y N
(1) In accordance with the requirements of 42 U.S.C, 991Cta), a community action agency or
nornprc4it private organization receiving CSBG funds pursuant to this Agreement shall establuh a
board so as to assure that
(a) At least one-third of the members of the board are eected public officials,currently bolding
office,or their representatives,Letters re-affirming the delegation,signed by the eIea,-d
officials,shall be required each year regardless of the number of years the teens run,Agencies
providing services in multi-county areas are required to submit to DEQ a plan to ensure
representadon of every countl,served.When an entity expands to include a new county into
its service area,the new county must be represented on the board by an elected public official
currently holding office,or their representative for the First two years,
(b) At least one-third of the members are persons Chosen its accordance with democratic
selection procedures adequate to assure that they are representatives of individufls and
families with low-income in the area served.Each member selected to represent a specific
neighborhood within a community roust reside in the neighborhood represented by the
member.
(c) The remainder of the members are officials or members of business,imdustry,labor,religious,
welfare,education,or other major groups and interests its the community. Interest groups are
orgarsiZations with nonprofit status,incorporated and registered With the office of the Florida
Secretary of Stare.
(2) In the rase of a public orgarazation receiving CSBG funds pursuant to this Agreement,such
organ.izadon shall establish a board meeting the requirements of 42 U.S.C.9910(b),
(3) The Recipimt shall demonstrate that the CSBG program is adnuaistmed through 7 tripartite board
that rneets the requirements of 42 U.S.C.9910(a)or(b)by maintaining documentation imludkC'
but not limited to,the following:
(a) Board member application,resume,letter of intent to serve,background check or due diligence
documentation
(b} Minutes of the member's seating
(c) Appointment letter
(d) Yearly reaffumatioa letters (for public sector members)
(c) Vacancy declaration
(f} Resignation lettet or notiFication of term end
(g) Election selection documentation(for low-income sector members)(h) Excused/unexcused
absence documentation
Page -— --
21
(d) The board of ds_zcc-tors unit folly pat-�cipate W the devclopmrnt,pluiring, implementatzota.and
evaluation of tite CSBC,program to serve commumuco,anc individual;with l--income. Full
pavuclpation invades,but is not Emi7ed to,regulst arrendaucc at board ntect zgs,pa•ticipatiou on
Board co*nmirtre�,?razicdge of the orgaaizat_ion's ❑fission and goals,and fiduciary dudes.
(5) The Recipient will have a proccdure wluch tivil a_]ow ndividuals with low-income,corrMUnity
orQanizaaons,and religious orgarsrations m petition fn=adequate represenratiosz on the board if
they fe-j madequately representcd.
(Cr) AL)board of directors meetings titd board committee meetings subjecr to Florida's Government ill
the Sunshine Law(Section 286.011,Fla. Stat.),as stared in Fatagraph (1 9)(n) Of UhL Agreement,
-;ha11 be pubLcly roticcd at least seven caiendw days but bat more than thitt7 calendar days prior t:-i
the date on which the mceting is scheduled Such notices must be given by pubhshicg meeting
information by methods acceptable under dye Flonds Sunshine Lau=. if nnmedintc danger to the
p:ablir health,safety ar welfare occurs requiring emergency ncrion by rite board,a board meeting
may be scheduled by any procedure that is fair undet the circumstances and necessary to protect
the public urte-rest.
C. P&OQRAM UQUIMMENAS
{t] T7te.Recipient shall use the funds pursuant to this Agreement to carry out t4gible activities that
ittclurle,but are riot limited to,
(a] supporting activities that are designed to assist families and individuals with low income,
including families and individuals receiving assistance under part A of`ride N of the Socsal
Security Act (42 G.S.C.GO? et seq),homeless fami]es and individuals,migrant and seasonal fazrn
workers, and cldcriy individuals sod families with low income.
(b)addressing the needs rif youth it cotmrtaunittes with ltrn income tluoitgh youth development
programs that support the primary role of the fzmily.
(c)making effective use of and coordinating with other programs,
(2) The Recipient shall rnainmin written appeal procedutes.Any applicant denied CSBG services must
be provided a wntten notice.of denial which includes the appeals ptocess and the reason(®)for the
denial. in cases where the denial i5 for lack ofdec:unaeutation,the agency must Ctplain sulrar
specific documents are required m order for the applicant to reapply for services
-
(3) In accordance with section 678(G)(a)of Public]_.aw 97-35,as amended,the Recipient tna}•conduct
drug testing on CSBG grogram participants. If the Recipient does so,it must m£oirn participants
who test positive and refer them to treatment faciLties.
(4) Ail rerozds, corzespondencr,employee t]sne sheets, board minutes,board rnectirg acuces and
other documents related to CSBG funded activities di2R be avalahle for public.tnspertou during
normal business hours.
f5) The Recipient shill maintain docwnentauon to drmonstrate coordinitibn and nonduplieanort vI
sen1ces with other anti-poverry programs in each community served,
(6) In accordance with section 678G(b)of Public Law 97-35, as amer;&d,the Recipient
T Page �_�
assures that it will inform custodial patents in single parent homes tivho pattiupate in CSBG_
funded programs about the availability of child-support services and rtfer them to the appropriate
state and local child support offices.
(7) If the Recipient administers a transporration program,it must comply with Chaptex.427 Florida
Statutes;so that it will coordinate with the appropriate transportation provider($),
(8) The Recipient's Attachment M to this Agteement must be consistent with t_ht most recent
community needs assessment officially adopted by the Recipient's board of directors.
(9) 'Ile Recipient shall enter into a Memorandum of Understanding(MOL!)with 211 Workforce
Florida,Incorporated boards in its service area. The MCDU shall detail cooperative workforce
training and employment efforts and shall describe the actions that will be taken by both parties to
assure the coordination and partnership of the CSBG Program and Workforce Florida,
Incorporated "One-Stop"delivery systean,services and information. The l fOU shall be reviewed
and renewed every year.
(10) The Recipient shall maintain a written policy and implement procedures to secure applicants'social
security aurnber5 in order to protect their identity.At a minimum,this policy sha21 address the
handlingcf both paper aad electronic records and files_
(11) The Recipient skmll,in collecting applicants'social security numbers,use the Notice Regarding
Collection of Soci&I Security Numbers.The Notice shall be signed by the applicant and maintained
in the client Le.
(1 2) The Recipient shall develop,implement and maintain written policies and procedures that shall
include.at a minimun-4 types of services provided,written appeal procedures,intesuaj monitoring
processes,and family self sufficiency program guidelines,
(13) The Recipient shall develop and implement a Family Self-Sufficiency Program(FsSP).The FSSp
represents a community and neighborhood based approach to the organi2ation and delivery Of
locally available social services in order to help eligible families become self zeliant and independent
of all forms of public assistance.The program shall be designed to identify the needs of
participating families and to deliver a comprehensi`e and coordinated set of service,to facilitate
the participant's efforts to achieve and maintain self-sufficiency.
D. CLJ_E_1<TTGIBILITY
(1) The Recipient shall certif-that each household receiving CSBG funded services i$income eligible.
The sum of all countable income from all household members must be used in detetmiring
eligibility. The total household income cannot exceed 125 percent of the current affiee of
Management and Budget Poverty Guidelines.
(2) The Reupient shall use income dommentation of all household income sources that is no more
than otie year old and maintain the documentation in the client file. In the event that the applicant
cannot provide income documentation,the Recipient shaU require the applicant to provide a signed
self-declaration of income to attest to the applicant's verbal decaration of total household income.
Page -
This self-declaration must specify the reasons that no current Wcarne documentation can be
supplied by the applicant and a smtcment of how the applicant is providing for his/her basjc needs.
E. LIE, -f PLECORDS
The Recipient shalt maintain a separate file for each CSBG applicant that includes at least the following
information:
(1) Applicant's name,address,sex,race,age;
(2) Names,ages and current identification(no more than one year expired'}of all household members;
(3) Social Security Numbers and documentation of such numbers for ai] household members or the
citation to the applicable exemption;
(4) Income amount and method of verification for all household members;
(5) Income documentation to support,!4bility;
(6) Statement of self-declaration of income,if applicable;
(7) Signed Notice Regarding Cotlectian of Social Security Numbers;
(8) Date client wss interviewed,services provided to the&etit and documentation of any denial of client
services;
(9) All fSI3G assistacce applications must be signed by the applicant and by the Recipient's
representative and supervisory staff.
(10) When providing rental or mortgage sssistance with CSBG funds,the Recipient shall secure
documentation of either a rental/tease agreement or mortgage and place a copy of the documentation
in the client's file..
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24 —�-
IaY2014 CSBG AGREEMENT
ATTACHMENT B
PROCQ$,ATy_I STATUTES AND REGUi,ATIQM
A. TN P Q f lF5,REGTJ_LATjQI�J.&_ND
Both the Recipient and DEC shall be governed by applicable laws and local rules,
indud4,but not limited w (3)The Omwbus Budget Reconridation Act of 1981, (Public Law 97-35,as
amended),,and Tide 45 C.F.R. Part 96; (2)The provisions of Public Law 105-285,Title lI_Communizy
Services Block Grant Program,Subtitle B—Community Services Block Giant Program of the Corurnunity
Services Block Grant Act,the provisions of the current approved Commaity Services Block Grant State
Plan,including ali approved amendments oz revisions;(3)Department of Health and Human Services
regulations codified in Title 45 of the Codc of Federal Regulations are applicable:
1. Pan 16,Procedures of the Departmental Grant-Appeals Board;
2. Part 30,Claims Collection;
3. Part 73b,Debarment and Suspension from Eligibility for Financial Assistance(Non-prC cW m"r),
4. Part 80,Nandiscrirnination Under Programs Receiving Federal Assistance through the I7ep2_rtmeut of
Health and Human Services, Effectuation of Title VI of the Civil Rights Act of 1964;
5. Part 8,Practice and Procedure for Henri.gs under Part 80 of this Title;
G. Part 84,Nondiscrimirnat7orn on the Basis of Handicap in Programs and Activities Receiving federal
Financial Assistance;
7. Part 86,Nontlisciminatioa on the Basis of Sex in Education Programs and Activities Receivin8 or
Besregting from Federal Financial Assistance;
8. Part 87,Equal Treatment for Faith-Based Organizations;
9, Putt 91,Nondiscrimination on the Basis of Age in HHS Programs or Activities Receiving Federal
Financial Assistance;
10. fart 93,New Restrictions on Lobbying,
11. Part 9G,Block Grants;
12. fart 97,Comohdation of Grants to the Insular Areas;
13- Part 100,Intergovernmental Review of Department of Health and Human Services Programs acrd
Activities.
B. FUNDING A
Fends ate available for expenditure in accordance with Title VI of Public Law 97-35 as amended by P.J.
105-277,45 CFR Part 9G. For States,local governments and Indian Tribes follow OMB Citculaz A-87 for
cost principles(Relocated to 2 CFR,Part 225),OMB Circular 102 for administrative zequirements and
OMB Circular A-133 for audit requirements and the laws and procedures applicable to the CSBG Program.
For nonprofit organizations,follow OM$Circular 1-122 for cost principles (Relocated to 2 CFR,p,,j 230),
DMB Circular A-110 for administrative requirements, (Relocated to 2 CFR,Past 215)and ON(B Circ,liar A-
133 for audit requirements and the laws and procedures applicable to the CSBG Program. 'ac CSBG
Program is authorized and funded through the United States Department of Health and Human Services.
Page y
25
C. F=MLUMLMQN
(1) Fuading of eligible entities shall be awarded based on an alloration plan designed to facilitate statewids
expansion of the community action network and a gradual equalization of funding based in part on the
percentage of the povesry population for the service area.
(2) pursuant to H.R. 3061, the Departmrnt of Labor, Health and 3-=an Services, and Education, and
Related Agencies Appropriations An of 2002, CSBG funds shall be distributed by DEO to eligible
entities in accordance with the requirement in Section 675(C)(a)(1) of the CSBG Act which requires
that,to the extent CSBG funds are distributed as grants by a State to eligible entities provided under the
Act,and have not been expended by such entity,the funds shall remain wi6 s-urb entity for carryover
into the next fiscal year for prpgrarn activities consistrnt with the CSBG Program. However, poor to
carryover of unexpended funds, at the time of dose-out, these monies must be returned to DEO. Al]
carryover funds must be expended within the next fiscal year or be returned to the federal funding
agency.
D. $QIF.90 Oft PROGRAMS FUNDED IN WHOLE!QR PART VXWLI_EF.D n r r�r ray
The Recipient assures,as required by Section 506 of Public Law 103-333,that all statements,press releases,
requests for proposals,bid solicitations and other documents describing projects or programs funded in
whole or in part with l edetal money shall clearly state:
(1) the percentage of the total costs of the program or project which will be f`wanced witb Federal money,
(2) the dollar amount of Federal funds for the project or program,and
(3) the percentage and dollar amount of the tots] costs of the project or program tkat wT be financed by
non-governmental sources.
R. PROGRAM IhiCOME
Program income is gross income received that is directly generated by the federslly-funded project during the
grant peziod. The recipient may reapply program income,excluding interest income,to cnq out eligible
program activities. The amount of program income and its disposition Must be reported to DEO on the
monthly financial status reports and at the time of submission of the final close-out report,
P. INIB 7 ERQM CASH AQYANM
Recipients shall irr4est cash advances in compliance with section.21 (h) (2) (i of the Common Rule and
section .22 of OMS Circular A-110 (now 2 CPR 215). Recipients shall maintain advances of Federal
funds m interest-bearing accounts unless one of the following conditions applies:
NO P Y-
1. The Recipient or subcontractor receives less than$120,000 in total Federal awards per feU.
2. The best reasonably available interest bearing account would not be expected to earn interest in excess
of;250 per yeas on all Federal cash balances.
3. The depository would reguise an average or min rnum balance so high that it would not be feasible
within the expected Federal and non-Federal cash resource. Interest easncd off rash advances shall be
reflected on the monthly manual status report and the close-out report.
--_— Page _ 4�
l`QC&LQQ—VL. MENTS CaI LY.
Except for interest earned on advance of funds exempt under the inter-govesnmentaj Cooperation Action
(31 U.S,C 65C1 et.seq)and the Indian Self Deternunation Act(23 U&C.450),recipients and subrecipients
shall p-romptly,but at least quarterly remit interest earned on advances to the Federal agency.'die recipient
or subrecipient may keep interest amounts up to$100 per year for administrative expenses.
G. MMIFICATTONS
(1)DEO sl'rall not be obligated to reimburse the Recipient for outlays in excess of the funded amount of
this Agreement unless and until DEO officially approves such expcndhures by executing a written modification
to the origiaal Agreemmt.
(2)Budget changes must not result in over expenditure of the amounrs stated in section(17)(2)of this
agreement,nor the limits set for admir�imtative or secondary administrative expenses.
(3)Attachments I-M of this Agreement may not be altered without_a written budget modification submitted
m accordance with the terms below.
(a) The Recipient must use a Department approved Modifsration package
(b) Only unobligated funds may be transferred from one line item to another lisle items.
(c) The Recipient may transfer unoblipred budgeted line items within a budget Category as long as
the budget category subtotal rtm-ms the same For the purpose of transferring funds,the
following are considered budget categories:Administrative Expenses,Program Expenses and
Secondary Administrative Expenses.
(d) Each modified line item must meet ail comtractu d minimum and martimurn pextcntsge budget
requirements.
(e) All requests for modifications to increase or decrease any line item must be Submitted to DEO for
approval thirty calendar days prior to the anticipated implementation date.Faih:rr to meet d
,Li S time
frame may result in reimbursement delays,
(f) A letter of explanation and a completed modification package(Budget Summary,Subrecipient
Information(if applicable),Budget Detail,Secondary Administrative F-apemes (if applicable)avd
Community Action Flan(if applicable),signed by the Recipient,must be submitted to l]EC}and
approved prior to the submission of a financial status report in which the changes are
implemented.
(9) Upon approval,the Recipient's budget detail will be revised in DEO's electronic payment system-
(h) None of the budget transfers may violate this Agreement or 2 CFR 215(previously()MB Cir A,r
A-110),2 CFR 225(previously ONE Circular A-87),2 CFR 270,(previously OMB Circu!$r A-21)
and Z CFR 23q tprcviously OMB Cucular A-122).The budget revision{s}v]br reviewed by DEp
for compliance with these circulars.
— — Page --
H, MONITORING
(1) DEO shall conduct a full onsite review of each eligible entity at least once during each three-year
period.The Recipient shall allow DEO to carry out monitoring,evaluation and technical assistance,and sha?1
ensure the mop era tion of its employees,and of any subrecipients with whom the Recipient contracts to eaxry
out program activities.
(2) Training and technical assistance shall br provided by DRO,within limits of staff time and budget,
upon request by the Recipient and/or upon determination by DEO of Recipient need.
(3) DEO shall conduct follow-up reviews including prompt return visits to tloble entities and its
programs that fail to meet the goals, standards,and requirementa established by the State and federal funding
aF23 cp.
1. 50NUI. G
(1) Nwpr fit Organizations: The Recipient agrees to purcbasc a blanket fidelity bond covering all
officers,employees and agents of the Recipient holding a position of trust and authorized to handle funds
received or disbursed under this Agreement. Individual bands apart from the blanket bond are not acceptable
-
The amount of the bond must cover each offices,employee and agent up to an amount which is erlual to at
least one-half of the total GSBG contract amount.
(2) Loral Governtutnrs:The Recipient agrees to purchase a fidelity bond in accordance with
Section 113.07,Viand/or Section 524.4622 pia Sta.t. The fidelity bond must cover all officers,employees
2nd agents of the recipient holding a position of trust and authorized to handle funds received or disbursed
under this Agreement
Page -
F"Y2014 CSBG AGREEMENT
ATTACHWNT C
MEORTS
A. A.0nual reports
(1) Close-out Report:The CSBG Close-out Report is due forty-five calendar days after tertninanon of the
Agreement or forty-five calendar days after complc000 of the activities contained in the Agreement,
whichever occurs first.If the forty-fifth day fails on a weekend day or holiday, the Close-out Report shall be
due no later than the next business day.The Recipient shall submit original signed documents to DEO that
include,at a minimum,the Close-out Cover Sheer,the CSBG Final Financial Status Rcport�property
inventory and accrual report,report on interest bearing accounrs,a refund check for any unspent funds,and
a refund check for any interest earned on advances.
