MEMORANDUM OF UNDERSTANDING FOR SENIOR CENTER FIXED CAPITAL OUTLAY STATE GRANTS AND AIDSDEPARTMENT OP
March 13, 2009
Kerry Kimball Marsalek
City of Clearwater
ELDER 100 S. Myrtle Beach
AFFAIRS Parks and Recreation Department
stare"oF""i?aRiai? Clearwater, FL 33758-4748
CHARLIE CRisT Dear Ms. Marsalek:
GOVERNOR
In connection with the Department of Elder Affairs grant award to your agency for the
Fixed Capital Outlay (FCO) program, please find the enclosed documents for your files:
(1) Executed Memorandum of Understanding
(2) Attachment 1; Letter of Intent/Facility Program for Construction
(3) Attachment 2; Financial and Compliance Audit
(4) Attachment 3; Standard Budget Forms
E. DOUGLAS BEACH, PH.D. i. Receipts and Expenditure Report (DOEA Form 105f)
SECRETARY
ii. Request for Payment (DOEA Form 106f)
iii. Statement of Use of Funds (Form. 107f FCO Senior Center Use of
Funds)
(5) Attachment 4; 'Lien - (if applicable, otherwise security interest must be filed)
(6) Attachment 5; Senior Centers FCO Grant Monthly Status Report
Please refer to MOU, Paragraph M for instructions regarding the filing of a lien or a
security interest in an amount equivalent to the department's funding of the Senior
Center project. Once the lien or security interest has been filed in your County Clerk's
office, please return the original document with the recording stamp (date, time, and
location) to our office. To eliminate possible delays in the processing of payments for
this project we are requesting that you return the lien or security interest within ten (10)
days of receipt of this letter.
If you have any questions or concerns, please contact your contract manager.
Sincerely,
4040 ESPLANADE WAY
TALLAHASSEE
FLORIDA, 32399-7000
phone 850.414.2000
fax 850.414.2004
TDD 850.414.2001
Jaime Bustos
Contract Administration
Florida Department of Elder Affairs
Enclosure(s)
Cc: D. Holmes
Connie Hall
http://eideraffairs-state. H. us
January 2009
City of Clearwater
(Project Name: The Aging Well Center)
and
State of Florida
Department of Elder Affairs
MEMORANDUM OF UNDERSTANDING
FOR
Senior Center Fixed Capital Outlay
State Grants and Aids
MOU# XQ913
THIS MEMORANDUM OF UNDERSTANDING, entered into this 2nd day of January. 2009, by
and between the State of Florida, Department of Elder Affairs, hereinafter referred to as the
"department," and the City of Clearwater hereinafter referred to as the "recipient."
WITNESSETH:
WHEREAS the State of Florida, Department of Elder Affairs, by authority granted in Chapters
20, 216 and 430 of the Florida Statutes, administers state funds appropriated by the Florida
Legislature, and
WHEREAS $10,000,000 was appropriated by the Florida State Legislature to the departm ent in
Line Item 496A of Fiscal Year 2008-2009 General Appropriations Act, Section 3-Human
Services, grants and aids to local governments and non-state entities - fixed capital outlay
grants and aids- senior citizen centers from general revenue f und, and
WHEREAS City of Clearwater has received $727,500.00 for The Aging Well Center in Pinellas
County, and
WHEREAS there is a need to provide a facility for provision of fixed capital improvement to
construct, repair and maintain Florida's senior centers in order to fulfill legislative intent, and
WHEREAS the department has received from the recipient the Attachment 1 (approved Letter
of Intent or Facility Program) for the development and provision of fixed capital improvement for
projects to construct, repair and maintain Florida's senior centers.
IT IS THEREFORE agreed between the department and the recipient as follows:
1. THE RECIPIENT AGREES:
A. Services to be Provided
To plan, develop and accomplish the projects described in Attachment I and
activities specified in I.B. of this Memorandum of Understanding or otherwise
cause the planning, development and accomplishment of such projects and
activities.
B. Manner of Provision of Services
See Attachment I, Letter of Intent or Facility Program
C. State Laws and Regulations
1. To obtain all supplies and services for use in the performance of this
Memorandum of Understanding at the lowest practicable cost and to
purchase by means of a system of competitive bidding wherever required to
do so by law, or whenever practicable even if not required by law.
2. To comply with all state licensing standards, all applicable standards, criteria
and guidelines of the department.
D. Civil Rights Requirements
1. The Recipient assures compliance with:
a. Title VI of the Civil Rights Act of 1964, as amended, 42 U.S.C. 2000d et
seq., which prohibits discrimination on the basis of race, color, or national
origin.
b. Title VII of the Civil Rights Act of 1964, as amended, 42 U.S.C. 2000e [2]
et seq., which prohibits discrimination by covered employers on the basis
of race, color, religion, sex or national origin.
c. Section 504 of the Rehabilitation Act of 1973, as amended, 29 U.S.C.
794, which prohibits discrimination on the basis of disability.
d. Title IX of the Education Amendments of 1972, as amended, 20 U.S.C.
1681 et seq., which prohibits discrimination on the basis of sex.
e. The Age Discrimination Act of 1975, as amended, 42 U.S.C. 6101 et seq.,
which prohibits discrimination on the basis of age.
f. Section 654 of the Omnibus Budget Reconciliation Act of 1981, as
amended, 42 U.S.C. 9849, which prohibits discrimination on the basis of
race, creed, color, national origin, sex, disability, political affiliation or
beliefs.
g. The Americans with Disabilities Act of 1990, P.L. 101336, which prohibits
discrimination on the basis of disability and requires reasonable
accommodation for persons with disabilities.
h. All regulations, guidelines and standards as are now or may be lawfully
adopted under the above statutes.
2. The recipient agrees that compliance with these requirements constitutes a
condition of continued receipt of or benefit from funds provided through this
Memorandum of Understanding, and that it is binding upon the recipient, its
successors, transferees and assignees for the period during which services
are provided or obligations under this Memorandum of Understanding
continue. The recipient further assures that all contractors, subcontractors,
sub grantees, or others with whom it arranges to provide services or benefits
to participants or employees in connection with any of its programs and
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activities are not discriminating against those participants or employees in
violation of the above statutes, regulations, guidelines and standards.
E. Audit and Records
1. To maintain complete, accurate and adequate financial records and reports
relating to funds received under this Memorandum of Understanding and
expenditures made with those funds.
2. To maintain books, records, documents including electronic storage media
and the evidence and accounting procedures, practices and internal controls
which sufficiently and properly reflect all direct and indirect costs of any
nature expended in the performance of this Memorandum of Understanding.
3. All records shall be subject at all times to inspection, review, copying or audit
by authorized state personnel and other personnel duly authorized by the
department.
4. To include these aforementioned audit, in Attachment 2 and record keeping
requirements in all approved subcontracts and assignments.
F. Retention of Records
To retain all financial records, supporting documents, statistical records and any
other documents including electronic storage media pertinent to this
Memorandum of Understanding for a period of not less than six (6) years after
the ending date of this Memorandum of Understanding. If audit findings have not
been resolved at the end of the six (6) year period, the records shall be retained
until resolution of the audit findings. State auditors and any persons duly
authorized by the department shall have full access to, and the right to examine
any of the said materials at any time during regular business hours.
G. Status Reports
To provide the Department with the Senior Center Fixed Capital Outlay Grant
Monthly Status Report, see Attachment 5. Monthly status reports are due by the
15th day of each month. The report will be numbered sequentially and shall
reference the MOU number and project name. Detail should be sufficient so that
the department has a clear understanding of the project status during the
reporting period. The report shall also include anticipated expenditures for the
next three months.
H. Indemnification
If the recipient is not a governmental entity, the recipient agrees to be liable
for all claims, suits, judgments, or damages, including court costs and
attorney's fees, arising out of the negligent or intentional acts or omissions of
the recipient, and its agents, subcontractors and employees, in the course of
the operation of this Memorandum of Understanding. Further, the recipient
agrees to indemnify the department against all claims, suits, judgments, or
damages, including court costs and attorney's fees, arising out of the
negligent or intentional acts or omissions of the recipient, and its agents,
subcontractors, and employees, in the course of the operation of this
Memorandum of Understanding. Also, the recipient agrees to def end the
department, upon receiving written notification from the department, against
all claims, suits, judgments, or damages, including costs and attorney's fees,
arising out of the negligent or intentional acts or omissions of the recipient
and its agents, subcontracts, and employees, in the course of the operation
of this Memorandum of Understanding. In no event shall the recipient be
liable for or have any obligation to defend the department against such
claims, suits, judgments or damages, including costs and attorney's fees,
arising out of the sole negligent acts of the department.
2. If the recipient is a governmental entity, then liability and indemnification will
be governed by the provisions of Section, 768.28, Florida Statutes.