(2) CSBG Information System Survey: Recipients will compiete and submit the CSBG Information System
Survey on an annual basis. The Recipient will be notified in writing of the due date and submission
requirements_
(3)IRS Form 990: A Recipient that is below the$500,000 threshold for all Federal awards in its 5sc21 year
and thus is exempt from the federal single audit act requirements,shall submit with its contract proposal a
copy of its most recent IRS Form 990.
B. Qua=r ageports:The CSBG Quarterly Florida Outcomes for Community Action Systems (FOCAS)
Report shall be provided to DEO no later than twenty-one calendar days Following of the end of the
qusrter.For the purposes of this Agre=en,the ending dates of the quartets are December 31,March 31,
June 30 and September 34.In the event the twenty-first day of the month falls on a weekend day or holiday,
the Quarterly FOCAS Report sW be due no later than the next business day.
C. M n l o :The CSBG Monthly Financial Status Report shall be provided to DEO no later than the
twenty-fist day of each=nth following the end of the reporting month in which funds were expended.
The report shall be provided regardless of whether or not funds were expended. Reimbursement of
expenditures shall be based on this report. Only with prior approval by DEO will more than one
reunburscraent be processed fox any calendar month.The Monthly Financial Status Report shall be
submitted in DED's current electronic financial management system and a sigried copy submitted via
facsimile or electronic mail by the twenty-first day_In the event the twenty-first day of the month falls on a
weekend day or holiday,the Monthly Financial Status Report shall be due no later than the next business
day.
D. $oatd Mirsutu_�_Copies of minutes of board meetings,draft or signed,shall be provided to DEO no later
than thirty calendar days Erorn the date of the sheeting.Tf the thirtieth day falls On a weekend day or holiday,
the minutes shall be due no later than the next business day.
E. Monito S ort Responses:The Recipient shall provide a written res})onse to DEO for all monitoring
report findings and/or concerns no later than thirty-five calendar days from the date of the original
monitoring report.DEO shall notify the R¢tipient of the due date for any subsequent monitoring report
responses as may be required. If the thirty-fifth day falls on a weekend day or holiday,the response to the
Page
29 — _�
oria nd report shah be due no later than the next business day.The Recipient may request an extension in
wtiang for DEO's review and approval.
F CosLAIIgc2don Plans;2 CFR Part 215,Subpart C,Section 215.21(6)requires that Recipients have written
financial management system procedures for detrmrinfng the reasotrableness,ailocabihty,and allowabiuty
of costs in accordance with the provisions of the applicable federal cost principles and terms and conditions
of the award. To document this,the Recipient must submit copies of its written cost allocation plan to
DEO with its contract proposal.The cost allocation plan must be approved by the Recipient's Board of
Directors.
G. Other reports:Upon reasonable notice,the Recipient shall provide additional program updates or
info=wtion as ma}be required by DEO,including supporting or source documentation for any reports
identified in this section.
H.The reports shali be submitted to!
Ms.jean Amison,Manager
Department of Economic Opporturnity
Division of Community Development
Office of Housing arad Community Development
Commuraly Assistance Section
107 East Madison Street
MSC 400
Taliahassee,Florida 323994120
Page
Fl`2014 CSBG AGREEMENT
ATTACHMENT D
PROPERTY MANAGENMb"I AND PROGUR MENT
The Recipient shall compiy with property management standards for non-expendabl£property equnvalent,at a
minimum,to OMB Circular A-102,revised or OMB Circular A-110,revised,Subpart C,Post Award
Requirements,and the awarding federal agency's"Common Rule."
A. AU property purchased under this Agreement shall be inventoried annually and an inventory report
sW be made available to DEO upon request.
B, AD property purchased under thhis A,gxeement shall be listed on the property records of the Recipient.
Said listing shall include a description of the property,model number,manufacturer's serial number,
Funding source,irdbm-ation needed to calculate the federal and/or state share,date of acquisition,tastit
cost,property inventory tiumber and inforr=tian on the location,use and cortdition,transfer,
replaternem or disposition of the property.
C. Fide(Ownership)to all non-expendable property acquired with funds from this Agreement shall be
vested in UP-0 upon completion or termination of the Agreement.
D. The Recipient agrees to comply with Section 507 of Public Law 143-333_As stated in this section,it is
for sense of Congress that,to the extent practicable,all equipment and products purchased with funds
made available in this Act should be Arnerican made.
-- Page
FY2614 CSBG AGREEMENT
ATTACHMENT E
STATEMENT❑F A5S�QESS
A_ Intewt-OL Qtam Federal
No member of or delegate to the Congress of the United States,and no Resident Comrrzissioner,shall be
admitted to any share or part of this Agreement or to any benefit to arise from the same,
B. Interest r,f'le,r6e;:.Officers Members of.;_o Gocetr
Public Officials
No manber,officer,or employee of the Recipient,or its delegates or agents,no aternber of the governing
body of the locality in which the program is situated,and no othet public official of such locality or localities
who exercises any functions or responsibilities with respect to the prograrn during]us tenure or for one year
thereafter,shall have any interest direct or indirect,in smy contract,subrecipient agreement or subcontract,or
the proceeds thereof,for work to be performed in connection with the program assisted under this Agreement-
The Recipient shall incorporate or cause to be incorporated is all such Agreements,a provision prohibiting such
interest pursuant to the purposes of this subsection. No board:member,officer or employee will be permitted
to receive any remuneration or gift in any amount. Board members may receive travel expenses in accordance
with s. 112.061,Florisia Sta to .
C, tis
The Recipient agrees to abide by the provisions of 5.112.3135,Florida Statutes,pertaining to nepotism in
their performance under this Agreement-
D. CSBG Assurances
The Recipient herehg assures and certifies as a condition of receipt of CSBG funds,that it and its
subxecipients will comply with the applicable requirements of Federal and State laws,rules,regulations,and
guidrlines. As part of its acceptance rind use of CSBG funds,the Recpicnt assures and certifies that:
(1)The Recipient possesses the legal autheaty to apply for the grant,and that the contract Proposal b2s
been approved by the Recipient's governing body,including all assurances Contained herein
(2) *Ae Recipient will use CSBG funds to provide services and ac6viries having meastuable and
potentially major impact on causes of poverty in the community. Funds not used during the contract period
will be returned to DEO with the dose-out report on or before the due date.
(3) The Recipient will provide for coordination among anti-poverty programs in ends community,
(4) The Recipient possesses the sound fiscal controls and fund accounting procedures tsece,ssary to
adequately safeguard the assets of the agency,check the accuracy and reliability of accounting dot$,promote
operating efficiency and maintain compliance with audit procedures and prescribed management policies of the
agency.
(5) The Recipient will permit and cooperate with Federal and State investigations designed to evaluate
compliance with the law. Tine Recipient will notify DFO in writing immediately of any allegations or acts
pertaining to fraud or the misuse of CSBG funds.
Page
(6) The Recipient will give DBD, &e-Auditor General or any authorized represcutart:ivc complete
access to exvni-ie ail records,books,papers or documents related to 0 fiscal and program opeta6ons of the
grant,including those of any sabrecipient.
(7] The Recipient will comply with non-discdm.Mtion provisions,in acCordarncc with Florida Statutes;
section 678(F)(c)(1)of Public Law 97-35,as amended;Titles VT and Vll of the Civil Rights Act of 1964;and 45
CF-R, Farts 94, 86 and 90.
(8) The Recicipienr will comply with section 67$F(a)(1)ofPublic Law 97-35,as amended,which
prohibits use of CSBG funds for purchase or improvernmt of land, or the purchase,construction,or
perma.vent mprovement of any building or other facility.
(9) CSBG administrative expenses shall not exceed 15 percent of the total final CSBG expenditures at
close out. Arsy amount in excess of this limit shall be refunded to DEG at time o f contract close aur.
(10) Secondary Admvrnistrative Expenses:
If secondary administrative expenses are requested, the follawxng conditions must be met:
(a) Attachment K,and Attachment M,must document how these expenses will be used to
support eligible CSBG 2ctsvities.
(b) The admi aistrative expenses of the secondary groat source must be fully utibed prior 10
using CSBG funds for secondary administrative expenses,
(c) CSBG funds may not be used to increase administrative expenses for a
secondary grunt source above 15 percent of the secondary grant source's total grant amount.
(d) On ,the Reupient is r_ligible for these fends. Secondary admisristration=l,not be
claimed or used by subrecipients.
(e) All contracts and fiscal expense documentation related to the grant sources for which
secondary administration is claimed mast be made available to DEG upon request.
(f) Audit casts,travel and association dues are not allowable secondary administrative
expenses.
(p) Under no circumstances shall secondary administrative expenses be approved for coats
already covered by the secondary grant source,nor for any other administrative costs exceeding the total of 15
percent of the total secondary gran t source budget
(11) This contract proposal and all its attachments,including budget data,are ratue and correct.
(12) k accordance with section 678F(b)(1)(2)of Public Law 97-35,as amcudcd,the Recipient will
prohibit any political activi&s by the Recipient or employees in accordance with the Hatch Act restrictions on
political activity.
(13) In accordance with section 676(b)(11)and section 676(b)(3)of Public Law 97-35,as amended,the
Recipient must provide DEO with a Comnaxinity Action Plan as provided iin Attachment M of this Agreemer�G
The Community Action Plan must be supported by a community needs assessment for the comtrittnity or
cornmunities served. The community needs assessment must at a minimum include the following:
(a)Agency mission statement;
(b)Agemy service delivery system;
Page
33
(c)Linkages and funding coordination;
(d) Case management system;aad
(e)List of services and programs,including N-2uoasl PerFormanee hidicators
(14) The Recipient agrees to adhere to a provision of section 675C(a)(1) of public I-Iw 97.35,as
amended,aad the FFY 2013 through FFY 2014 CSBG State Plan regarding the recapture of uuablzgated funds.
Funds allocated in this contract and not obligated by the Recipient during the contract period,will be returned
to DECt A the time of close out. AnT unobEgated funds will be reallocated to the Recipient during the next
fiscai year.
(15) Each Recipient receiving an ailctment fora fiscal year shall adhere to the Application aad Plan
assurances set forth in section 676 of Public Law 97-35,as amended.
(16) 'Me Recapimt assures that this Agreement has berm approved by the Recipient's governing body by
official action,and the signatoty is duly authorized to sign the Agreement.
(17) The Recipient shall have appropriate s%ff attend training sessions as detertmii„ed by DEO to cover
CSBG policies and procedures.
(18) 'f he Recipient shall comply with Public Law 103-227,Past C,Environmental Tobacco Smoke,also
)mown as the Pro-Children Act of 1994 (Act).This Act requires that smoking not be perrr4jnrd in any poxtion
of any indoor facility owned or leased or contracted by an emtity and used routinely of regularly for the
provision of health,day care,education,or library services to children under the age of 18,if the services are
funded by Federal pxograma either directly or through State or local gov-ernsnents. Federal programs include
grants,cooprxztive agreements,]oasts of loan guarantees,and contracts. The law does not apply to children's
services provided in private residences, facilities funded solely by Medicare or Medicaid funds,and portions of
facilities used for in-patient drug and alcohol treatment.The Recipient further agrees that this last uVe will be
included in any subswards which contsin provisions for thddren's services and that al]subrecipienta rho certify
compliance accordingly. Failure to comply with the provisions of this law may result in the imposidor,of a civil
morietary penalry of up to$7000 per day.
(19) Direct Federal grants,subawasds,of contracts funded through CSMG shall not be used to support
inherently religious activities such as religious Msuxiction,worship,or Pros elytiration. ]recipients must take
steps to separate,in time or location, their inherently religious activities from the services funded wader the
CSBG pxognm Regulations pertairii to the prohibition of Federal funds for inherently religious activities
can be found on the HHS website at. hU./Iwww.os.dhhs.ME/fbeily seat�2l,szdf.
(20) This award is subject to the requirements of Section 106(g)of the Trafficking Victims ptotection
Act of 2000,as amended(22 U.S.C. 7104).The use of Federal funds from this Agreement constitutes the
Recipient's acceptance of these terms and conditions.
Page
34
FYN14 CSB G AGREEMENT
ATTACHMENT F
WARRANTIES AND REPRESE,"TA Ic NS
A. 1'na. I41anatmcnt
Recipient warrants that its financial manageneat systr_rtt shall provide the following-
(1) Accurate, current and complete disclosure of the financial results of this project or program
(2) Records that identify the source and use of funds for all ictivities.'These Reords shall contain
infocragdon pertaining to grant awards,authorizations,obligations,un-obligated balances,assets,
outlays,income and interest.
(3) Effective control over and accountability for all funds,property and other assets. Recipient shall
safeguard all assets and assure that they are used solely for authorized purposes,
(4) Compadson of"penditures with budget amounts for each Request for Payment.Whenever appropriate,
financial information shall be related to pcafor rtance and unit cost data.
(5) skitters procedures for determining whetter costs are allowed and rfasonable under the provision$of
the applicable ONM cost principles and the tents and conditions of this Agreement.
(b) Cost accounting records that are supported by backup documentation.
B. Cowed"
Recipient warrants the following.
(1) All procurement transactions shall be done in a manner to provide open and free corttpetitiata.
(2) The Recipiesze shall be alert to conflicts of interest as well as noncompetitive practices among
contractors that may restrict or eliminate competition or otherwise restrain trade, In order to ensure
excelient contractor performance and eliminate unfair competitive advantage,contractors that develop
or draft speciRcations,requirements,statements of work,invitations for bids and/or requests for
proposals shall be excluded from competittg for such procurements.
(3) Awards shaD be made to the bidder or offeror whose bid or offer is responsive to the solicitation and
is most advantageous to the Recipient,considering the price,quality and other factors.
(4) Soliamdons shaH clearly set forth all retluixetnents that the bidder or offeror must fulm in order for
the bid or offer to be evaluated by the Recipient, Any and all bids or offers=T he rejected when it is
m the Recipient's interest to do so.
C. Codms f C-=duct
Recipient warrants the following.
(1) Recipient shall maintains written standards of conduct governing the performance of its employees
engaged in the award and administration of contracts.
(2) No employee, officer,or agent shall participate in the sclection,award,or tdministration of a contract
supported by public grant funds if a real or apparent conflict of interest would be involved. Such a
conflict would arise when the employee,officer,or agent,any member of his or her immediate family,
- Page -- - —
.hss or her partner,or an orgai=ation which employs or is xbour to employ arty or ttic parties indicated,
has a financial or other interest in the firm selected for=awzrd.
(3) The of6cess, employees,and agents of the Re6pient shall neither solicit nor aeeept grstuitics,favors,or
aaytlung of mcmetasy value from contractors,or parties to subcontracts.
(4) The standards of conduct shall provide for disoplinary actions to be applied far violations of the
standards by officers,employees,oY agents of the Recipient.
D. Bu es our
The Recipient warraots that it shall have its offices opexi far business,with the enuance coot open to the
public,and at least one employee an site,Monday through Priday, from 8:00 am ro 5:00 pm.
E. Lsgersing attd_Peunitt su_
Rtcipicnt want=ts that all subcontractors or employ=hired by Recipient shall have all cumnt licenses and
pe x6ts xtquired for alt of the particular work for which they ate hired by Recipient.
Page 36
FY2014 CSUG AGREEMENT
ATTACHMENT G
CERTIFICATION REGARDING DESARMEN'1,51ISPEh'SION,
INELIGIBILITY AND VO T Y EXCLU$I-pN
NQTE: Prior to issuing subawards or subcontracts under this Agreement,the Recipient must consult the
Excluded Parties List Systcm(EPi S) to ensure that organizations under handing consideration are not
ineligible, The list is available on the Web at https-.//wwis.sam.goz•/portal/public/5A-Nf/.
(3) The prospective subcontractor of the Recipient,_ _-� -- . terrifies, by
submission of this document,that neither it nor its principals is presently debarred,suspended,proposed for
debarment,declared inrligilale,or olunridlyexcluded from partiupation in this transaction by any Federal
department or agenq.
(?)%Klicre the Recipient's subcontractor is unable to certify to the above statement,the prospective
subcontractor shall attach an explanation to this form.
SUBCONTRACTOR-
(Type Name) Recipient's Name
13Y --
Signature
Name&Tide DEO Contract Number
Street Address
City,State,Zip
Da to
- - - - - -- Page — -
PY2014 CSBG AGREEMENT
ATTACHMENT H
RECIPIENT INFORMATION
FEDERAL FISCAL.YEAR: 7014 CONTRACT PERIOD: October L 2813 through September 30,2414
Ipstructians: Complete the blankshighligbted in yellow. For item I I,put an"X"in wh'scheverbighhghted box applies to your agency,
I, mcrrnw.-Seminole County Government CONTRACT#. 14SB-OD-06-69-6I-075
II. RECIPIENT CATEGORY: Non-Profit Local Government
III,COUNTYP.SJ TO OF SERVED WITH THESE FUNDS, Sera'tnolc County
I'V. GENERAL ADMINI5"MTWE MPORMAT[ON
a. Executive Director or Chief Administrator. Valmsde H.Tamar,Lector,Seminole County Comtounity,Ser"Mr,
Address: 534 R!.].ales Mzr1 Bouicvard CJCp Sanford ,FL 7aptpde• 32773
Telephone: 407-665-,2301 Fsx 407-665-2309
Cell Email S ep mus s MY v
M446,g add+rrs#&efferent fiats ob-
Ma>'Iing Address: City ,FL zipe:ode.
b. Chief Elected Of6cW for Local Csooemmentr or President/Chair of the Hoard for Nonprofits:
Name: Robert Dallsri Talc: QLaicmm,$=n"County Board afGounty 0.nmisioaexs
Address*: 1101 E.1st Sheet City: Sanford ,FL Zipcode: 32771
Telephone: 407-665-7275 Fax: 407-665-7958 Email:
xEeter AWe Or hAIM t dddtrt,lr/aphosre ruwmberr rs d rvr 1 orlaer rl:mr ter Ila�rsur s
C. For Public Agtncies:Chair of Community Aet:ioa Board
Name: N/A Title:
Address*: City
Telephone: Fax Email: c.