1. Publici and Public Notice
All notices, informational pamphlets, press releases, research reports and similar
public notices referencing the construction, repair and/or maintenance of this
building and prepared and released by the recipient shall include the statement:
"This project is funded under a Memorandum of Understanding w ith the State of
Florida, Department of Elder Affairs."
Safeguarding Recipient Information.
The recipient shall not use or disclose any information concerning the eventual
recipients of services under this Memorandum of Understanding for any purpose
not in conformity with state and federal regulations, as determined by the
department, except on written consent of the recipient of services, recipient of
services' attorney, or recipient of services' responsible parent or guardian.
K. Monitoring
The recipient shall permit department personnel or representatives to monitor the
projects that are the subject of this Memorandum of Understanding.
Public Access
To allow public access to all documents, papers, letters, or other materials
subject to the provisions of Chapter 119, Florida Statutes, and made or received
by the recipient in conjunction with this Memorandum of Understanding.
M. Security Interest
1. By signing this Memorandum of Understanding the recipient acknowledges
and agrees that its acceptance of funds for the purpose of construction,
repair and/or maintenance of the property is subject to the conditions set forth
below.
2. In accordance with s. 216.348(3), F.S., if the grantee, as defined in s.
216.348 (1) (c), F.S., is acquiring real property with the grant, or if the grantee
owns the real property upon which an improvement is being constructed,
renovated, altered, modified, or maintained with the grant, the grantee must
execute, deliver, and record in the county in which the subject property is
located a lien or if a governmental entity, a restrictive covenant that:
a. States a correct legal description of the real property.
b. Sets forth with specificity the buildings, appurtenances, fixtures, fixed
equipment, structures, improvements, renovations, and personalty to be
purchased pursuant to the grant.
c. During the term of the agreement, prohibits the grantee f rom selling,
transferring, mortgaging, or assigning the grantee's interest in the real
property, unless the administering agency approves the sale, transfer,
mortgage, or assignment; and, in the case of sale, transfer, or
assignment, the purchaser, transferor, or assignee must fully assume, in
writing, all of the terms and conditions of the agreement required by this
subsection. The administering agency may not agree to subordinate a
mortgage.
3. If the grantee, as defined in s. 216.348 (1) (c), F. S., is not acquiring real
property, or does not own the real property being improved, the agreement
shall:
a. Specify the leasehold or other real pro perry interest the grantee has in the
real property.
b. State the name of the owner of the real property.
c. Describe the relationship between the owner of the real property and the
grantee.
d. Set forth with specificity the improvements, renovations, and personalty to
be purchased pursuant to the grant.
e. During the term of the agreement, prohibit the grantee f rom selling,
transferring, mortgaging, or assigning the grantee's interest in the
leasehold, improvements, renovations, or personalty, unless the
administering agency approves the sale, transfer, mortgage, or
assignment; and, in the case of sale, transfer, or assignment, the
purchaser, transferor, or assignee must fully assume, in writing, all of the
terms and conditions of the agreement required by this subsection.
Additionally, the grantee shall execute and deliver a security instrument,
financing statement, or other appropriate docum ent securing the interest
of the administering agency in the improvements, renovations, and
personalty associated with the grant.
4. The department's interest shall commence at the time the funds are
transferred to the recipient and shall be proportionately amortized and
subsequently vacated over a five (5) year period. The recipient may request
that the department relinquish its interest sooner if circumstances arise and if
the department finds that early retirement is in the best interest of the state.
The decision to approve such a request is the exc lusive determination of the
department and shall not be reviewable by any court or administrative forum.
5. As required by s. 287.05805, F. S., recipients agree to grant the department
a security interest in the property at least to the amount of state funds
provided for at least five (5) years from the date of purchase or the
completion of the improvements unless otherwise specified or required by
law.
6. The recipient shall notify the department in writing of the date of completion
of construction, repair or maintenance and shall m aintain a copy of the
notification in its files together with a written acknowledgment of the
department's receipt of the notification of completion. The recipient must
notify the department in writing a minimum of 30 days prior to any change in
the equitable ownership of the property and agrees that, if it or its successors
in interest dispose of the property before the department's interest is
completely satisfied, the recipient will refund the proportionate share of the
state's investment. In the event the recipient fails to notify the department a
minimum of 30 days prior to any change in the equitable ownership of the
property, or fails to notify the prospective new equitable owner of the
existence of the department's interest, the recipient s hall forthwith and
immediately refund to the state the total num ber of dollars transferred
pursuant to this Memorandum of Understanding.