*Rate•brew ar bad4us eAkus,hltpboae rrrmhm and&wd1&*r tAra the R.10,;r7,
d. OtBtulra Receive Start�sacrau;:
Nurse: Maryanne Morse Title: C le*of the G-tit C*M-k&=kl lc County'CL-4,of CousLs
Address: PO Box 80.99 City: Sanford �Pl
?.ipcode: 32777.8099
C. Rec:ipitat C mitaen
1. Bmg=m Name: 5hideg Dallis-Ba Tale Division Manage,Semnole County Cowmwi.4 A.Amoiate
Address: 534W.Lake May 8oulmud City: Saafard � code --
Telephone: 407-665-2363 Faz 407-665-73D9 32773
1 5M L Name. Jeff Aldddgs Title_ Frasnd3d Husioess Admtntatratnr,SC CMMWty Srrvieea
Address. 334 W.Lelre Mary Boulevard City: Sanford FS Zipcode: 32773
Telaphone: 40x7-665-3393 Pox: 407-&&2358
Cell: FM al
f. Perean(s)sotbofised ro sign reports:
Nattier VaImmie H.Turner -fide~ Director Semi axle Cove Community services
Name 5hidey 17auis-Ho a Tiile: DioiSion Mager,Semmok County CoahnuzutP As wee
Name: Taman Jobnsao ,�! Tide: Psogesm Manager,Seminole Cauatp Commainirr Aesiatttnoe
g. Agency's FEID Number. 596000856 h. Agency's DUNS Number. 067634-358' —�
v. AUDIT DUE DATE: Audit(r)are due by the cud oftbe Ninth month following the end of the agency's fiscal year,
Recq ieat Fiscal Yes.. October 1,2013 thru September 30,2014 Audit Due to DF-O;— jute 30,2015
Page 38
FY2014 CSBG AGREEMENT
ATTACHMENTI
BUDGET SUMMARY
RECIPIENT: Ser»inole Caunrc Govemmem CONTRACT: 14SB OD,06-69-01-025
tnstrucftas: Enter the aaamprists figures in the boxes highlighted In yellow.Use only whole dolar amounts.no conrs.Round al:figures up tv
nearest"Ole dollar.
CSBG FUNDED PROGRAMS ONLY BUDGETED AMOUNT
EXPENSE CATEGORY
1 CSBG FUNDS
8175,2$2.00
ADAHNLSTRd TNB
2 RECIPIENT (Salaries/Fringe,Rent,Ut litics,Travel,Other) 813,349.QQ
3 SUBRECIPIEN]" (Salaries/Fringe,Bent,Utilities,Travel,Other)
4 TOTAL ADhCMSTRATME EXPENSM {Line 2 f Line 3) $13,,349.04
ADWNISTRA"EXPENSE PERCENT;(Line 4 divided by Lane 1) .Allay
$ fiat e:rceed lSYo afdie rural funds 6'sred oa l.iee l 7 Gld°/a
PROGRAM
6 RECIPIENT DIRECT CLIENT ASSISTANCE LXPPNSF,S 8157,596.00
7 RECIPIENT OTM EXPENSE(Salaries/F=ge,Rent,I]silides,Travel,Othex) 84,337.00
9 SUBTOTAL RECIPIENT PROGRAM EXPENSE(Tine 6+Line 7) 5161,933.00
9 SUBRECIPIENI'DIRECT CLM Tr ASSIS'T'ANCE EMNSES
10 SIIMF,CIPIENI'O'T'HER PROGRAM EXPENSE(Salaries/Fringe,Rent,Utilities,Other)
t1 SUBTOTAL SUBRFCIPIENT PROGRAM EXPENSE (Line 9+Line kl) S0
12 TOTAL PROGRAM Mr.PENSE (Line 8+Line 11) 8161,933.00
13 SECONDARY ADMINISTRATIVE EXPENSE
14 GRAM}TOTAL EXPENSE (Lint 4+Line 2+Line 13) 8175,282.00
page 39
F'YX14 CSBG AGREEMENT
ATTACHMENT j
SUBRECIPIENT INFORMATION AND BUDGET SUMMARY
{Complete this page for each subreeipienr by providing information in the yellow-highlighred fields.}
RECIPIENT: CONTRACT-
Seminole Counn,Government 145B-0D-46-69-41-025
511ARECIRIEIVT
SUBRECIPIENT NAME:N/A
MAILING ADDRESS:
AFL ZIP
STREET ADDRESS(IF DIFFERENT);
,FL ZIP
CONTACT PERSON'S NAME AND TI'T'LE:
PHONE:
FAX:
SUBRECEIFIE _SiLRT SUMMARY
Irrslrralicnr 7 Gr joFla ud+ig One urwrs(3-9, 10 and!I)snit mrretpowd 1011lt srlbsarrrl f, 13r+dgd S+ib+ma.Y. ff 16err ix Mon r/wN one rnhmciliiaal,r!it tGr
Reuprenl' mpvnriGi &to tuvre llwl 1hr latul ajull xbmt4 wnl b+rirli add camrtly. &%prodifnrer wart be delvilar!rn:Ltae�imrpl IC
CSBG FUNDED PROGRAMS ONLY
EXPENSE CATEGORY gG Dg
SUBREGiPLENT ADMINISTRA.TIOE EXPENSES:
3. SUBRECIPIENT
(fa.briel/Trinhe.Resr4 ca/ifs,Tram Ulbrr) $0.00
S-UBRECIPIENT PROGRAM EXPENSES:
9. SUBRFCTPIENT L7I F(;T CLI1;Iw'T,ASSISTANCE
E..I&E tiSES $0.00
10, SUJRECII`iCN1'OTI TER PROGR.•01FXPF.NSF
(S�lnrirs/Friars,Rent, rJ k&er,Trmr!QlberJ $0,00
11. %;UBTOT'.k-LSUARF.CIPIENTPROGILILM
1..3PEN5FS(Line 9+Line 16)
$0.00
TOTAL SUBRECIPLENT EXPENSES: (Lrrre 3
Llne 11) $0.00
The RedpienI must have a written agreement with all suhrecipieats_ The agreement must meet the requirements of Section 14 of tN,
agrecrncn[. .1 copy of the unsigned sgireement with the s1krecipiew must be forwarded to DRO for review and approwai aloag with this
agreement. See C;IIB Circular A-133 210,SubAedpiern 1'endor Determinstion,for further clan v=ion.
Page 40
PY2914 011G AGREEMENT
A,TYACRM> NT x
BUDGET DETAIL
IlEC1PIEhIT+Serrenule Cuunrr Gnrcrnrnen[ CGNTRACT 1gtiS-9I7 OGG9�]-0?a
BLDGET lti aT[(]t F 7L AAlt} IVT i 1
I �Uj'�.%l_aRI' iPER7C7R�IANCEI [tiBG fuxr)s
MNE INOICATC]RS Rnon3 UP line irem trnals to anllara. 31-rD(3FTFD
ITEM (Dimct Clicnt Do Ni)T use ccnts and decimals in totals
+ ILL AI2F.R k,�;srancc Onh
j AdMINISTRATWE EILPENSES
RFCIPIENT ADIVOY.EKPEIW
I Travel:
3 1 empieyee to attend ROMA training:Per Diem!200 miles 9.445 per mile=US
2 employees to attend FACA Conference-
'todgrng:$306 x 2=5600
Perpiem:$450 miles L&.445 per mile-$201 f
i
TOTAL TRAVEL:$890 890
OTHER:
Operating Supp4es;Toner,Ink Cartridges):$900
'Office Supplies(Paper,Folders):$40.0 400
Transparatlon-Postage:$90 80
Building Lease:$3091 3.01
Florida Amr laden far Community Action{FACA)membership'51200 l A6
ROMA Training Registration:$200 200
FACA Conference Registration:$200x 2=$400
Employee Training:(Case Management)=$300 40U
Co m munity Needs Assessment-$4,642 302
3r1?
Advxrtisement/Newpaper:MG Baird meetings and
Program Advertisements$371li x 8=$2,646 '4646
9 TOTAL RECIPIENTADMIN EXPENSES 14349
PROGRAM E7SPEIIiSFS
6 ?'P.I. 12(A) Approximateiy3lcustomerswRtrecelvetratningschnlarshipstcotnalnskills
,c4mpeteAcks required taattiin,maintain,or 3nerease employment.
Vocational Training:219$3,750(avg;n$78,760 A9E/GED:10 x$30(avg)_$300 79,450
N.P1-1.2(!]) Approximately 39 customers rviu recdve Scholarships to fund Reglstratton,Extended flay
1-2(E),4.3(63), before and agar school,and/or Sum merCamp programs.39X52014=$78,546 78,546
6.4(A)
TOTAL,RECIPIENT DIRECT CLIENT ASSISTANCE 5157,596 f
RECIPIENT OTHER PROGRAM tXPENSES fJ
7 Case Managenletrt database Maintenance Reports:Maintenance fees for the database 4,337
TOTAL RECIPIENT OTHER PROGRAM EWENSES 4,337
GRAND TOTAL: 173,282
1
f
Page 41
FY2014 CSBG AGREEMENT
ATTACHMENT L
SECONDARY ADMINISTRATIVE R)CPENSES
tirennJat}Adminisrtadvc l?nP.—e N.LE RECIPI$NT;6cminote 5 ktunnr Governmcac CONTRACT: HM3-01).06-691)1-025
IN5fR!JCFIONS: !f nnlumtin(;titxunJary:Wminiarraeivc]?xPnsca,you musr supply tits k>ltnwiny,,inhrxmatit,n far each xcumdan pntgram for whith.adminisrrasiec cxpcnac�are briny;r�tyucsi r{. h
secondary pnvinam souvcc"ix the nun-CtiHG pn>gram that will tcecivc adrninirt-,i, suppon from the—oF(a!i(;f nd, Sce Atrnchment,\,5c[lion(6},and.\mchmenr h.,ti Yna„D(10)tin addirianol
infi,xmatinn.
Name o£ Namc nF Name of Name uF Nome of
' tiacondary Program Sccnndary Pnvam Secondary Prtrgram Secondary Progmm SCaondart Pntgram
H11M&A'INPORMATION
Craut k7ares Grant i?atcs Gran(1}atca (;rant Oares Gene 1)aec.
titan. Start: scary Starr. start:
I tod: lira& Vn& l ift&: l ing:
'oral cash budy;cr fsr secondan pny;nm:
f O.OU S 0.00 f OAD f 0.00 $ 0110
2. Maximum percent administrative expense
including indirect cost allowed by 0.00% 000°/a 0.00% 0.001/1 O.ODY
secondary Pn)grnm.
3. 'lTrcnl ndninisxcative—pemc approved by 'feral
—olldan Program funding w,urce:tty f 0.00 f 0.00 S 0.00 S 0.00 f 0.00 rrf ptugra"
4. (SHG xecntrdaxy administrative expense f 0.01 S 0.00 $ 0.00 f 0.00 $ 0.00
rcqunetedv yid E0.06
S. Total adm+nistrntive cxPrnsex(Line 3&4)
30.00 $0.40 $1.06 50.00 $0.00
6. Percent of mcd adrnirustrittve expenv:m
total Uudgct(Linc 5/Liar l}-'I'his-vrnl #1)(V/Ol M)1V/0! tlDIV/01 01mv/01 HUIV/0!
nos uccreJ I�Po of l.inc I
7, N, m k NN ii N111# NPI N NI'I f)
suPpnncd by rhis:ticondary
adminiatrarive tundinn.
(Prom Atmehrn nr,.M.GSHG Community
_
Arnim Work)fan
(1F'Ibe Rtap-,musr cake Full advanragr of all administrative and indinrr dollar AI(nvad by the rccenJary•pnrgtarea funding wnlmc beam Q5iR(;se vtdary admini—vve cxpms-Arc
r,;uatte`d. Fitt Inch,Cntnrdxry ad.6—ti—Prrrgram,Provide d„0vm0v,mrinn uF the maximum adn i.i—d-limirc of nc�xeeundary Pmy;n andca copy of nce commet bu&),,et detailing th,
amau„r r,(nc�cnntraer and the adrru. neive Fund,Prnvidcd by nc—eeandaty xourec
(x)You are rrgtl n d m provide hud},n-r detail in Attach—I,Line t3 for the amounts)on 1-inc 4 above frr each pn,gtam.
Page 42
FY2014 CSBG AGREEMENT
AY ACHMfsNT M
CSBG COMMUNITY ACTION WORKPIAN S 6- ee Tkeni no!e
CONTACT:Shirley DBys-f3r,•ea PHONE:407-666-2263 EgIL
FECfPIENT Saminole Counf;•Government CONTRACT; 14Se-0D-0669-{71.025
A a
Unity Erpt?cred
NPi OUTCOME To 6e
Achieved
A Ln I dandWalneda jot �❑
Em lo d and MOM100d.a JG3 for al least W dayS. 0
C E.�Ada yed aid cUterned an Increase n e to errs"rcome ariejor denerts 0
d Ach•evad'rtv .F a'em la em and i a Danatila 0
A .Gbta A skiilycdm neees required forem to ment 3S
S.ICam Ief edAB&Gr11enditwmadtnttlli rat onordl logs 6
G. Cum e'- t-secvnpa education ram ana oh:aired re'AI Ie::a :r ma ci
❑ Enrolled[Herren in be'ore or error scnood r rams 39
E- of a led care for adder Other tie Haar.;
F Qbtain Aecers to r ztlle rrang rlal,an ancYor dnvers 11cen5e 0
G phtalnod hea>tn care serosresfor trlemselvas or a[amp} member 0
H. CtUinm sale andaffordabte nousi 32
I 17btained load assztanca
❑
Vreened non-e'nu r LIl EAP ens a%*�*Iance ❑
tafnednon-time WXBne asSlslanCe
wried over m.r-amc Bfr ens asaistaxa IS.Idu 219!UiEa LrMEAP orw 25
ained idertif�catm or won =4 documantnf o for erk ermrt,etc, 0
Err
A Partic me r+t ax eparatian ---rtes wr;p a.safrfied for Emy Federal cr Stale tax credit ❑ Q
B. p,,,UeCdnts ObWnlnu[spurt-oigGmd child R pd a Ira. 0 ❑
G. NtMoe•ertraktad In telephone l0ahne nndrerane discounts with ncv assistance. ❑ 0
t�tf -
D, Panl nts d"Onstratr ablll to edrtiptata and mamtaln a bu e!far aver 93 day" Q
E Peninpants openln an InWv;dual nevelopment Account(IDA)otoiher savings account D
F. Parlir nts who Incrrrased their savin th h fDA or othEr SaYn s accavrn ❑
G. NiemP2r ca SaliA 22 a small husiaess wilt accvmufated Savings
p,clecish allot,V015 04,;sdvoc a's v With 01hol P%St)lb,�andpnvpLU bgeriCitS as mtazi,rMd byone cc Inoratt thc follow. Opipor
H. numbs} ursu: st•s6Wnda educ�tionwrlhsavin s D D
I !aurn;~ar urcP,asin a home with accumula:lea Ravin s 0 0
�- NumGer Aurrfrasirl0[:tier asses whn aocumulatea Ravin s ❑ o
A. ,iota est•d,ar saved.from redact an pr eummastan to the CErfrl}WfX ❑ U
6. ArL sii'')!e IM W3 [retired,ar Uved from redudwi or ellmirrMlon its the commune 0 0
C. We and 6nordable haustn units[Heated ire the cstrrtmunt 1 18
D Sale aflmdat4o nouSln unts in the mmmunl reserved or im ed throe Commun+ Action Dr advoG3. 31 02
E. Acceaalble,safe and affordable heeith aare servtceSRac+lk{es for low-wne la created or saved. 0 0
F. Access b'e sale 8 affordable child t arelcfltltl d0ve1 ant cement rturdlles created or savt3d. 0 U
G, Accessible 6efosefe8er t:cftpal ro ram facement o for ksw incorna Itameles create i or saved 0 4
3 Accsssitsle news re5ervedle ended trans salon resources evellahielo low-ncame le bll ha}e 0 0
! AtCp65ibig new.' leservedrmcreasm educational and trainin olzetxnenl o :rarities for Icrr-income le 0
A. iNitiafm Ln earTmuni assets dug to a CAa b!n tzvd u4tan IIC -reSullln in Fetter auar. o!ilia 0 0
r Ir•Lre� C ova loci ia'osErvafi0'1 of Commun faclkcs stnoois iha,Sgs,rvmml,nl •aanters,etc.] p �aol C l,:rcase:n Me avallatwity er prrservasra�o+arimrnunTy ssi v."%to r gyove publlc heahh and bale,scregse In ere avallatrr.� ar reservation of p;rnmercial services Nrtia:t lawanrrme�teightirhaCas ,
E IacRase in o; nese^ralivn p}Her utaorn[rod gar -uf•li}B r2saurtas n 0
Ff.,ggcM 2ntry,prnvidx a dCacriptr4h of what asset,.2 rvice,or facility ra been repo rtecl qr kite FJSPLAKAYIGN 7d¢
2012.2013 CSBG work Plan ATTACHMENT C of fl
fieC1PIENT:Seminole Coinovernment CONTRACT;14SB-0O-06-69.01-025
A I EZ
UOUS Ed
NPI OUTCOME ro Be
AChloveat
A Go—a'+ur-ry*~e-aura rr:peip+.1';y pan�tpatc--t cpm-wntry rciAa�9rlt�on unq grU-povert�ln LatWei t2
trrtifs 4 w-f Ic
a SBNe on the CAA Board of❑[rectors 24
bl Sme on Head Start P61! Go Its 0
{ c Serveon Famity.Conlerl Parent Ccundls 0
d Serve on other CAA AdvlsoN Boards,councls.or wanness C
$ 1 t e, Serve on ether commuri advl or govemin�t»erds pr CMMfttees as a CAA repfesentative 24
n Assisi With program activities and Ixlsfics 0
q Partic}pate in 8dvoracy to meal agency and communi als 0
} h Particicate m adVOCa. lu iralluenm ooticesl tscftces of government andlor ptivale entices 0
Met CAA 0orgs or km-lRCome persons volimleer wrlth She agency, C
rotal votunur tours from low income people 45
f'r011rS dctla DYr�Alsle- 6
at Genom Public 414
bl GAA nan low-income bowl members dg
B c Oche+via- oM nr vammanl a enc es
dl t3uslhess Cammun 0
l
aJ Other 0
Total voIwrRaerhours from non low-income people 0
e54
7p;�1 r.Umtlef t71 ve1unla9r hdur5 donated w ihB a n 1 002
A .Icas created,a!rcasl m d.A AiifMA funds D
9. Sops saved-at least in Or% AAAA hinds 0
Irv" rumOOr of vcAunleer hours danate7 try 1e,r4mcoma individuals fonry to CSrnmvriy Apron 48
A. lrnr;nCome le--r fnnria! decWon,rnakm ,cornm Limty profizatiorts,gm emment,ocatas or counrals 9
9 low-mcorne to i -Alg businesses in their community as a result of Communl Action 0
G. LdK•rrarna Pao a pu(chgaina their Own home in their wmmun.y as a ruavh of Co-rnsinlry Acton 0
13. LD+r�n�'ne o in nun ovemance cammun adivlrie5l rPU [reetedf5v Red b Gommuni Action 0
eo -
_ e ,
A Wx.•Pmm 28
H. faM Based 0
D r}
C. Lxat Garernment 7 7
p.
slate Garemmenl molky 2
E Federal GovemmenlEnt
F 1
For eusrc-ss or GO m n ttC
Fo 1
G ConsoniumsrCnrar�sticn 12 12
H }i��5ln CorsoniumsrCOUttnara.o� �� 0 D
--- D 0
t Scfaal D:slri�-LS �
list'+Acim of t secanda adUrari�ryt!-a n�nq 4 1
4 q
9 FinanrialBaniun Insltutiors 30 55
L Health,x rvrce Institetans 3
3
M Stake-wide asaoGafoas or collab o alwns
1 1
C[hers. Peaseido--Wr
z n
plal undunli numWof otganlxeHona CAA works with to promoles amity and community outcomes 49 124
2012-20t3 CSBG Work Plan ATrACHMcNT C 2 of 6
RECIPIENT:Sominols,Poo rly Government CONTRAC7: 1 45S-Od-06.69-07.025
A. B C
Unffs Expected
NPI OifTCOME T000
Achieved
Table 1 roadrrrf tAa Fiesaur�a$ese
A. Communi Services Block Grent tS9G ,� 175282
B Irederai Government Resources-01hpr Than CSBG - —
a Weatheri i—p55is1ar.G8 rc ram! ndea o CC]E trno r•c 7GA tl
HEAP-Fuel Assistance(HH5) 0
c) LI
c LIHEAP-Weatherixat[pn rHH5: D
c Head Start(HHS
EaTI hieadStaA IHH&j D
olderAmedcans Act(HHS; -
r SSBG 1iHS} 0
h 0
LwrarelNedicaid IHHS -- -`
i 0
Temporary Assislance to Needv Famines TAN
0
Child Care Devel ment Block Giant fro �BG�-
m GC-
0
Other HH5 Resources(List fr order of size. Give the name OF the source and the CFDA number De not use��
k) abbreviations.All HHS CFDAS start with'93'] 0
2) 0 0
¢ 0 0
ti Women,Inlaniand0hitdren(VV C,)uS0A'
m USDA non-feed rame a.0 rural development` 0
ni Ail other USDA Food F rams — 0
a1
DOG federal,slate or lognl 0
Housin Pro---- HUD 1781371
0
1) Section 0
2) Section 202 0
3) Home tenant based assistance �— 0
4) HOPE 1W Homeowners Program Mt _ 0
5 Eme enc Shelter Grant Program iESGP 123.876
Q Corwnuum of Care(Co[C 254.111
'r All other HUD a rams including homeless pWarns '
_ r] Employ rant and Training Programs SUS DOLT X4.330
s' other US DOL 2rmamis
0
t) Corporstbn for Nalional and CommunitySerAicJONCS)•amgrams _ D
u FEMA p
v Tranwortation fUS DOT
w peflanmentof Edueatlpn IEDU 0
0
c] Department e[Justice(DOX _ _ __
0
Ce artment of Treasury
z 0
Other Federal Sources: List tv name of funding source and the CFDA Number_ Do not use abbravfadons.
4
1' 10 0
z) 0 0
3' 0 0
41 0 D
TOTAL: NON�SBG FEDERAL RESOURCES 2 679 888
C. I Slate Resoursea(Non-federal stste-ep prop riated funds) —
ar Slat ose as federal CSBG iun6s 0
b1 State HousiN and Homeless P' ma Vuclinq housing taxcredite 695450
c Slate Nutrition P rams
0
^_i SiatoDay Care and Wy Childhood? rams 0
w Slate EneM Pro rams 0
r, Slate Health ft grams 0
9. State Youth Dayelopmard P rams D
hl State Employment grid Training ProSrems 0
it Stale Head Stan Programs 0
State Senior Services 0
k, StateTransoodstfan Pro^rams 0
1) Stale Education Programs
0
mi Stale Communiy,Rural and Economic DevelapMerd Programs 0
n, State Farniry Development Proyams 0
01 Other Stale Fundod orog_ram5: List by name of[undin9 source- Do not use abbreviations._ D
o
3 v �
4) 0 0
TOTAL, STATE RESOURCES 895,450
2012-2p13CS6G Work Plan ATTACHMENT C 3 at 6
RECIPIENT:Seminole County Government CONTFIACT: 14SS-OD-00"R-01-025
A. B C
units Earperlecr
NPr OUTCOME TO Be
LS) ernment Resources _
Achieved
Lo nt nrlcitl fund `nt of restricted funds enarp;Aatad b•104al^ovomment Tag�or Cionlract ser ices afln-$indboodS+SeMcesrecelvedhomlocalpovernment
a
Locei Govemmoni Aasources: G ve descnFtlan ar tame or pra�rdrn, Do Nor abbrev 2te. 0 0
0
4) 0 0
TOTAL; LOCAL GOVERNM ENT FIFES NFICES 6ff65112
E. fprjYM40 Sector fiee0vr0$S
a', Fulyds from FmAdattons.Co_rDaratlons,United Way,other non:ro n _ q
b; Other donated funds �l
c1 Value of donated Items,loW,clathlrpj,furnnure_etc. _ 0
d Vahje of in-kMseroims racAlved Iran badnesses 0
e Prn
a entst! cfie its for SOMCBS �y— 0
Pa eats b dusts antid¢a for cods or services for ipw-hcomE clients or communittss 0
— 0
1 Otrar Private Seravr Resources 0
1 0 0
P 0 0
31 0 _ O
4} 0 0
TOTAL, PitIVATESECTOR RF„SOURCE5 0
TR&L NON-C$sG RESOU"CES t%Beret.5mtr,l oea3 GOVAVAMM14PthMM Sactor 10 Ytt
TOTAL t;fiBGFunck
175 82
TOTAL LOEWY BUDGET
10509 Z
Toga 2 M Stndi aei I%vo ii"MA Tb Training _I
A. Shall with cu stomers in self-sutllcien a ram rao*a kald r &P-Ac to case manas emem ;£ 4
t3. staff w th cuslornars In self-s+�dencv rams receive traln V edffc to family deveLcoment 0 0
C. SfaNW110 worts w th rantslcuntract man Treceiva tlalnlrn rA el rrrldl� dalalu node theft skills 0 0
D, Fiscal staff aarrnd traIN-i on OMS Circular or audit co lianoe 1 24
E. FiseW staff receive arxpurltln data collection or mane Tern lrafnfn . 3 24
F. Pm m staff r�acotve data C01fec1 on or mans ernes l trwmn - 0 0
G. Staff or mane am tit receive SOMA tralnl f om a co~ROMA tral per.
H. CHherftrll recGMW tr slaff cr ant. 1 iS
Me Stiff E oHgh H above. 0 0
J. s �
ecard members receive trafnin related to their rotas end ibrlitSgs, d 0
K 10mrd members receive ROMA batrMn from a oerthr+ed HOW trainer_ 0 0
1 102hertraikil regwad b CAA Board members. 0 0
Total ISoard Member Ttaintn [Total of J through L fl 0
Tadis 7 JAQgMCY YELO . LM N4"*�C4 t0 Thr TFOWM2 !i rt ea
VNairrtbud er of nurtuut ca itai rosourcaa avallabta
or0'C�APs
er of Gertifiad AOhtA Trainers er of cerltlfed Feml1 Devolapmont Tremors 0 r of Carolled Child Deveid era Trainers staff obtained other credential fttdt increase theircaPSc1'r to achieve resvha ie;<alaln in narrative 40
rataloftandrranaQernardwrendi-ytlrelnl n — - 27
r pi board members artBndln fralnl s 9
H.IHDtirs of staff and Tana emernt tralnln s
8
t. Hours of bpaid members in tratning 9
2012-2013 CSBG Work Ptan ATTACHVEMT C 4 of g
RECIPIENT;Seminole Count Govemmen! CONTFIACT,-1456-0Q-06-69-01-025
A 8
NP!
OUTCOME Units Expected
To Be
Achieved
ASOW ncruwAbttfVto toodwe" rlickCN.6WPrognras7bmMseF urrlgfelley. IrtdienteWfthan'X"f}reONEaraivn,anllrrA*no
Tahk 4 g ingt B�5'f deecrlbee yourbrgeetissSon. -
Client Intake Process
A 1. A common W""------and common DOW used forjJ rftts _ x
2. A common JA-fake process and common 100+is used for some clients 0
3. A se orate intake rtTCase arfrYaf sa orate iDfi FS used 1al raeeR m admintslerad� 0
CiienVCtMtprrrer Was ura Prograss at+
towd Achiavame ntof Sobs_ulficisncy _
L A, utilizes a uafatasen for all clients 1w use In intake and assessment and rovisJan of services X
R 2. A = ufiliM dalaa seas ter a dents forusa in intake a,cr as3essmer-.and proVision of services 0
S. Aqenc uses daiabase to:all clrrn+rttakelassassrnenil le•c• or services&outceme mamuremenl ❑
6. A en, us—dwa6 t—rqg Ci;er.l Inl6kelas595SittenVservv�e g,wlsior R_outcome massuremant 0
Computer ro rams used tv mane B Gnarl!Information and track of ont pmogress
1 t. Client Soda;Se Vcos T rocker ICSST Gata Ca Sal
C. 2. 0
3. 0
4. a -
s. o
TWO VA nc O s 6 d rates. ne Se cetulfldptdrttieaT td note frShi Farm Gnlnri+ttnt Door,*,. war Yon
A enc etas the ca c' tore rts]ishVcus[omer read 10MM SWI•atltf tie
1. A enc can ra rt autoames that messure ar wRhoul use of an aukome scale. Ya5
A.; 2. a cn utilizes outcome soates to rneeaure otert mavemere toxsard self eutNclan No
3. Ac-arc y has C486ty to dark*unft cos!Stall fts'CDStlServECe defnrered or rxst tM service per dierd Yes
1.a-LA rc has[erotic tcl detfva ur It cost stulistics tar etfeeflveness• cost egrouftmedefivered No
1kR+provid*d ROMA raining w+trin thrr�sest 2 years k a cartlrl0d dOMA trainer
st'Od d me A f "hen TtOO MW ROMA tralnin Na
+nan3 amen;slafl has reWVW ROMA lrairrirg Yes So eels cot h receied pOMA trelnrn� No
nc sc'?ha r�ceveTr FROMA lrelnlnv Yes
o ram r a:hieved■cc ronitation demnstmUn the meet or excaed nationall recoanked standaC. ChiiOhooa care antl erluCatlar sites rmiwe NAEYC oTrMerroc '11;ed Tomis of accredlavon ms aMo4 ww lorm d rec nmed accredilafson. No
fin lemen l ROAAA mole and mane eRlent raetices
0 i. A has er ed and fen,enrea Y ac otais Ior ae rams and activltles YeB
2- A rams and act•vrlios are avviufoco using ROMA ais No
3. FOCAS&IS Su re rs are o•Cfulda3!o,ra%sewea It d�_aad vArh board members at ieasl uanen y9s
A 5e'lot Z5 ans SS a is oio Or olden 1 100
Individuals with Dialbltities 34Z
!•,A 0 I. ' 342
8 2, A 18-54
0
3_ A"S5 and Over 0
e-; Llnknowr+
AfCSIE:Santora are also rYit=iNdrd x isAv[tna'55 and C xr'calory
A-JETtemencv Food
S Erne Pn.. Fue'Of Uub Od Qn15 r.nciud,r. _iHEA?Or other aokC ar pnvase rur.dn^scLrcz} 117
0, Erne an_ [?err ar rrarlgagB kssista ncIE 344
❑, cn arc Cer e,Nome R air f[ St rL Chiral,ac liar,ce,r ea rn s..Tern, ,P(-) 0
`c. Enre! &n.. Tnm ra` 5—Hf 24
F nemen V4WJ1_a1 Cara
125
G EneMencyPro:a''!rwPurr Virlacce f�
N. Enerr n,. Lo al Ass�slance ❑
Ems en T ens oratmrn 12
J. floflel ❑
K. IE ne en[y clot�'np ❑
L PrSvde!-aniaTon as3lsiarsc[ �--nraLrto•s;e,nr'crc�:eive erne;,ern•se:v..es r
2012-2013 GS 6G W o1k Plan ATTACHMENT C 5 of 6
RECIPIENT-Seminole Caunry Govemrnt'rlt CONTRACT; 14EB-00-46-(i"1t 025
A S
UnNS Etpacfrd
NPI OUTCOME To Be
Aahifaved
ChN and fan Uy a-
e
Intam and CNO
MY arls and cn�Idren Dt)fam�Da auvT•pna:e rnmu^!r;atirms r'lEdical aid dPC.a,ca:c ants ana chi,dren healTh and C:f: siG31 aeva'❑ menr ere ii.nNeO r5 a reSiI[u•'adep!,a}e n1,tm:C- 0
Idran TP In ra it hp•�eC iryrNES to deyeipp scroo.iaaOm E55 3klIJS. 0
r;tlren pa IiuD3I:r !n rE•SCh]Cacuv t es ere cseve!o menlaL' rd for K-ndergarien or i5r G ade jrh Im rave neanh and on alai develDmeni uth im rave sociavemo8onaf development unt[avoid tisk•taWn behavior far a definaad erbd of time s9
uth have reduced im d merit wlttl criminal'ustke fens Q
tl1 ncre�se of etlemid athletk or social sklUS rtic Sin to before or after school ra rams ente antl other adults leam and axhibit f roved 6ntln Slrlits rl
2 P1r& N antl Wier ad Wls learn end elrhibll rm roved Ierrrlt UrwAorrn skills 6
A. Enfat+csi rhrldren in b5fore or ShBr school pmgrams 39
6.,Cbinmedcarefachudorotherde endart
C c3bfarned access ro reliable lran rtailm apcVor drivels Incense fl
a.'ODWred neafth care S"icas'ar rhernsetves or a iamly memov ! 2.579
�F I(XI&n0d seta and a'roida Ws hous' -
1.4
F D[ralns t toad assrsfence
954
G. D41 fined nan�rne 9n LIHEAF ones ass stancr 20
H. C.a!ned r�6rii`Tn Qr'4rt W x aria d55!SIenCC D
I. Ootalnod other non-ems EPIC a^er RSStstance tSular Ymwr:1 r ny Cr ran•N VOT r.c,.,,l:Hf-AF c•WA 0
A Fv]tl QaReP 1 923
8 F clyds oI Food D
G. ilnf5 Cf Cothln
D
p RiC63 Prutieed 76
E. liformauoi and P21onal Calls 1947
2012 2013 CSSG Work Plan ATTACHMENT C 9 of 6
FY1014 CSSGAGREE;MFNT
ATTACRMF—NT N
JUFTIFICATION C1 ADVANCE PAYMENT
R.EC1P1E►JTc Semimolt County Govcmmtnz CONTRACT NIIMBE;R:145$-0D•G"q_411-025
Any xdxance paym n(wader;his Agmefriene is subject ro 5,21 G.18] Morida Statutes and Section(17}(h)of this Agteem"t(sec S;, Nou
L+elow).the Recipient t)-d enrest cash adsancas w complancc with serior..21 (h)(2),1)of the Common Rule,sECt10 n,2?of();\JB Circu,a A,t i t?
as revised and Attachment E,5ectian F of tivs tgretr�ect. Check d.e mplimble hoe below(check only one).
�NO ADVANCE REQUESTED ADVANCE REQU—
STED
No advance payment is beinz miuested Advance papmenr of is mquested I3aIance of payments thll
Payment sviD be mode solely on a ht made on a semburscrr+wt basis. '11ese funds are needed to pay staft,awaxd
reimburscaaent basin No addiconal beme5rs to clients,duplicate formE and pvschase sran-up supplies and cquiysnent.
tafurmadon is roan d We would nut be able to operat.the prograry without this advance.
cam' R L Rr'fS��ET 'fan advance is[cyue?red,cfxnplete the follo'1VMg worksheet by FLM:zgin rlte ceilt Li4ibgl red in yellow.