N. Public Entity Crime
Pursuant to section 287.133, Florida Statutes, the following restrictions are
placed on the ability of persons convicted of public entity crimes to transact
business with the department:
A person or affiliate who has been placed on the convicted vendor list following a
conviction for a public entity crime may not submit a bid, proposal, or reply on a
contract to provide any goods or services to a public entity; may not submit a bid,
proposal, or reply on a contract with a public entity for the construction or repair
of a public building or public work; may not submit bids, proposals, or replies on
leases of real property to a public entity; may not be awarded or perform work as
a contractor, supplier, subcontractor, or consultant under a contract with any
public entity; and may not transact business with any public entity in excess of
the threshold amount provided in s. 287.017 for CATEGORY TWO for a period of
36 months following the date of being placed on the convicted vendor list.
THE DEPARTMENT AGREES:
A. Consultation
To furnish consultation and technical assistance to the recipient, if requested.
B. Method of Payment for Services
The following procedures for payment will apply:
1. In no event will payment be made under Section II.B. for matching grant
situations under the Memorandum of Understanding unless recipient
illustrates to the department that the project is fully funded with proper
matching funds as specified in the Letter of Intent or Facility Program.
2. Subject to the availability of state funds, the department shall award to the
recipient a sum not to exceed $727.500.00 during the term of this
Memorandum of Understanding.
3. In no event will payment be made by the department in excess of
$727,500.00 as agreed upon by all parties to this Memorandum of
Understanding.
4. Payment shall be made as work is completed in accordance with Attachment
1 (approved Letter of Intent or Facility Program) and submission of invoice,
which is in Attachment 3 of this MQU.
5. Payment shall be made in accordance with section 215.422, Florida Statute
and after the submission and approval of a complete and accurate invoice
and supporting documentation.
6. The department may advance parts or the whole of any advances before they
become due if it is agreed by the parties and advisable to do so and all such
advances or releases shal I be deemed to have been made in pursuance of
this Memorandum of Understanding and not to be a modification hereof. The
making of any such advance, or any part of such advance shall not be
deemed an approval or acceptance by the department of the work therefore
done. Written justification for advancements must be documented on the
recipient's letterhead.
7. All sums advanced hereunder shall be used by the recipient solely and
exclusively for the purposes intended, to wit: fixed capital outlay project to
construct, repair and maintain Florida's Senior Centers.
8. Upon completion of the project, a final accounting will be made and any funds
not used in the completion of the project shall be returned to the departm ent
within thirty (30) days after the final accounting report is subm itted to the
department.
9. Any interest earned from advanced moneys shall be returned to the
department.
III. THE DEPARTMENT AND THE RECIPIENT MUTUALLY AGREE:
A. Effective Date
1. This Memorandum of Understanding shall be effective January 2, 2009, or on
the date in which the Memorandum of Understanding has been signed by
both parties, whichever is later.
2. This Memorandum of Understanding shall end on December 31, 2011.
B. Termination
1. Termination Because of Lack of Funds: It is agreed that in the event funds to
finance this Memorandum of Understanding become unavailable, the
obligations of each party, hereunder may be terminated upon no less than
twenty-four (24) hours notice in writing to the other party. Said notice shall be
delivered by certified mail, return receipt requested, or in person with proof of
delivery. The department shall be the final authority as to the availability of
state funds, and as to how any available funds will be allocated among
recipients. Any payments advanced by the department are to be repaid as
described in Section II above.
2. Termination for Breach: Unless the recipient's breach is excused, the
department may, by written notice of breach to the recipient, terminate the
whole or any part of this Memorandum of Understanding in any of the
following circumstances:
a. If the recipient fails to provide services called for by this Memorandum of
Understanding within the time specified herein or any extension thereof;
or
b. If the recipient fails to perform any of the other provisions of this
Memorandum of Understanding.
c. Termination shall be upon no I ess than twenty-four (24) hours notice in
writing delivered by certified mail, return receipt requested, or in person
with proof of delivery. The recipient shall continue the performance of this
Memorandum of Understanding to the extent not ter minated under the
provisions of this clause.
3. Waiver of Breach of any provision of this Memorandum of Understanding
shall not be deemed to be a waiver of any other or subsequent breach and
shall not be construed to be a modification of the terms of the Memorandum
of Understanding.