DESCRIPTION F'SZ41] FY2012 Fy13 (D)
Tatal
1 TOTAL GOhTftACT ALLOCAT ION{Includes
any base inereasts and earryferonrd doIIars) p•'
FIASTTWO MONTHS OF CONTRACT'
2 EXPENDITURES' 9.Ot7
AVERAGE PERGENI EKPEhMED rN FIRST
3 14 ffiONTFY5 wide line 2
by iior 2 #Il1V/91 #DlVJGl #I7lV 10l #IDIV/C!
s TIC nvmses feu the fire[two Months in whieh.�tuzrs were need m be provided for the years you received a csW eontiact. if vw do not
)Lave this infom+aarm.tall your contracrmanager and they wA"6q you.
The Recipient may request as amnnnt up to the historical prrccnt of expenditares for the Gast 2 montha of the Agreement OR W/.Of the award,
whicbever is km.
( STl1R A 1.PERCENT p�$_FSRST 2 M �]5 #iDFV J0! x S 17V8100 _ 4D1V 101
C I-UMrica Advance C a
1?°Ja_GALCULALTIOX — 175,282-00� _ x 0.17 _ = 29,707M
CSBGA%wd PerrtutofAwned 14fwdmttrnAdrancc
Special Note Re ding Psucessing of Payments after Advances:
Tha Recipient is allowed to naquest an advance sxnimmt of Agreement fun&g to-m Mat tamely payment of benefits along with covcsing rte initial
oPcmxtorlal f nrtxhtsd owls far ptoviding C$BG strutter. However,ivy advance payment under this Agreement is subject to E.216.181(16),P3.i a Statnte3,To
ensure compliance with thia&tcdver
S) DEO will cvmpancthe adVaacc amount received by the Recipient wit,the toW to date expended amount oQ the Rccipsenes second PSR to cttczr ji a if an
a:movntegLmI to the advance amotwr received has been expended
l+) If the Reripient his not expended an aramwt equal m the mitral advance,DEC!staff tivD c(matt the Recipient to determine if t6",13 a reasosaLle
juatifieatinn for not meeting dais gnat 11at justification adoag with any supporting docwneotxtion shall be eabrrutted m v idng to DEO Cut revinv.
cl If tht jvstibca6"is met appmrM.an adjustment may be made to tht Reo`Pr eytt's reimbu"`ncat xetyvcst armo+mt on the Reapirnes secamd l.SIL 'Me
taluested rtimbnrsement aaroum aaay be=dneed by the unexpended bakace te*r+a!*ri a on the advanm. 'Phis reduction will Jower6r..cash Advance
arnaunt the Recipient w+Tl have on hand to meet expendituaes.
9diustmfnt5 to the adicoeed amount mar be made at any time durin•the Agreffownt riodlvhim deemed approvtiate by DEO
Page 44
MODIFICATION OF AGREEMENT
BETWEEN
FLORIDA DEPARTMENT OF ECONOMIC OPPORT[]NTTY
AND
Seminole County. Florida
This Modification is made and entered into by and between the State of Florida,Department of
Economic Opportunity (Abe Depat'trnent`%and Seminole Count v,Florida("the Recipient")to modify
Department Contract Number 14SB-4D-06-69-01-025("the Agreement").
WHEREAS, the Department and the Recipient have entered into the Agreement,pursuant to which the
Department has provided a sub-grant of S.175.282 to the Recipient;and
WHEREAS,FY 2013 carryover funds are available to increase the amount of the funding granted to the
Recipient;and
WHEREAS,additional funds have become available to increase the amount of the funding granted to
the Recipient;and
WHEREAS,the modified sub-grant is now$411,271.
NOW, THEREFORE,in consideration of the mutual promises of the parties contained herein, the
parties agree as follows:
I—Paragra€h € .)(a)ftilding
(a) This is a cost-reimbursement Agreement. The Recipient shall be reimbursed for casts incurred in
the satisfactory performance of work hereunder in an amount not to exceed$411,,271,subject to the
availability of funds and appropriate budget authority. The Recipient is authorized to incur costs in an
amount not to exceed$34,55831 until further notificatioii is received by the Department. As funds and
budget authority are available,changes to the costs the Recipient may incur will be accomplished by
notice from the Department to the Recipient's contact person identified in Attachment H.Recipient
Information.The term of the Agreement slF.aIl be considered to have been modified to allow the
Recipient to incur additional costs upon the Recipient's receipt of the written notice from the
Department.
This revised contract amount includes:
A. $ 175,2$2 Current CSBG Allocation(FY 2013-2014)
B. $ 155,718 Carryover from FY 2013
C. S 80,271 Base Increase(FY 2013-2414)
D. $ 41I,271 Total (Amended CSBG Allocation)
2. If applicable, Attachment H,Recipient Information,Atrachruent I,Budget Summary,Attachment i,
Subrecipient Information,Attachment K,Budget Detail, Attachment L,Secondary Administrative
Expenses and Attachment M, 2013-2014 CSBG Community Action WoTkplan are hereby deleted,in
their entirety and replaced with Amended Attachment K Recipient Information,Amended Attachment
1,Budget Summary,Amended Attachment I, Subrecipient Information,Amended Attachment K,
Budget Detail,Amended Attacbment L, Secondary AdminiWative Expenses, Amended Attachment M,
2013-2014 CSBG Community Action Workplan and attached hereto acrd incorporated by reference,
3, Exhibit 2,Special Audit Requirements is hereby deleted in its entirety and replaced with Amended
Exhibit 2,Audit Requirements and attached hereto and incorporated by reference.
4. All provisions of the Agreement being modified and any attachments thereto in convict with obis
Modification shall be and are hereby changed to conform with this Modification, effective as of the date
of the last execution of this Modification by both parties.
5 All provisions not in conflict with this Modification remain in full force and effect, and are to be
performed at the level specified in the Agreemem.
REMAINDER OF;PAGE INTENTIONALLY LEFT BLANK
IN WITNESS WHEREOF,the Parties hereto have executed this document as of the dares set out herein,
RECIPIENT STATE OF FLORIDA
DEPARTMENT OF ECONON BC OPPORTUNITY
Seminole Count ,,oard Co my Commissioners
(Type Le pie g.
By: -0r By
Robert E.. _pallari, Chairman BCC William B.Killingsworth,Director
(Type Name and Title Here) Division of Community Develc)pment
7" r Date:
Date: _ 6
596DD08S_�
Federal Identification Number
067834358
DUNS Number
*Data Universal Numbering System
Approved as to form and legal
sufficiency,subject only to full and
proper execution by the parties
Office of the General Counsel
Department of Economic Opportunity
By: --
-- i
Approved Date:
FY 2014 C513G AGREEMENT
AMENDED EXHIBIT 2
AUDIT REQUIRENIO TS
The adnninistration of resources awarded by DEO m the recipient may be subject to audits znd/or monitoring by DI;G as
described in this secriols,
M CsNITORIN-
In addition to reviews of audios conducted its accorciance with C)i•O Circular A-133 and Section 21.5,97,Fla- Stat,,as revised
(see"AUDITR"below),manirmr.-ing procedures:nay include.but not be Lpuuted to, on-site visits lay DEC)staff,'Mired scope
r
audits as deftaed by OMB Circular A•733,as revised,and at other procedures. By rntenng into this agreemuent,the recipient
agrees to cornpIy and cooperate with Any monitoring procedures/processes deemed appropriate by D$U, Its case event DEC)
determines that a limited scope audit of the recipient is appropriate, the recipient agrees to carnpls with any addidonal
instructions provided by DEC} staff to ncc recipient regauczng such audir.The recipient further agrees to comply and
cooperate'xith any inspections,reviews,investigations,or audits deerned necessary by the Chicf Financial C)fficer(Cpo)oz
Audmtot Gener21.
!}_£IJITS
DART 1, FEDERALLY FUNDED
This part is applicable if the recipicrtt is a Stare or local government or a non-profit organization as defined in QMB Circular
A-133,as revised-
1. 1n the event that the recipient impends$300,000{31�4,d00f rfrrcnllcarr e�Jdin�g after D:cm,,bcr-3 l,?Q0j)or more in
Federal awards in its fiscal year,the recipient must]save a single or pcogxam-spceiflc audit conducted in accordance
with the provisions of OMH Circular A-133,as revised. EX 1.1SIT 1 to this agreement indicates Federal resources
awarded through DE❑ by this agrccmeat_ Ia drtemmining the,Federal awards expended in its fiscal year,the recipient
shall consider aE sources of Federai awards,including Federal tescurcer received from DEC), The determination of
amaurtcs of Federal awards expended should be in accordance with the guidelines established by OMB Circular A-
133, as revised. An audit of the recipient conducted by the Auditor General in accordance with The provisions of
MvM CircWar A-133,as revised,will meet the requirements of this part.
? In connection with the audit requirements addressed in Part 1,paragraph 1,the recipient shat!Fulfil!the requirements
trelaft to auditee respons1ilities as provided in Subpart C of 01,43 Circular A-133,as revised.
3. Ff the recipient expends less than$300,000 J500,000 for fiscal years enciisrg after December 31,2003)in Federal
award; in its fiscal year,an aticEt conducted 6 accordance with the pruvisiorss of DAB Circular A-133 as=wised,is
not required. In the event that the recipient expends less than$300,000 ($500,000 for fiscal years crdi,ng after
December 31,2003)in Federal awards in its fiscal year and elects to have an audit conducted in a.ccordaace With the
provisions of OMB Circular A-133,as reviscd, the cost of d-ie audit must be paid from non-federal resources
cost of such an audit must be paid from the recipient resources obtained from other cyan Federal entities).
4. -Although the audir provisions of DNTB Circular A-133 ordinarily do not apply to for-profit sub recipients,in the case
of Federal funding prn,nded by the U.S-Deparanenr of l`lenkt and Human SeLvicnes,Circular A-133 dues apply. See
43 C.F.R. 74.26 for further detaits.
S, A web site that provides finks to several Federal Single(Audit.Act resources tan be found at:
Ittt{,� ha n'ester.cettisus�.or.;sa�!sainFo.html.
PART II: STATE FUNDED
This part is applicable if the recipient is a non-state entity as defined by Section 315.97(2),Fla.Star,
1, lathe event rhar the recipient expends a total amount oEstare Financial assistance equal to ox in excess of$500,000 in
anv fiscal year of such recipient{fox fiscal years ending September 30,2004 or thereafter),the recipient must have a
State single or project-specific audit for such fiscal ycaz in accordance tv-ith Section 213.97, Fla- Stat.;applicable Writs
of the Department of Financiai Seivicrs,and Chapters 10,550{local gorertimental enunes) or 10.650(nonprofit and
for-profit organizations),Rules of the Auditor General. EXHIBIT', to this Agreement indicates start financial
assistance awarded through DEO by this agreement. In detemurung the state financial assistance expended 1n its
fiscal year,the recipient shall consider all sources of state financial assistance,including state Est�ancial assistance
received from DF.0,other state agencies,and other non-state rntides. State €financial assistance does not include
Federal direct or pass-through awards and resources received by a non-stare entin,for Federal prograrst matching
requirements.
2. In connection with the audit requirements addressed in fart II,paragraph 1,the recipient shall ensure that the audit
complies with the requirements of section 213,97(8), Fla.Stat.. This inc:udes submission of a financial reporting
package as defined by section 215.97(3),Fla.Star.,and Chapcera 10.550{local governmental t:ntides) or 10.6S0
(rsonproftt and£or-profit organizations),Rules of the Aud-;tor General,
3- If the red'pient expends less than$500,000 in state fiaaacial assistance in its fiscal year(for fiscal years ending
September 30,2004 or thereafter),an audit conducted in accordance with the provisions of section 215.97,Fla,Star.,
is not required, In the event that the ieripient expends less than$500,000 in state financial assistance is its fiscal year
and elects to have an audit conducted in accordance With the provisions of section 215,97,Fla,5tat.,the cost of the
audit must be paid from the non-scatc entity's resources (i.e., the cost of such an audit must be paid from the
.recipient's resources obtained from other than State entities).
4- Additional information regarding the Florida Single Audit Acr can be found at:
hf!t,:!'tii�vti:•,m;r'�orida�r m,,fs�3_'atat_ tu__eSrIzS�11.
PART ILI; OTHER AUDIT REQUIREMENTS
VOTE.-TGil art iwplll be used!a S ee ,aiLy addi/loin!audit izgairemeiitt impaled Gy 1he.State aw I iug entity Thal are salr�
mailer of that Stale amaldfrig enta!}'t palig(ii a, the aildrl is Nat regnired Gy Federal ar.Stale.',r?Ps aid a 1)01 en ran_,7U u Atli other Fedt7'al
dl'S'lafc ri�lr11117c3Ni727ileJ1lrj. Pv?wtaw to,Seaiov 2U97(8),- lorirla Slntufes,Siaie agondes ivg Cal7dea OIL arTplSefor Aw dilf of ta,
f/7d1717g1 alSLrldACe thol alt'Ili ad6rtia71'n midr'1S tofidnrtrd iii ascards�nce twill)Sertiaa 21S_97,F,vida Statxler, In slab art eueut, &0
Stale owardi'i ❑.,eiic9,,,,Irt anzrlJe f,rrfruidirig t"e fir 11 LOS/of sllcli adddtaanal alydil rj
N/A
PART rv: REPORT SUBMISSION
7_ Copies ofreportirtg packages for audits conducted in accordance with COMB Circular, -133,as resnsed, and required
by Part I of this Exhibit shall be submitted,when regcru•ed by Section 320(d),OlvfB Circular A-133,as rtriscd.by or
on behalf of the recipient directly to each of th&`odowing at thr address indicated:
?. DFO at each of tltc following addresses:
EhectroniCtopies(preferred} ,•�u�irrc�,r�eo,rn•flarida,_curu
o:
Paper(hard copy):
Deparanert of Economic opporttsruty
AEC# 130,Caldwcll Building
107 East Madison Street
Taliahsssee,FL 32399-4126
B- The Federal Audit Clearinghouse designsted in OMB Circular A-133,as revised(the number of topics required
by Sections.320(d)(1) and(2), CkM Circular A-]33,as revised,should be submitted to the federal Audit
Clearinghouse) at the following address:
C. Other Federal agencies and pass-through enrides in accordance with Sections .320 (e)and(0.O1�0 CircWar A.
133,as revised.
?. Pursmw to Section .32C (0,OME Circular A-133,as revised, the recipient sl^alt submit a copy o.f the reporting;
package described in Section .320(c), U 1MB Circular A-133,as revised and any management teeter issued by the
auditor,to DEO ar each of the following add-resses
Electronic:copies (preferred): '.0 ;a.d v_.m:Iuri a.Lo
or
Paper(hard copy)-
Departanesrrof Econotnic Opportunity
MSC #k 130, Caldwe.L Building
107 East Madison Street
3ali2bassee, Fl,32399-4126
3_ Copies of financial reporting packages required by PART II of thus Exhibit shall be ,ubjTizrca h`-or on behalf of tlzc
recipient ec %to each of the following'
A. DED 2t each of the following addresses:
ElrctrQZticropies (preferrco7: .luciit��clec>.tn #lnrrdg,ecm�
or
Paper(hard copy):
Departrmnt of Economic Opporrumty
DISC# 130, Caldv ell Building
107 East N12&son Streer
Tallahassee,Fl. 32399-4126
B. ne Auditor General's Office at the fallo-v.ing addres.-z:
Asa&or General
Local Gm-ernment Audin/342
Claude Pepper wilding,Room 4dI
l i I West Madison Street
Tallahassee,FL 32399-1450
EmaR A.ddtess: flu cn 1. cal;r�v_t•t-':auci,statr..2•us
4_ Copies of reports or the management letter required by Part III of this Exhibit shall be submitted by or on behalf of
the recapient directly to:
A.DEO at each of the following addresses:
N/A
5. Any reports,rnanagemerst letter,or other information required to be subxrdcted ro DF_O pursuant to this Agreemenr
aball be submitted timely-in accordance uith OMB Circular A-133,Florida Statutes, and Chapters 1G.550 (local
governmental entities] or 10-650 (nonprofit and fot-profit orga=ations), Rules of the Auditor Gesseral,as applicable.
6, Redpiertts,when submitting financial reporting packsges to DEC for audits done in accordance with ONO Circular
A-133 or Chapters 10.550(local governmemal entities)or 10.650(non-profit and for-profit organizariors),Rules of
the Audhor General,should indicate the date that the rcporring package vv-2s delivered to the recipient in
correspondence accompanying ncc reporting package.
PART V. RECORD RETENTION
1, The recipient shall retain sufaient records demonstrating its compliAnce with the tetras of this Exhibit for a period of
fsvc(5)years from the date the audit zeport is issued,or five (5) State fiscal years after all repotting requirements aze
satisfied and {•trial payments have been received,whichever period is longer,and shall allow DEO,or its designee,
CFO,or Auditor General access ro such records upon request_ fn addition,if any litigation,claim,rcgo6ation,audit,
or other action involving the records has been started prior to the expiration of the conrrolling period as identified
above, the records 6211 be retained until completion of the acdon and resolution of aL issues which arise from it,or
until the end of the controlling period as identified above,whichcn er is longer.The recipient shall ensure that audit
worldng papers are made available to DEO,of its designee, CFC), or Auditor General upon rertuest Far a period of
five(3)years from ncc dare the audit reporr is issued,unless exrended in writing by DEO.
FY2014 CSBG AGREEMENT
MODIFICATION TNSTRi7CT'IONS
For Amended A.ttachmems H through L*
-3n.tcuctipns Fu:ccnplcting Amcmdcd Amchmznt hf,Cornrnuuny:.ctun Wo' kphn,sct er n1v VXce!I'uc.
5ectinn 1: Excel Notebook
This Excel Notebook contains the following tabs:
Instructions -READ FIRST
Sample Budget Detail
Amended Attachmenr H
Amended Attachment I
Amended Attachment J
Amended Attachment IC
Amended Attachment L
These tabs correspond to the Attachments in your FF'Y2014 CSBG hfodiftcation Package. Complete these
.kttachmeats using the worksheets contained in du5 Excel Notebook, Once you have completed the worksheem
replace the blank space holder pages in the two original signed copies of your CSBG Yodiacarion_
Sectiom?, a mn-1-c-S—Udg"_L) 1
This tab connins a sample budget detail for your reference when completing your agency's CSBG Budget Detail.
Se_Cugz&,- A=udeAAtt eAt ecimgnAnf'amari-qu
Complete this worksheet ONLY if you have amended recipient information to report.
Section 4: AmCr dA-=clas�se �'-
Amended Attachment I,Budget Summary,is to be completed by the Recipient. Subredpients,if any,are to
coniplere Amended Attachmer_t j, Suhtecipient Itxfoin-adon and Budget Suzx qw7, Amended Attachment I,Budget
Summary,is a composite of the Recipient's budget derail and 0 subrecipient's budget(s). Rormd aI]figures up to the
nearest dolla-. All entrdes must be supported by Amended AttachmmL IC,Budget Detail, ND2'E.• Yau must crater
the Recipient's frame and the DEO Contract 11lurnber ar the top on this attachment. J'Ais U.0 arrro adeally
populate this information to the other attachments,
Line 1: CSBG Funds: Enter the ORIGIN AI..allocation amount in Column B, the total ANIENDED but{get,
including the base in=ease in Colutaan C; and the amount of carryover,if any;in Column D. Column E will total
automatically.
Line 2: Recipient Administrative Expenses:Enter the total admillisuative costs including salaries and fringe,rent,
utilities, navel,and other items to be charged to this contract. See enclosed OCS 4fGniaii0n dfenlarandrirti#37 ng j-,&g
the deniiim of achwinislrutiue coil.
Line 3: Subrec:ipient Administrative Expenses: Enter the rotal of all admisaistrative Subrecipient Expenses
including salaries and fringe,rent,udJl tics, travel, and otlier. This line must be the sum of all sub_recipiellt expenses
as reported in Amendcd Attachment}. To ercntrule.fietueert a smGjedpecal and a vendor,see at'�ched excerpt from()MB
CirwlarA-133.210, .filbrecipient Vendar.t'Deltrniairalion.
PAGE 1 of 4
Line 4: Total Administrative Expenses:The total of Lines ?and 3,This number witl be calculated automatically,
Line 5-, Administrative Expense Percentage:This pet•cent is the Iota:amount of adnvn1st2ative expenses from Iwe
4, Column C, divided by the total amcaunt of C5BG grant funds from line i- This may not exceed 15 percent. This
nurnbet will be calculated automatically. The unspent adn-unistutive amount cartied forwatd horn die 2012-2013
CSBG contxacr is not part of this calcui2d0n.
Line G: Recipient►Direct Client Assistance Expenses:Enter the total rrotn.Amended Attachment K,Budget
Detail.•All activities paid for under this line item must be supported by and directly correlated to the outcomes in the
Amended Attachment M,CSBG Commusiiry Action Workplan. See dafinitio&avid f-thew-f kPlatrntion rev Bvdgel Dead
InStFvr 0nT-
Line 7: Recipient Other Program Expenses: F,nter the total from Attachment 14,Budget DetaiL All activities paid
for under this line stem must be supported by and directly correlated to the outcomes in the CSBG Comrnunirg
Acdon Warkplan, Attachment,1d.
Line Ss Subtotal Recipient Program Expenses.The total of Lines G anal 7, This riurnber will be calculated
autornatica131.
Line 9: Subrecipient Direct Client Assistance Expenses: Enter here the sum of all subrecipient direct client
assistance expenses as budgeted on Amended Attachment i, Subrecipient Detail. Ail budgeted expenditures must be
derailed on Amended Attach ment K,Budget Detail,and supported by and directly correlated to the outcomes in the
Amended Attachment M,CSBG Community Action Workplan.
Line 10: Subrecipieat Other Program Expense: Enter here the sum of all subrecipient Other program expenses as
budgeted oa Amended Attadunent J, Subrecipierit Detail.All budgeted expenditures raust be detailed on.Amended
Artachtnent K,Budget Detail,and supported by and directly correlated to the outcomes in the Amended Attachment
M,CSBG Community Action Workplan.
Line M Subtotal Subrecipient Program Expense:The total of Sines 9 and 10. This number will be calculated
automaticaUT
Line 12: Total Program Expense:The total of Litres 8 and 11.This number will be calculated automatically.
Line 13: Secondary Admu'listradve Expense: This line must agree with the total Secondary Administrative
Expenses reported on Amended.Attachment L,Secondary Admim. See Attachment A, Section(G),and Attachment
E,Section D(10) for additional information,regarding secondary administrative expenses_
Line 14. Grand Total Expense:The total of all admiuistratLire,progtaru,and secondary=expennses. This number will
calculate automatically and must match the CSBG allocation amount on Lute 1.
Secu'uu_ Am aid Huth S�rnmary;
Complete this attachment far each subrecipient,if applicable, or rnark N/A.
PAGE 2 of 4
Section 5: Amended Attachment K Bud-get D7MLI
The budget detail must Follow the forrnar reflected hz the "Sample Budget Detail." Budget detail not submitted in
this format will be rgccted and will delay the contract. Each recipient and subrecipient is required to provide budget
detail for ail anticipated expenses.All CSBG funding expenditures must be detailed.. Subtotal all Items vidlIn a budget
line, Report the line itctr.subtotal on the,lmmded Attachment i,Budget Summary,
Budget Line Item Number. This column ties the eapmsc derail to the line item oaa the Amended Attachment 1,
Budget Summary.
NA!k nql Ptrt' rman,ce Indicator NPR: .All program expenses budi,=ered on Lines G,7, 9 and 10 on the Budget
Summary,must be identified by lV-PI dumber and must tie to the Amended Attachment 1,budget Suinmaiy, and the
Amended AttacErnentM,CSBG CortmurdtyAction Wotkplan.
Expeuditurc Detail
The riarrative given in this column must be sufficient to explain the expenditure. The expenditure category-OdLa:"
most be itemized fegardless of its total budgeted expense. Provide explanation and description of the costs. Small
items such as office supplies may be categorized. Any equiprneat purchases must be acquired and accounted for
according to OMB Cirollus A-110,and property,management, and procurement standards.
jI Q4Q2j;Mizase•
Any single itern purchase costing mote than$1,041}including services trust be specified in the budget. This includes
cornttaets for services such as computer ox equiPlrruc maiatenance as well as the equipment, Purchases made for
intemal agency use as well as purchases trade for clients must be specified.
TL3V �"
Mueage. Because of the strict travel t6rnbursernent rules related to mileage,be careful to specify any tnileage ra;e you
rp
plan to use, the puose of tht travel aid the estimated number of miles. The cost of automobile tepa.irs or
cnainrcrzauce and fuel are included in the mileage reimbutsement and may not be budgeted or claimed separately,
Current State approved mileage late is 44.5 cents per mile.
v t r
Travel ourside of the Recipient's service axea and travel to conferences, meetings or tts ing events,roust be specified.
If the total a-mount budgeted for this type of travel exceeds 2$0 of the CSBG award, the Recipient must provide
additional justi fication. The lust:Lwion must include. the name of the event,who will be attending, the persons'
position-, total estimated cost for the person to attend the event,and the benefits the CSBG program will obtain frorn
the person's attendance_
:;alarm
Identify sources for the balance of salary for any position where CSBG funds are used to pay less than 100 percent of
the salary. 7"us information should be consistent with your cost allocation plan and indirect cost rat,gany)_ See
sample budget_
PACE 3 of 4
PROGRAM EXPENSES
Describe the activities to be paid for in general tennis,but with enough detail to ans%ver die questions VA-jar is being
ptuchasW How much is being spent per person or cvenO Ilow many people or events does the agency anticipate?
For eaatnple,use"A maxin-.um of 25 self suffscie-ncy clients will be pxoN7ded with public r.r-asasportation Vouchers
worth no more than$75 per participant". rather than, "Self-sufficiency clients will b e proN�ded with transportation."
This will give the agency some flexibility and reduce the need for contract rnodi;scacions,but still give enough detail to
tie the Funds to the NPI,
Direct Client Expenses. `these expenses can be traced to a specific client or group of clients and 5uppolted by a
NPI in Goals 1 or G- Tius includes psyrarnts made directly to a vendor on a customer's helaalf. For example,costs
incurred in achieving Goal l rnight include rttition,books,work supplies, etc. For Goal 6 it night include rent or
utility paytnencs,food or fuel vouchers,or medical supplies. Acth ties such as case rxranagement, counseL.-jg(budget,
careez, housing,etc.),transportation, or tax preparation should also be included. These costs n-my be provided ditecdy
by agency staff(cost of salary, benefits, etc.)o,t•by subcontract with another entity. Then budgeting staff expenses,
give die job tide and a brief description of the type of direct client assistance the position vain be providing. For each
expense,indicate a related National Performance Indicator. if a salaried ernployee whose position is normally
considered 2-n administrative in natuze,such as executive director or fiscal director,is included under this category,an
explarutian of what direct client assistance acd%ities he or s€re will be providing must be included.
Recipient Other Program Expenses are non-administrative expenses related to providing services to uustemcrs
that cannot he tied directly to a specific client or group of clients,or directly to a National Performance Indicatar_
Exarxiples are expenses related to general program outreach,client intake and income certification,pxogra n
cooxdination w'th otherservice providers,rent and office expenses,staff training,travel,etc.
se -on�: A�&n4f �� L SeoQiltlars Admin's tivcatpen.ee
Gotnplete tl:is attachment for any pxogzasns you axe claiming secondary admirristrative expense for,or mark N/A,
PAGE 4 of 4
FY2014 CSBGAGREEMF-NT
AMENDED ATTACHMENT H
RECIPIENT INFORMATION
FEDF-RAL FISCAL YEAR: 2414 CONTRACT PERIOD: October 1,2013 through September 30,2014
Instructions: Complere the blanks highligh[ed in yelow- Far item 11,put 26'X'in whichever highlighted box applies to your agirocy.
I. RECIPIENT Seminak County Gaverntnmr CONTRACT#E: 1456-[717-05,69-0I-025
II. R.ECIPIENTCATEGORY: ❑Nan-Profit li,oca (7ovtmmer-t
III.COUNTY(IBS)TO BE SERVED WITH THESE FUNDS: Seminole Covnry
IV, GENERAL ADMINIISTRATIVE INFORMATION
a. Executive Direetor or Chief Admitristratur: lralmaric I I Turner,Director,Semin[rlc County Community Scrriec�i
Addrt:ss: 5341C•,]fake,hlnry 13otilevard City.Sanford RL 4code. 32773
Telephone:407-665-2302 Fax; 407-665-2309
CCU: Entail: �turri ti+;�mut[ticxn[zntif}.n��•
Afa,Wq.addrrts i;raifereor1rarn above
Mailing Address: City: FL Zipcode:
6, Chief Elected Of£tcW for Local Governments or President/Chair of the Board for Nonprofits;
Namc: Robert DaRari Title:Chairman,SCmicole County Ikzud of COUnty Commissioners
Address*:7701 E 3 s c Street City:Sanford ,FL Zrcode: 32771
Telephone:407-565-7215 Fax: 447.665-7458 Ema l; f �r i,na drn.,• 's r y�srunnfl.ac�
"Enter tome or buu'rre-u a&=-.a,40Gn4e nusrberr and emalia)w lbow r6e Reripianr'r
c. For Public Agencies:Chair of Community Action Board
Name: NIA Title:
Address" City: FL Zipcode
Telephone ax: ki=iik
•Enr&hw-er bxshrrrs adiirnx.rrlephcne nun16er1 and email el h?r than Ike fi nowit'f
d. Official ra Receive State Warrant:
Ntrnc: Nfaryanne hiorse 'Title: Clcrk of the Circuit Cove,Semino]c County Cltrk of the Courts
Address:PO Box 8699 City: Samford FL Zipcode: 32772-8094
e- RecipientConmcns
1, pmMfli: Name:alivette Carter 'ritic:Division Maaaget,Seminole Cvunry Comrittmiry A,y$tancc
Address: 534 W.Lake Mary Boulevard City: Sanford ,FL Zipmdc: 32773
Telephone: 407-665-2303 Fax; 407-665-2309
Cell: EMA L•Ocarter @seminolewnrttyl3gov
2. 15X1 Name;Jeff Aldridge Title: Finantia]BuSiacssAdminiaC:atos,SC:Cammvnit}+Services
Address- 534 W.fake Mary Boulevard City: Sanford ErL Zipcode: 32773
Tekphonr: 407.665.2393 Fax. 407-665-2304
Cell: F.mail: ialdri d s nlc g fl vov
f. Persons) aWhatizcd to sign reports:
Tfame:Valmazie FL Turner Title: Director,Scrnionle County C;om(nurtity Service.;
lame:Olivece Cuter Titic: Division Manager,$ctmrtolc Cowry Commu oityAssiatance
NurTm :'Tamara P Johnson Title: Program Manager,Seminole Cnunty Camrnuttity Assistance
g. Agency's FEID Number: 596000856 h. Agency's DUNS Nurnben 067834)58'
V. AUDIT DUE DATE: Audit(s)are duc by the end of the Ninth month fviinwing the end oFthe agency's fiscal year.
Recipicnt Fiscal Year October 1,2013 thru September 30,2014 Audis 1)uc to DI-*U:,June 30,2015
Page 38
FY2014 M30 AGREMENT
AN1E"ED A.TUCHMENT I
BUDGET SL AMLRY
RECIPIENT 5erninoic Cauuky Gov"nmerr CONTRACT: I4SS-0rt-Drs-6901-U2 S
INCITE':Usc only whole dQUar amocw6i to cents.Round ma fiprea up to acassst"bolc dollar.
A - --T E --� _ 8
E::
0MG FUNDS ONLY Last Ammded Budgtl" Canyaver Amount i TOTAL
BUflGE1'CATBGC3RY Approved (IorJuderrne
alloaetos phu bar; CS8G fUNDS
Bu et lorrraeel 2012-2013 CoIC+I1
t MODIRED CSBC;Grant Fuudt(1 oWs) I7s,zm00 u 553.00 I55.71&00
j 4t1,Z.91A0
dDl4�7Vi�R,!<77Trt3
2 R"CSFIFN"""PM S"'2 � 73,30.pt} 36,972.00 0,00
3y SUSAMPIENTEXPENSPS
Sdarisf+ Rent U,-Lti a.Olhrr 0.00
a
TOTAL ADMINOTRATIVE EXPENSES 73,349.00 36,97200 0.00
jfe94CdMdW 5 lS77YAnW EXP NSF;"."CENT V LIIE fN 4C MAY NOT EXCEM W1
tars!l4C.t s I D0 I OF CELL IWC
MOM"
6 RBOPIENT DMHCT CUENT I 157,546.00 360,397.00} I 0.00
ASSISTANCr-,RKPENSM 3&l�l7.OA
]l!,[:IPIP.N'FO'FHFiRP8C1CrAAMEXPIiNSf? ---�---•- ---•--- -------��----�---�---------�Y..-_.`-----'�
1 4.337310 73,94200 0,00 n.90I00
� r Frio - Rent L]tilidea C�-
5tMTOTAL AMPIP.I T PROGRAM
$ I6Iy3]60 374,299.0 0.00
1DiI'TsNSB ,_lue Q+Lzna 314,299.00
4 Sl)$RPC1I11hW DIRECT CI.iBNT
_ ASSISTdNq AMJffSE§ _ _ alw
]S7`3g8RTSCIP LENT OTHER PROGRAM
T^ _�..�' -- •. i»—__---"-� � — —
F.7CPF.NSE f5al�dn.} ,Renr,i]u7it.es,[h7w' 0.00 •�
D 5EnrrCrrALL SUBR IENT PROGRAXa Cho 0.00 060
18XPENSE e 9+Line 101 0.00
12 TOTAL
B++Lied I67,R33.00 374,299.06 0 00 4r249L1>0
Woe 37
F 33 SECONDABYADMINLS'FMTrT
R7 ENSEV 0.00
En tpJid Nl)790 xAL JE> $N5r5
44,&oea-PL.Goc1i t7szr 6o a,?��r,va o.oa azl.MOD 1
PY 2OV-2013 C ncractecioscau 73D CANNOT 7CCBEL3 the eotrc�c►ading u�pont ad ,Nve baIZec from your
Cske desired adfusttnenta to lam approved CSBGr budget and include base increase wnvuut ill Column C•
FWU14 CSBG AGREEMENT
AMENDED ATTACHMENT J
SUBRECIVIENT D00P.MATIONAND SUAGE'T SUMMARY
(Complete this page fnr rach suhrecipient by providing informaminu in the yaorow-highlighted Gelda.)
RECIPrEIaT: CONTRACT.
SGaiivale county Govemment 14SB-0-06-54-014M
SUB RI^s lip—IBM SNFOR14fATIR33+T
SUBRECIPIENT NAME:-N/A
UMLING ADDRESS:
pF4L ZIP
STREFETADDRMS(IFDIFFEREN'T);
,FL Z[P
CONTACT PERSON"$NAME AND TITLE:
I'HdN,E: ---
FA�:
SLUER CEIP.