C. Termination Arrangements
After receipt of a notice of termination, and except as otherwise directed, the
recipient shall:
1. Stop work under the Memorandum of Understanding on the date and to the
extent specified in the notice of termination.
2. Place no further orders or contracts for materials, services or facilities except
as may be necessary for completion of such portion of work under the
Memorandum of Understanding as is not term inated.
3. Terminate all outstanding orders and contracts to the extent that they relate
to the performance of work that was terminated.
4. Prepare all necessary reports and documents required under the term s of the
Memorandum of Understanding up to t he date of termination, including the
final report due upon completion of the Memorandum of Understanding, if
any, without reimbursement for services rendered in completing said reports
beyond termination date if said reports are not completed prior to termination
date.
5. Take any other actions as directed i n writing by the department.
6. Immediately return all unexpended funds to the department.
D. Renegotiation or Modification
Any alterations, variations, modifications, or waivers of provisions of this
Memorandum of Understanding shall only be valid when they have been reduced
to writing, duly signed by all parties hereto, and attached to the original of this
Memorandum of Understanding.
E. Name of Payee
The name of the official payee to whom the department shall issue warrants shall
be City of Clearwater. The payee's Federal Employer Identification Number is
59-6000289.
F. Use of Funds for Lobbying Prohibited
The recipient will comply with the provisions of section 216.347, Florida Statutes,
which prohibits the expenditure of grants and aids appropriations for the purpose
of lobbying the Legislature, the judicial branch or a state agency.
G. All Terms and Conditions Included in Memorandum of Understandin
This Memorandum of Understanding and its incorporated attachments contain all
the terms and conditions agreed upon by the parties. No other agreements, oral
or otherwise, regarding the subject matter of this Memorandum of Understanding
shall be deemed to exist or to bind any of the parties hereto. In the event of a
breach or termination of this agreement, the recipient agrees to pay all costs of
collection of monies due to the department including a reasonable attorney's fee
and costs. Any real property purchased with funds paid pursuant to this
agreement shall be subject to a lien in favor of the State of Florida.
H. Attachments to be Part of Memorandum of Understanding
Attachment 1 Approved Letter of Intent/Facility Program
(previously submitted to the department)
Attachment 2 Audit Attachment
Attachment 3 Standard Budget Forms
DOEA 105f Receipts and Expenditure Report
DOEA 106f Request for Payment
DOEA 107f Senior Centers Statement of Use of Funds
Attachment 4 Lien - If Applicable
Attachment 5 Senior Center Fixed Capital Outlay Grant Monthly Status Report
Notice, Contact, and Payee Information:
1. The name, address, and telephone number of the contract manager for
the department for this contract is:
Department of Elder Affairs
Connie Hall
4040 Esplanade Way
Tallahassee, Florida 32399
(850) 414-2000 SC 994-2000
2. The name, address, and telephone number of the representative of the
provider responsible for administration of the program under this contact is:
City of Clearwater
Kerry Kimball Marsalek
100 S. Myrtle Avenue
Parks and Recreation Department
Clearwater, FL 33758-4748
(727) 562-4830
3. In the event different representatives are designated by either party after
execution of this contract, notice of the name and address of the new
representative will be rendered in writing to the other parry and said
notification attached to originals of this contract
10
IN WITNESS WHEREOF the parties hereto have executed this 12 page Memorandum
of Understanding, the day and year previously written.
Countersigned:
CITY OF CLEARWATER, FLORIDA
By:
rank V. Hibbard William B. Horne II
Mayor City Manager
A pr ed as to form: A st:
Laura Mahony Cyn a E.Goudeau
Assistant City Attorney City erk
STATE OF FLORIDA )
COUNTY OF PINELLAS )
The foregoing nstrument was acknowledged before me this >' day of
Qom, 20, by FRANK V. HIBBARD, Mayor of the City of Clearwater, who is
personally known to me.
4'".- 4.
Print/Type Name`77iir. '44/.
Notary Public
STATE OF FLORIDA )
COUNTY OF PINELLAS )
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MY COMMISSION * DD526033
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(407) 3984158 RoAda Nolary Sa vlan.com
The foregoing instrument was acknowledged before me this -A- day of
VhA&Ze.jr -1 2002, by WILLIAM B. HORNE II, City Manager of the City of Clearwater,
who is personally known to me.
Print/TypeNa ?q?? ? DIANEEMANNI
Notary Public' MY COMMISSION r DD526033
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STATE OF FLORIDA
DEPARTMENT OF ELDER AFFAIRS
By:
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Name:
92
Title: e4 t./
Date: /P ,Qy
APPROVED AS TO FORM AND LEGALITY
General Counsel's Office
Department of Elder Affairs
By:
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12
INDEX TO MOU ATTACHMENTS
ATTACHMENT ATTACHMENT DESCRIPTION PAGE
ATTACHMENT I APPROVED LETTER OF INTENT/FACILITY PROGRAM 14
ATTACHMENT II AUDIT ATTACHMENT 15-19
ATTACHMENT III STANDARD BUDGET FORMS 20-23
ATTACHMENT IV LIEN (To be filed after MOU is executed) 24-26
ATTACHMENT V SENIOR CENTER FIXED CAPITAL OUTLAY GRANT 27
MONTHLY STATUS REPORT
13
ATTACHMENTI
Signed Letter of Intent, previously submitted by grant recipient
(Original document in contract file)
14
ATTACHMENT H
FINANCIAL AND COMPLIANCE AUDIT
The administration of resources awarded by the Department of Elder Affairs to the provider may be subject to audits and/or
monitoring by the Department of Elder Affairs, as described in this section.
MONITORING
In addition to reviews of audits conducted in accordance with OMB Circular A-133, as revised, and Section 215.97, F.S., (see
"AUDITS" below), monitoring procedures may include, but not be limited to, on-site visits by Department of staff, limited scope
audits as defined by OMB Circular A-133, as revised, and/or other procedures. By entering into this agreement, the provider
agrees to comply and cooperate with any monitoring procedures/processes deemed appropriate by the Department of Elder
Affairs. In the event the Department of Elder Affairs determines that a limited scope audit of the provider is appropriate, the
provider agrees to comply with any additional instructions provided by the Department of Elder Affairs to the provider regarding
such audit. The provider further agrees to comply and cooperate with any inspections, reviews, investigations, or audits deemed
necessary by the Chief Financial Officer (CFO) or Auditor General.
AUDITS
PART I: FEDERALLY FUNDED
This part is applicable if the provider is a State or local government or a non-profit organization as defined in OMB Circular A-
133, as revised.
In the event that the provider expends $500,000 or more in Federal awards during its fiscal year, the provider must have a single
or program-specific audit conducted in accordance with the provisions of OMB Circular A-133, as revised. EXHIBIT 1 to this
agreement indicates Federal resources awarded through the Department of Elder Affairs by this agreement. In determining the
Federal awards expended in its fiscal year, the provider shall consider all sources of Federal awards, including Federal resources
received from the Department of Elder Affairs. 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 provider conducted by the
Auditor General in accordance with the provisions of OMB Circular A-133, as revised, will meet the requirements of this part.
In connection with the audit requirements addressed in Part 1, paragraph 1, the provider shall fulfill the requirements relative to
auditee responsibilities as provided in Subpart C of OMB Circular A-133, as revised.
If the provider 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 provider expends less than $500,000 in
Federal 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 cost of the audit must be paid from non-Federal resources (i.e., the cost of such audit must be paid from
provider resources obtained from other than Federal entities.)
An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year.
Compliance findings related to agreements with the Department of Elder Affairs shall be based on the agreement's requirements,
including any rules, regulations, or statutes referenced in the agreement. The financial statements shall disclose whether or not
the matching requirement was met for each applicable agreement. All questioned costs and liabilities due to the Department of
Elder Affairs shall be fully disclosed in the audit report with reference to the Department of Elder Affairs agreement involved. If
not otherwise disclosed as required by Section .310(b)(2) of OMB Circular A-133, as revised, the schedule of expenditures of
Federal awards shall identify expenditures by agreement number for each agreement with the Department of Elder Affairs in
effect during the audit period. Financial reporting packages required under this part must be submitted within the earlier of 30
days after receipt of the audit report or 9 months after the end of the provider's fiscal year end.
PART II: STATE FUNDED
15
This part is applicable if the provider is a nonstate entity as defined by Section 215.97(2), Florida Statutes.
In the event that the provider expends a total amount of state financial assistance equal to or in excess of $500,000 in any fiscal
year of such provider (for fiscal years ending September 30, 2004 or thereafter), the provider must have a State single or project-
specific audit for such fiscal year in accordance with Section 215.97, Florida Statutes; applicable rules of the Department of
Financial Services; and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules
of the Auditor General. EXHIBIT I to this agreement indicates state financial assistance awarded through the Department of
Elder Affairs by this agreement. In determining the state financial assistance expended in its fiscal year, the provider shall
consider all sources of state financial assistance, including state financial assistance received from the Department of Elder
Affairs, other state agencies, and other nonstate entities. State financial assistance does not include Federal direct or pass-
through awards and resources received by a nonstate entity for Federal program matching requirements.