)acrinvr,6�'u�.v:7Yrfadfo+�der i/emr(3,9,f 0 arUd 1 f1 um:e rvmrtperrd H j9rorea<Srd.4/Iar�uxr f,Br�u SN�r�+ary. If I,trts k anrr rdau opr 1,tbrropirn�,i1 it
Ibe Ardprrrr[i nsr�nartb�lery m eralrrre iErr!dia!nlel of all svbrer�irnl buddter add tasrart/� Bnpaddrwai sorrel br delnilyd is�tsvrrra�ed_;glrarGwarM lC
CSBG FUNDED PROGRAMS ONLY �
EXPENSE CATEGORY CSBG FUNDS
SVWWClIgXNIPADI16tSI9X RATNVE IM[PENSE&:
3. SIIHRF3CIPISN'C j
ira(ati-Ipnw,Aral,U/,"-,,T-1.Olbrr} 1p.00
81MRECIP1304T PRQC.R"BXPM4SB&
q. SMREMIENT DMEC-r CLIENT ASSISTANCE I
SES 40.00
10. SUBRECIPI13NT DTHETI PROGRAM 85iI' NSF-
(soletia Yia A UWOW,7-fame 066) su.OQ
11. SUBTOTAL"IMCIPIENT PROGRAM
EXPENSES alne 9+lifte 10) y
SQ.40
=TOTAL SUBRMPIEWT'WXPHNSES {I..Lvc 3+
17) 1 T J0 0[l _ �J
The Ra6pic ar must have a writmo agreement with all 6ubreripirats. The agreement must mett the rdgL&snenta of Src[ton 14 of this
agrce=at- A copy of the ul-igned sgreemear with the subrecip ear must he Foswsrded to DEQ far revAw mAa itpgzuww d,,8 Math this
agrearmne. See OW3 Catcular A-133,210,Subredpient Ve ldov Detcmoirudw,for further clarlftCaL on-
Page 40
)YN14 0980 AGREEMENT
A MENSE13 ATTACH NEW K
BI-IIGET PETAII,
1 ECFPIF.NT:S--'k C--)hem _____ __ _ -_-___- - -_ - _ :vim-!IP•[ddS-.147:5
-
;LPr.LtAl' 7FRE RMA.W i .i�=JLtTi i`C+F
LcIP. IT1I]IC ITOM 7.wna u 1++r gum u]m'e ro dvlha r,SryC ['S
r7-?j I%..Camt i Ch N(lr as ;enC Md de rrtnycm-1, BJL�GSF'FD
NLS18Pa ;�H1nr.LS1 1
RF-0n T ROb1 W.f11PFT SFS
Pmplaym wd 2 Q560 8-mvmbu m.n:ma RID1104 Sara:PC diem'1pOO md.e $80 aa,m,I-=O 560.09
';1 emplapan fa.N.FAP4 fwd-
91A
10T.1h.
Op4r.lnF1 Sl*p•n(Tsnes,1ni C-dOrp).7 MOC
CIf(I.e Suq,l7e.IPPP4r.F.ltl¢ j-IL IBM Z3r10
SW
� Pp.hpo S 307 3.d
&md ngl.w:S3"' 1.V71
Flwldi 4.W.V.,W Cummw,Ty 00 {FACA7 a s.nberhip.''SIM
I s"
RU[JA i•akJry Rdg411AC43e.90.9 Y 5+4]009 I I.CId]'
.FACA Canhlee.A1,021 ap W:1:i0.3+S-050
1 Pm 0".Train I'm 1Ca.p M...pue Qm S T50 I'.n
Gm+ JIT N..4.A..--L S22'm 7501
IA7JilEmm.ntlHewepapi^C88G B.-mr40�p On 21AbI
preWrm•Adverswn+.nlS776.5-52.3;47
I =,w5
ITGru mlo IR1T A CAF1R F74P[tii FS - 36,972
I
PpGGARM EIfPESl1S
RFp/IFM ptAFCr WENT OMISTANCf
x�i,yfr.r Sd.�l nlrins Zn[]IDOL:paallnd 7.�ltal FCYCN;va
6 N.N.1 l.l.. ApPN:,-UN 31 wEl Dr0dM b r-4v.lWnlnppMhpi4r[h:Al Ip ACWIIN111.
4cpmpdgM1w.a IegaV.d Ip edNn.m.IM11�IrI,tr Npeeea OrnK.ymeM
. IV9cYli0nd r..{nN¢40R SY,+�6(.r91�s 11B,074
I 1 59,.74
Chad_�n 4ed,ram ee
-A 1.20 'Apar0glm.lely 44 g4yple Ch7laen v 3e[9n1[3Chp:nrvl.[0 lwno R.pm41fi31p!v
].?{r_},1 1p3y b-Mr9.0 A..eN.eel l 44.il.R97 pa•rWIS.
Papallma�ly 1211:116164 ChIWr-vAl---50191 rim 0 WO ReW5n1m,
`for5--1 Camp prolgemi IS 721.00 pa[A:Ne{717 a6,ouc
N.P:.12'M 1ratry Prpraam 3FSS F)Rent and rluSW so""
10 1-ci[.yr4.4d IC me FSSp WFI neaele@ RMVef¢iIy Rwe[ence IP I——k0
F.++Nnymenl.[F,10 3 10 x S ma-04.6.000,III TOT 3 M.Ofn4S9,00P[9.YSep17614
' N PI.4'-0:1 [mOriCrrrV l{.gt2y901N A.IIfa11R[p
'30 hpus h*ds rill MmW Emcr0-.y A N--U.Ylity[aaiahnu
:so x S],1C01e a11.Yi.r cerrlrrs IS.mpbym.r.l 37
6-1,11 7pp.porhl.len AJYJUat.
ApprpR.f70 baS p394CY rtln l;S p4,d'a.r6la ppW I F$§P ppyMparNO rnd Slhef pflgiblp pi[RI.IO SO.k 4nd 01 IiralrRYn tl mpl9y'mml pr17 I
•I i-are NS 30-dey xe.p. hip CO e.ait904 TS 1?%7.&,..-0456-S 717 d0,.n6 ep-+-dr[d(10oS IQ.y p2f.ee 0 1,556
;52.06.,3.,4 2m.9C
:TUFAL FIRM rOMM0 CU MT A5%mTA&C 360.717
MD PIFMOIHEll M6GRAm rKprmsm
'Clap M.mp.mcdl Meinl.p4n.p flopprt,end LpyrdH 3 CbI.d1
'SON".P.WJS4,trilmng-11 M.ipl.CUM(FSiSP v.4pgr11:y an6 c1Be1 lI.�IQ Wahl
(17,495,mwuno$4,1 ill.and--of nUie-..w.I S 1 445) 10 610
TOTAi RUInEW OTHER PROGRAM FJwEYSA 13 in I
;MAFIA TOTAL;
411,271
[mats CSRG AGRRSMRNc
ANUMDED ATTACNMfiNT L
SEtCON>1ARYADbMgS['RATMU EX,8%ME5
Sav-dary Adminiavauve F:xpem ReguuR& YeaQ N.M RECIPIENT:Scminelc f Gaveorrnent CONTRACP: 14WOD-06-69-01-U73
iNSIRLIC-71T)NC If requesting 5—ndary Ads urduralive r pmKs,you must supply the foAoaring iaFotmatiDn for eaeb acmndery pxmgn fvf whirls administrative cxprnses axe being regne mi A
"eemaduy pmgnm suutce"is the non-(:$SG pmgxarn the wa(rcaive.cl::drrssnadvc-ppm ROM die uFe of CSBG funds.See AttarJtmrar A,Section(G),and Anachmam r secrsoo l](l0)(oc additional
inivmutlnty
,Isms of Z.yme of Nsmt of Name of i
&mndsry prvgrxm l Secondary Program Sacondnry Peogwm1 Secondary Program , Secondary Program
9iil]Cil•;TINPORYI.4TIf)Iti -- I - I 1 __
Gant hoses Gnnr I]atcs Grant l]ata 1 Grant Mt. i Grvnr l7am
Sdd: Seast: stare Sean< � Stazc
m—I _ 11ad: .__..— End:-�-- lsd.—_
t.�ntalcasShudgctfors�sxndaryprng'a h -- I - ---- - - --I--- - -- - '_ --
s aoo s a.00 s a.ao s o.w 3 n.oa
2 Yrssimum prrrea[admituateatrte eapenae —
rorladisrg ind4ttt cwt allowed by p.004'r 0.00?� OVA
O.Oar o f o.nw�o
sewndu3,Ptogrvn. II
7--royal adminicrcna.c rsPMt a apprw<d by rm.l
Secondary prngeun(uxading -$_` 000 -- a -- Im a OAO - -5---0.0f1 - �-9 --- 600 uEPro,ams
--- ---- ---- - --- - --- - -- - - r - - -- - - �- - -�-
a, COG secondary ndmirristraf--p—c
f regm:sM&m ¢ 0.00 0.00 ¢ 0.00 5 9.00
S. row adminamtireexpenses(I1tu3&4) -'---- --`------ - ------� ` �. �` ---� ._--__ --- - t- --- -----
50.00 $0.00 -- _ _mot _i0,0a _FO.Oa
6, Puceat nFtvtal admirrisetarivc ecpenae to - - - -- - - - -
mtd hudgrt(lanc s/sane 1),This tot.[ U))I V/oi #Inv10i NDIVAW - .1-11"m
c�nnw r seed IS%af line I
7. tiariunal PerFoxmaur Tndirl[vt(NPT) 13P1# NPI k Niji# NPS# I NPI#
supported by lhls ceroadasy � � 1
advwrisvative funding.
(Fmm Attacb—Ah(;SBG Coramnmty
(1)The Rceiptmt must take lull adwnrage vF a9 administative and indsrea dullasa allowed by the srzvndary pmgvm's Cunding snores before CSFifi crrondasy administrative capensee ace trcryesred
f:°rearh recondary adrrdnisar[ive pmg—,provide duasmeatation of the meaimum admmi+treuvc luaus of the aetnndarl pmgcarn and a copy of the contras budges deviling the smut—of the
mnmrr and the admiaiarrarivc fureda p.ovid�hY nc�accvndarp source.
(3)You are.p-.d m provide budwt derail in Anx ht nl f,Line 13 for the smaunt(s)on Line 4 ahoy far each prrWam
page 41
FY2014 CSBG AGREEMENT
MODIFIED ATTACHMENT Af
CSBG COMMUNITY ACTION 1WORffi'LAN
CONtACt Olivatlo Garter PHONE;40.686.23Ga EMAIL:—rter�ysemhdmountyn nw
RECIPIENT,Seminole Count—GOvemmoni _ _� CONTRACT:1458-00-W.8"1-025
A
HYf t7rtg7aa! ModrYred
OUTCOME ExpeatedTb Be Expeetedto Be
Achieved Aehlwmd
A llrtem o dand obtalnad aJeb __1. 10 _ - 10 _.._
B. Empl old srre3ntaln�ajob foratleaar e0 days. r�__ 0 _____ i0
C-Em fo dend ohbinee onencreas6 In emptoymeM income andlor beneflLv n 4-
D.lAcNevwd'I'lvkn xU ,impiormni awiorboneflm — o -�" - a
A lOtMmad sk&ftam Iba e re` Atl 10f era - + _ ----�--_ 40
B. Cora fetid ABFIGEO Bad,'B mMd WW=tltm ordlploma _ 6 0
C
CmOsfad pot-sEwndLq adace0on�pram and ahfefnad eerlifioete er dlGbalb _ m--_-- - -
p. Emoireclu Kkmnlnbefweoreflersuhool ro ms s5 _
E OMe1n6d care for ch ld or other dopendut _ _ 38___ _ 200
F. ObW.-mMSStOfalia BUS nandfor&W Olicense 0 TO
G. OMalned haetlh eels earvioee forthemsdvae d�ehmey lnanf4es_ - --- -�-- --- - 0- -- 4 - --_
V mw rred seta and aflbrtleb[a hmeetrt0 --_.- --- - _--_ _ _ "T _ S2
1, Oblatead food aeaiaunee
J. Obtained non-emar n OF EAP ens L-si4tance
K OeWned non emaryancr�llC energy aeeiatenee .��- 0 - - 0 - -�
E. Oblelnad outer non-ems nc en eaehlenee rw. oa na lvq�uHFllPS Vrh _ 25 __ _ _ _42 I
M. Onlelned ldont kcAVon or-,k d—anialien for em merd(m"l—orgy um wrk trail o!c 0 n lI
ennanc�mam -
A- Panrcl b+l t z Bpahsbon Dmmma%ftauslited for any type dl Fedi"or Shore hb c"Wd f 0 0 0 0
e. PerUC anle oMaiM 29 covet-mdbnA dt ldv nle.
C. NumbararlTallMh tm ne IIK&-endlor ydfemwshs vgrtk agmcy ebafalence. _ `- - - d -1-0--
iMlffwllo/r - -
O. PaNrtipsMS tlamrM - �rmn end mafntaine for veer 90 _ _f 0 o -
E enin an al eM or _ savinpe>romunl 0 0
F. PeracfpaM!wlro ip mm thairuv h I er atlreratrvi a evaunt 0 0
G. umber�pRafizir a Bmel es WE scow aavinme _ b o b o
K Nfan pumulnp mend adrwellon WMSBvin B -- _ 0 0 a o
I. ymhe5 pulcturbinQe home+Mtlr aocvmu WAnee 0 0 0 0
1 Number purcllaane OU+araseele wre 'almrmrdeNtl�'-iav as `_ _--___ � - -O_-_ 0 _O__I_�o_
A.,lotaacaurd,armed,1raR roductwn weplmineawt In the omnmunily
e.Accessalfe GWn wa a dbc ero6lad ar Saved tram redudjon eral;rnl„eenn in a.o cen.mi,mar - --_ - o'_-_ -u_-
C. Safe emd vffordeble h-Mng wfts mw in the cemmlmmr - - -- - 1 13 1 13
D. Sale e1l�rdaYfa houabry wits In the aommun eryad or an roved lhmu Commune As4ion or eGVOC_ac �31 62 3 73 _
E. Accessible,site and affmdahle haaahem eervkeaifaulNba for lOWID bme le created or U"d. D _0 0 0
F. Accessible,sate&affordabkaldr�elChNddrvelapmantpubmentappafir�e�acaefedorsaved._� -_- �fo _ D o u-
fi Amtbla belt lager schod P--rem placement apporLdries for km4nwme famNies created or aevad._ _
H,A—I We nearisacelvedletpended lremepoAalbn reSwr avallable lolwwlnWme people lw'hlirJw wets) D o D a-
I. ACOCee'tl cwar resarwldlurWeeaed eduallmnal and tretllill 19rxment ranilln ter fowwrmm e 9 o a -S
A o. fnrateaea in mmuni aaaete dve taadrartae in levl oepuladonrpolcr,lesultln4 in hexer ratarsr Mlife- ---- �7 0 0__
0.incmaw avaHab6tyl�reaetvabon of cmnmumry fedllfies�draols lihryie6.communit aeMSR etc W— , 0 0 0 - 0 -
C. laT!Rw to the anilabadr or preservation of cammu6ty eefyieal to unprava puhfic hedth and mict1 I _ e _D ttt 0
D.In Zone h the evelahVit er....-m-MmnmercLf services wrThln lowlncema neighbedreeds ` U �
R, Inc ease n or�m�erval mn of na phhorhood QtraDgmptde rea— 1 D a o -D
eavfda a deuti on of v'balasal,servin or facitf to heirs weaeited en the EXPLARATIOH TAR
.fit• pl rf l� 1 . -.rt=-�_� .4s�i '• ..in.x. - �.��_'T� rcJ 2
A Community members moWitxab to•yertidpa[e In mmrrlundy rpn Gmtlen and afdFpWerlvinitiatkaa 12 ]2 --_
e1 Serve an the CAFk Board M WreetaR _ _ _�-_ _ - .
24
b) Serve an Head st.d Polky C-MIS f T __ 9-- ___L on Famlir(?enter!Parent Gout cfls _T- a Serve on other GM AdYnory 9oande,taunts,ar mnmift— _Sarva on other commune adufap m hearts ormmmdteea eca CAA aantaha 7A ft Aneiat wlih Prooram aelWhs and loPSrf�t _ D =_D -
1 )_varsc�ieinadvarewmmaetalwnvandwmmumS It °-
h? ft Ala in adyous to BlAUanCa PCiidaclprndm of 9w Fart a.ftr oiivets en%m- n a V
r Other CAA dieMS or lOeNncame➢araans Volunteer VAh Ile a 'er - p J u
Tent volunteer heels hom law[aeeme r- 16 _ _ 40 so
Ime nMad,bYSL°,..L.°-.IDO�+�.Ee_ I°�- � —_ -i - - __- it r F�`__
General Pubffe 514 r 2077,
b, CAA non-pwlnedma bOWiftembOm .. _ 40
—
dh Bus�ese Commuhlty � --- - - D -_- d _------
c)
Fatal vofunt»r hhwms From man lw A"rt people- au 2,137
Totet wrabarof [Ante mrs donared�-fie
n. Seas araePod.a[least In pvt r�r ARRA funds_ _ .-- _ _ _ a 0
relei number Of vmumamrhdum donolod,by Irr lnap-indlyWuals rmnlb to Community Alan 40 30
A Low-inwme In fa mal.dsdeien-mdanB.emmmunay arwU25om,gmemm"ll.tweNc or rafmft
B. Lowtrimmm Peoptamr u-gbru3kmsmm olrmmirunnormukofCOmmwut Action _ 0 T_ 0
G. Lw4m=e peopla q*_pyni+a^ sing V can Game in thdreommunity sa a mauSlN Eammunny Action 0
- �-
D. LWKAnwmuaoole In Iron avemgnce Cammu a*MeslgmLrps vmetedfsu�orted I;ommun' Acti-n � _�_ o a A. Non.Pmfit_ _-
'2fi 1 28__
B.