In connection with the audit requirements addressed in Part II, paragraph 1, the provider shall ensure that the audit complies with
the requirements of Section 215.97(8), Florida Statutes. This includes submission of a financial reporting package as defined by
Section 215.97(2), Florida Statutes, and Chapter 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit
organizations), Rules of the Auditor General.
If the provider expends less than $500,000 in state financial 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, Florida Statutes, is not required. In
the event that the provider expends less than $500,000 in state financial assistance in its fiscal year and elects to have an audit
conducted in accordance with the provisions of Section 215.97, Florida Statutes, the cost of the audit must be paid from the
nonstate entity's resources (i.e., the cost of such an audit must be paid from the provider resources obtained from other than
State entities).
An audit conducted in accordance with this part shall cover the entire organization for the organization's fiscal year.
Compliance findings related to agreements with the Department of Elder Affairs shall be based on the agreement's requirements,
including any applicable rules, regulations, or statutes. The financial statements shall disclose whether or not the matching
requirement was met for each applicable agreement. All questioned costs and liabilities due to the Department of Elder Affairs
shall be fully disclosed in the audit report with reference to the Department of Elder Affairs agreement involved. If not
otherwise disclosed as required by Rule 69I-5.003, Fla. Admin. Code, the schedule of expenditures of state financial assistance
shall identify expenditures by agreement number for each agreement with the Department of Elder Affairs in effect during the
audit period. Financial reporting packages required under this part must be submitted within 45 days after delivery of the audit
report, but no later than 12 months after the provider's fiscal year end for local governmental entities. Non-profit or for-profit
organizations are required to be submitted within 45 days after delivery of the audit report, but no later than 9 months after the
provider's fiscal year end. Notwithstanding the applicability of this portion, the Department of Elder Affairs retains all right and
obligation to monitor and oversee the performance of this agreement as outlined throughout this document and pursuant to law.
PART III: REPORT SUBMISSION
Copies of reporting packages for audits conducted in accordance with OMB Circular A-133, as revised, and required by PART I
of this agreement shall be submitted, when required by Section .320 (d), OMB Circular A-133, as revised, by or on behalf of the
provider directly to each of the following:
The Department of Elder Affairs at each of the following addresses:
Department of Elder Affairs
Attn: Connie Hall
4040 Esplanade Way Office 335J
Tallahassee, FL 32399-7000
16
The Federal Audit Clearinghouse designated in OMB Circular A-133, as revised (the number of copies required by Sections
.320 (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
1201 East 10`n Street
Jeffersonville, IN 47132
Other Federal agencies and pass-through entities in accordance with Sections.320 (e) and (f), OMB Circular A-133, as revised.
Pursuant to Sections .320(f), OMB Circular A-133, as revised, the provider shall submit a copy of the reporting package
described in Section .320(c), OMB Circular A-133, as revised, and any management letter issued by the auditor, to the
Department of Elder Affairs at each of the following addresses:
Department of Elder Affairs
Attn: Connie Hall
4040 Esplanade Way Office 335J
Tallahassee, FL 32399-7000
Additionally, copies of financial reporting packages required by Part Il of this agreement shall be submitted by or on behalf of
the provider directly to each of the following:
The Department of Elder Affairs at each of the following addresses:
Department of Elder Affairs
Attn: Connie Hall
4040 Esplanade Way Office 335J
Tallahassee, FL 32399-7000
The Auditor General's Office at the following address:
State of Florida Auditor General
Claude Pepper Building, Room 574
111 West Madison Street
Tallahassee, Florida 32399-1450
Any reports, management letter, or other information required to be submitted to the Department of Elder Affairs pursuant to
this agreement shall be submitted timely in accordance with OMB Circular A-133, Florida Statutes, and Chapters 10.550 (local
governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General, as applicable.
Providers, when submitting financial reporting packages to the Department of Elder Affairs 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, should indicate the date that the reporting package was delivered to the provider in correspondence
accompanying the reporting package.