. F'E SaaEd_--.-----.---- __ - ------ 0�-�-_ 0- 0
C. Loran Ghyemmem _--_. ._. ___ __ __ �-- -.._-_-�- 7 Jl--? 0
_ -7
D,Stet.GmrernrnOM Entiiv - - --- _ _ _ _----— - - _q - 7'TT�2 E.-Federdd Gevamment Enviy_ _- -_--- __-_ -- - -- 12 —n2 12 _ _772
LF. Farms 01 t fUameas or Ce paretron_ _ _ --a---
C, aonaoruum-srGoRehcraTnn - - - - _. e - o-H. Nouelny CbnsorliumdCOilehon3flen _ - - - __ - _ __ m O_ _ o__ __o
t. SucJroel 0isrrlall _._ __ - _____ - .� __ r_ _
a- i Ntuu=+e 4
9EGA-
L. Haelai Service fnantuamm _ __ __ _� - 9 -
M. Slatewvida aaaodeAons orralieLmra9mns. � �-_ ___ _ - -_— -
00�ers:Please idsn6>y] _ -_. - ---_-_ -_ --
6t 171td7� ��umh�n orgflnlauonnZ�iw� �xtn 100x--1 �a^n�y er�wmmuN -!camas !!B 124 !13 163
Tq K Sltri11tlh1n- RaY�rrree,nias- _ __ _
1l_TgommtM 9ervlcea Wook c3rmcjc38
e] WeemerimUon Assistance program funded by DOE*h upn DCA
)-LIHI-i Fuel Axelsmrxx Ili_ -- - °--- - -- ° -
-C1 LryIEm-WetdheduaSien[HHS} - - - --- - -b- -- -p ---
dL_H-dStart JHH - -
E Ead ead Sla (HH6) _-
--
g}SSW(HHSI - ----- - --6 -- ------° - -J
h�Nledlnt0lMadlceld jY+HSi ---_T--- -----— - -
) Tamporory 0.vlsranrr.to Needy Fgmhfee[TANFfj_- - '- ----_ - - - - 0 _ u
; _j} Child Care Davelopmonl 816&Gra_MiremL ISAG �T _ _ __ _°__ __ _ a_ _
Olfier HHS Reaourres LLSnt in ceder of a[a.GIYb fha name of the source and 1!t¢CFpA numhar Do nol use
k) ahhrevlallons.M HHS CFDAs alert vfitll"a3.").- -
f}_ _�--�_
41 0 0 {
Women.lnfard end Chada WC SDA) -_ _ - -_ _ - - o-- l
m}45DA no food programs{e,g,rural deuelo end __
n1 All whet21A Feed Pmaeme----�--L- --- —--- --- - --- - -- --_ _
o 0
_eJ_COBG Lederer, 764
x} Sawion 262 _ Y _. _° 6 _
-
4j HOPE for Homeowners P�.4ry1 J .__. _ _- ° - - 6 -
-- - 51 E merpency Sheher Gant Program LESGPi __- - -__123.876 123,676
--G) Canlinuum of Care LCafC] __ _ - _251.111- 6 ...-
a7 Afl olhar HUP preWams lnddudin hh-ale.prrepreme— - —_. 5a4,33U
---r}_Emp[omenl and TreIr"ProgrM (48DOl.l p---
s-Other HS DO L AreprmnE
_ �Ceation!orlVrllpnalar_rd Com_munil rLServlea�CNCSj_omgams
07
-
�:) Dapadmenlor Jua!IeetLD:Wj_
_ yL Dgadment of Treasu7 -_ _ 6_ -°�
z}_OIMrFaderol-SOUn:es:List bl_rrema of funding aeurm and,dte CFDA Numlrer.Do ewtux ebhrevie6onE
TOTAL:Nom-CSBG FMEf#AL AMO ROES i 2.BT8886 2410,577
7
G Sdta Respuraes--pndedelexstelwiPPtaPlia fetlFane:7_� -- - - - -,
v Slvla a led Nnai VaB(I fif t;f681m9 —- - -0 -
� __ pll eM a fedarvl C6d0 hs�de _ ���fl _ -
_ ss.wand.o-rnnelassPra�semsSlndin�h ol,.lns±ax�d�.�
cl Stele Nomm PmplBryi6
_d} Slere Da_____L Eu Chu dhaod_Pmnrams_ -1_- 0 0
--
el--State PaGrBy Promems _ -.— _ _—___ __ I O _ --_- 0 _ _
_el-- Rea_- Itfi Program s ---
_ -
�LS�Bte Yoylh OsvW
h1 6iela Em menldnd Trektin P_mvwrks - - -__---__ - __ -_ --_ 0
o --
kp StetetraR ftllo Pro cmna o--
_ 3 Slate Fdutellon P rams T- - - - -- - - - --
—7 �_ _ d—
r2 State Gommunllr,Rure1 m11d Ecpnomkl}ev_elnomesll s _ -D -D -
_ n� sdfe Fdrnl�OdyslpOm'erd Pmpama- - - - -__ - - -• - - -0 - _- -D-. -.
o} Ot�!,Stale Funded p+o rsms-Lfat pY reme of TLndl_ttt aou"- Do r t use v t;m lel"lons._ _ 0
L 2
o�
41 0 -
TOTAL;STATE RESOURCn 69S,00
D.JLxelCcvcrnmonfRevourcm -
. Amaoat of un.+slr+cLed.-d.vPP+aPdrtad Iry local Pwernmanf_,�4_ - __
_AmaO ds nl Or reSbid8d fun eppmoated by local 9m'emment _ ___ _ _ __ 7_93CDO
_ ci Value Of COmrabt 6eMoss _ __ _ 0 0
d] Valus of IndWd Rg2dV=Oms ra ye d from I*wl p yarnmenl - -- -_ _ -- ___ _. _ a - - 0
�_ Dlher Loral Govammeni Reawmss Gfve deaeri_ption pr npr pane pl Prpgram�Dp NOT abhreyisle. O e - _
0
— 3L_ p_ 0
E D O -
TOTA =LOCAL G ONT RESCUR 6 8{5112 T s!1 Kam!
E Private Sector Reaeursae
A
_ d - C _ u
b-Ohdaed lunch
e; Value of danaled i%-.'-aod.-IWM%,kMhU a arc-
e)VBe W of in-" servloes"ra�fved Mom Eueineeaea 0 p
--- eLsymaMa by ailardstdrb-inq s� -
Pdymema by Vbmft ehBbee ror ypatla or serAo for low:inrnme dkrrb or oommunNm O
�LOlher POvele SSdpr Reseurpel __ -_ -- - -6 - - _ 0
e
TOTAL:PRIVATE-8 TOR. - D D
rd c986'Rfi3 F.sdssala8tab..l,eea aramrnenNPdvetriecto 1 i1e aD 18-88 98i
70 _ Fonda 1T M
A w V0 ey BUDGET 10608 1 1 t2B6
Tabla2 A naX intrusa�34HC_s olty;To• a r..n..r shr: ,7abn_bg __ _ 'L1�'i- ';,,. .I,;,r -
A Slaft vAw.wrk wary WY19gi6f9lnf�Ul l�Dla_cy4Hh137��41C 1a tAea myn+r0amatt _ __ 1 �_'4_ 5 E4 1
g. 9ieh..Ab w«k+Mh weLpmalt In 541t-fulF�icn a r.c ive be1Mn a lilt to la__7niSy devekP�nl � _�'A 0 _ T 0- -_n
C. Stag who worst Nilh gleril6lCangaet emenl teceire lraild 6v ex dlupdetefup rat_da tlrair afdlfa -_ n__�F a
d. Fiscal alaft egaM frelm.R9 en UMB Gimul°r oraudlt oamp6anos __ _ _T_1 24 -
E. Fiscal amTl radaiv0 eccvun�./fala DDpaeNsnwmeaaOe+Mnitreininy. -�_ g t'-' xa -
F. Pro rem atatl rewire deSu odlatbon ar menaBamenl W�iiny --- ---- - -' --o -� - a_ D G. $LaF(7rfiar18QaiI1B'fi mroWo ROMAtrvtnNmacereaed[ZOAIA 4einer� _ _ 1 16 2 32
FiyOtl7er traini�n.7 rerehred u daifvr ms�ne t _ - __ - -_ _ D- __ _D _D - —D
To f SriH and-Me gamrnt ief 1Tpta. Tor �euug�-abuve.l _ 6
66 9 123
KJ. Sv_erd rnembarc leCalre treanlrt9 related to dleir mite anda@DTies. _ --� D 9 D o
JBbard members mcaiv°ROILLAI nl+ro ham a c°rtlRed ROMA trainer. __--- _ -_. --_o D L-_32
Olher ua4ning received by CAA Board members. -_ f_.- 0- _ r D --D __
T_olel Board Mambo,Tnlning{TeUl of 3 through t-J - ---- _- - -- --- -- - - D 9 2 32 1
7abls�-1l-Y OE t'l. gun rtcreas»lae.Cap chfevE ugn Trrauph lalnlpp RNauteee_ Recaure
The nu7raar vY human capgai m5burrAS avalkuly _ 1
A !M -W of C-CAPS
13- Number of cariKedliOhL�7ralaiS
Cr Number orcertiged family Oevelopmem�m
b. Number d CerDfied C Cevelapmen!Trslnera _ __ --__- - _ a
E. ncy�Lla ned Otltaranhel that inerceeatheir capacly 10 achkve rasa is( gkin in narreilve) __ D_ __ '� ___D--, _ {{
F,Numlxr pf stelfend memlpmeM Ntendina DdNngr_ _ _ __ ___. _ -- ____ ._ ___ n 1 26
G- Number of heard members alm�n_ rakrhge - s a_
1,100_
I. ours edbn meartl mbersin tmmin9 __. _ ._ 9 a
led Agency Memou AMY to Must"and'iraoh'011enla"Vrogr+as Tavnrd46t tlenay lodicaer with an"%" —
-
theONEstuirmst In A fnd 8 that REST dnaninsy womenwman. _
Client Intika Prsceas --
A 1 A commm uHa Rwwa and common lOC is uevd far all rJlema __ _T x -
k2. Acowman in, a and a«nmon IO5 is aced Tor Ram.W°nt; -#-_ _-v___ -- o _
1, a_ae to la �ep ardlor g�a_"IiMis used to a b ro mm adm_ln161aied l` -
C11enHCuato�merMeasLral'ragnutomrdA.c iawmantaf Ba49ufflalaney ._ _ -__ _ _ __..
1.�ng�nclLUhfizec a datebaaee far�1 Idlads Mr ass dt klhrke and...eement an�rvriaieSr 2 eervicam x T_ _ _ __x --
9 2. !M°rcy uHf2ae datebeaae iarsmrre cYani for Deem intake and e"wysn1 end p WMon a1°ervkas -
���3. en9•aces dalabaea for aB diem inlel;eleaseaamentlPruralan services koulcoan meamavmRnt a _ -_ o
__ 4. n u data�a.0.4 tt Nl�kelsae.as a°rvM•e�prouis.-eblr&aNtelrie maeawameT_l _ _ a ° -----
�_Cemputor pcoyrama seed(a menage clienF hderm°tien and lock NNnt oroyreae_- _ �" _.
1.Cgsnl soryai sarvY.s trocke -- -.---- - -- --- -- -_ -_--
Table i Agsney 0igsnirastOperatu PrOQrAme',.'e*vlees andAeflvRh's TbwFrd ceom¢i1a�ft Famlhrand Commueay
Outcamse-uk"mem flee orPOO Tsr ms h:)
Ayen has tlla GPhtftte npam snenVCrntomer prpa[eaa forward setI_aulrye - __ '� -
t. A n t mp�at au6caareg that m®aurc prupmbi wi(huuS ure at anvulaoma -
-�--- --- —--Y-----
A z_ Agency uNllms putmma ecalai 6i maesure dfent movement tpwaad seSt-su{ficlan�-_ �
3 lsa0n4y Iles Ppscity m d°r14e untt aaaLsreYa11C8:COeUdaMe9 da![4Brad or Wet of smm per UieM ______
4. Agency hes aepaary to tladra uniS cost aiatbtk87craHxtivanes8:cast rout me da6vasad _ m _ nor
1 A hcy has provldad ROMA_trslnla v rtldn the est2 re ace RO trainer =
--
1. At?seat haH of the A pag hoard hae received KONA ksining -
B.
3. Agency euperviwr�smd has tapBlved ROMA lmirflnv__— -_-_ -__ -- no no -
__ 4. Agency line slelfHae"-Wed ROMAtralninv `.--- - yee _ -_—yOB
"-ncy-eD2 ems sehkVBd aeoradhaGen demaneVatleep lhBy_mteS W asCSOd mGen3fty eeee�Mzaditaederds _
C.�1. Eeri oh°dhoad rare end edu..tb.sir-mce{4e NAEYC or other me nlzed forma of aecred0.eken _- _ __no_- _ na
, _-�.
_ 2. Progama8lcnlevs amar term of feWSnieed accrertrtatlan. _-
A em f°l�Ier ne Fnp RDMM loofa a mmarwgame. pmettoe
° 1 JA4ency hse adopted and imolemer ted loeic modete for trey pmomme and acftv{tfac
2 IAaency pro rrsmc end arAvltn,c We ow�kreted ua4no ROMA dp ndpe4a __ _ _ _ no _ __ _ no_ - _!
3�POCAS k I5 5u,"y naparte a_re-r�°4fded to revhwed&dlepusaed vilh 6osrd members atlemmfgueeerty. -- t__-._�� -_ Yss _-
1, rtlSavt��Li tittuy�2uII>u1YU1ttW3]Air i111S?tic�, n'� vi�t. 7rtr
�r>at:l•��[3il-�S„g+t}sv.�lhr't�rrkt.;J�F�I!Uti7l�rUi�.�i3L'iti�S 1ui+lU_tiEip_itl�:Gif iYlriElu�-ell':�'t�
A Sanlor ClIzens{55_ pars old or alb_ - --f ----- - ---- -- 1,100 --- 3°° -
16dfrlduela vAth Ols�es --_- --� -- -�� - -- 342 0
�. AyeS 0-17- --------- - -- - - --- --- 942 - - -
8, 2- A9ee1a=5d--------------- ---- ---�---- _ - ° -.- Q�--
3. Armes%end Over-- -�._- --------- ---- - - °----- -- ° —
l4. tTknmrm --- ----_f---d_.---- 3QO-----i
CTE.Sen! a also l chided Mthla the'35 r -J fr-
c1u73I�i1��1�Trld37i LPJ - �' �1��'h.'�i; -�ir1+2/1.E� E
'frJ J4ll�ult3r�st3tirt��riS�a�+9.7�an71�A1t1�'tiiu^iitl �r 7r , *�,Irnrras ert��:=_
u
B Emerpencv Fuel or UUllfy tmy"�enSa�indudln�LIHEAP w°Mar whkc w mrete,iondn sou _ t_tt _- .-_20Q__
C. Ememem ReM or Mort0aya Aaslsta" _ _ I 344 _ _ _ 40d----- `
l D- irmergency Car or Nerve Repefr Il.o 0 4
2�
E Emernanay TemQor-ary_6tieilar
-F. Erne�rmcy Med+cal Cer=_ - -- - -------- ---- -- -- 125 — _—-125
G. Emer�encY Q??tsetlon lmm Ywlgnca ,----_ -__—_- - _ _� 129 -- l Ho
H. Eme�erfcyLe°elAieielanca _ —_— _-__- -. -I-- 6 =- _.-��p
I. Em Trmrmpxlstlon 12 170
- ° --_--
K_Eme .«en�iClotlunu - 6 °
L,)_Provide lraneletion asaiafance h erdarfor careen M ieteEve am�ey eervien __ ____ ____o_� _ 0 -
'dil4Ci:�itl3�y ��� � f• - -
ICl3.C:kCT;Giti +'•71S11R� _ �SCfiSGLlRInl.Pil;.
Infant end Chlld - -- —" — — -
S
We end childran obWn ape mpprapd8ts immuniulbns•mWical and dental cm
A IMfen4 onA children hU M and pAysleal dalrele_ yp impruyad
3 ChfldRn fslt'rcJpala m pre.adrpo5 ad itlmyou daYelop eCh0pl redmltm!shill.. _ 0
4 Citldd.Ta_md➢CI_pah".a Ind-3ChaaS aptlYtka3 Hfe d�YOte�Rtafl�ail rBRd,��Cr 19nd�erSe Or 751 GradB_-�___may _- -_0- -d`.__p__ __
Youth
1 Yputh lmpmve_hoe lM and a ern lal devebpmnnt -
fi.� Youth 3vOidva k-lgld re ballonei davelppmanl -
3 Ycuth evoki tkk_tekinp 6e!ravlpr far a tlafined period Mtime
Ycufh have reeuced Nwivamanl rith ciminal luriica�a eyem _ _ ___ _rp _� __ _p __ __
__� euth irtereeee amdemic MhleNC er Sedlakllla byQerNdln bafpro u�aRar erl±a°�r �ns_� _ ,I z20_ 350
C.1 it Perenrs and abler adults team end erhibd improved erenfim akllla -
.22 Parents and other a"to loam and eMl bll im ro ed fam,Y funedanbi akll}e
A Enrellod children In berate er after achpol pro lame
B. OGained crre roc cAiltl or other dopprdord __ 0 _ o ___
C. Otnalned aecoas la refiab}e lrert�natien endror dnvars Ar�nae '"�' �__'�____� D _ _ 0 ____
0. Obianod neelth care eervicestorthemeelvee refames OD-ioI_ _ __ __ 2579 -
E ObWin_d•ale anG effprdnnle hpuslnp _ __ _� 14
V Obla,-W food.ssslmse o _ _ __ _ _ 850
G Ohlaineri no"mer ene tIHEA9 one assmanra V _ __ _ 0 0
Ft OWalned nonemergency WX enelyy asalslenea _ � �_0 T 0 ___
t Oalempd eMernen eme enc�' A6 easialark06te1pbraNpiwq en aealpT}alude UNFAPWv
3 4r ,E Auk—I�IW 31 <j Jd3md t - S1�F irul zlGtY1�7 lt�t i f�+ �, 4,
77 Fpad 130m. iy04
13. Pounds of 0
��_ � —
lea _
E. Infarmal'mn and Refarmf Calla-- _`— —_ ---Y —— 5,487- �_A 3 447
EXHIBIT "E"
REQUEST FOR PAYMENT
Day Camp Provider:
Name of Activity: Seminole County Dav Camp Scholarship
Payment Request No:
Number of Total Amount
Weekly Weeks Due for the
Child Name Amount Attended Month
During Month
1
I
i
i
I
TOTAL_
Submitted Lay: _ Title:
Signature: _ _ hate:
EXHIBIT F
p R s
FIELD TRIPS SCIENCE CENTER
BOWLING MOVIES
" SKATING AND MOPE!
M 114
MA;foak for K-"e-Spv;v;sp FlogAdpaCP,
$ff0AFll"* 7,
to iif,rltljss r�r /ii, 1 7-.- .... �.'7. -.�.; .7.1.'. :' :% .:.. :. �-:.-.. ; ,