PART IV: RECORD RETENTION
The provider shall retain sufficient records demonstrating its compliance with the terms of this agreement for a period of six
years from the date the audit report is issued, and shall allow the Department of Elder Affairs or its designee, the CFO or Auditor
General access to such records upon request. The provider shall ensure that audit working papers are made available to the
Department of Elder Affairs, or its designee, CFO, or Auditor General upon request for a period of six years from the date the
audit report is issued, unless extended in writing by the Department of Elder Affairs.
17
ATTACHMENT 11
EXHIBIT --1
1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS AGREEMENT
CONSIST OF THE FOLLOWING:
PROGRAM TITLE FUNDING SOURCE I CFDA L AMOUNT
TOTAL FEDERAL AWARD
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT TO
THIS AGREEMENT ARE AS FOLLOWS:
The contractor (recipient) must comply with the applicable provisions of specific law(s), rule(s), or regulation(s).
2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS AGREEMENT CONSIST OF
THE FOLLOWING:
MATCHING RESOURCES FOR FEDERAL PROGRAMS
PROGRAM TITLE FUNDING SOURCE I CFDA I AMOUNT
TOTAL FEDERAL AWARD $0
CTATF F7NAN!`iAi. ARCYCTAN!''F. CiTR_iF('TTf)Cnr 214.4'7. F.C.
PROGRAM TITLE FUNDING SOURCE CSFA AMOUNT
Fixed Capital Outla : Senior Center Grant GR 65.013 $727,500.00
TOTAL AWARD $727,500.00
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO THIS
AGREEMENT ARE AS FOLLOWS:
18
ATTACHMENT 11
EXHIBIT-2
PART I: AUDIT RELATIONSHIP DETERMINATION
Providers who receive state or federal resources may or may not be subject to the audit requirements of OMB Circular A-133, as revised,
and/or Section 215.97, Fla. Stat. Providers who are determined to be recipients or subrecipients of federal awards and/or state financial
assistance may be subject to the audit requirements if the audit threshold requirements set forth in Part I and/or Part II of Exhibit 1 are met.
Providers who have been determined to be vendors are not subject to the audit requirements of OMB Circular A-133, as revised, and/or
Section 215.97, Fla. Stat. Regardless of whether the audit requirements are met, providers who have been determined to be recipients or
subrecipients of Federal awards and/or state financial assistance, must comply with applicable programmatic and fiscal compliance
requirements.
In accordance with Sec. 210 of OMB Circular A-133 and/or Rule 691-5.006, FAC, provider has been determined to be:
Vendor or exempt entity and not subject to OMB Circular A-133 and/or Section 215.97, F.S.
X Recipient/subrecipient subject to OMB Circular A-133 and/or Section 215.97, F.S.
NOTE: If a provider is determined to be a recipient /subrecipient of federal and or state financial assistance and has been approved by the
department to subcontract, they must comply with Section 215.97(7), F.S., and Rule 691-.006(2), FAC [state financial assistance] and Section
.400 OMB Circular A-133 [federal awards].
PART II: FISCAL COMPLIANCE REQUIREMENTS
FEDERAL AWARDS OR STATE MATCHING FUNDS ON FEDERAL AWARDS. Providers who receive Federal awards or state
matching funds on Federal awards and who are determined to be a subrecipient, must comply with the following fiscal laws, rules and
regulations:
STATES, LOCAL GOVERNMENTS AND INDIAN TRIBES MUST FOLLOW:
2 CFR Part 225 Cost Principles for State, Local and Indian Tribal Governments (Formerly OMB Circular A-87)*
OMB Circular A-102 - Administrative Requirements
OMB Circular A-133 - Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
NON-PROFIT ORGANIZATIONS MUST FOLLOW:
2 CFR Part 230 Cost Principles for Non-Profit Organizations (Formerly OMB Circular A-122 - Cost Principles)*
2 CFR Part 215 Administrative Requirements (Formerly OMB Circular A-110 - Administrative Requirements)
Requirements)
OMB Circular A-133 - Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
EDUCATIONAL INSTITUTIONS (EVEN IF A PART OF A STATE OR LOCAL GOVERNMENT) MUST FOLLOW-
2 CFR Part 220 Cost Principles for Educational Institutions OMB (Formerly Circular A-21 - Cost Principles)*
2 CFR Part 215 Administrative Requirements (Formerly OMB Circular A-110 - Administrative Requirements)
OMB Circular A-133 - Audit Requirements
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
*Some Federal programs may be exempted from compliance with the Cost Principles Circulars as noted in the OMB Circular A-133
Compliance Supplement, Appendix 1.
STATE FINANCIAL ASSISTANCE. Providers who receive state financial assistance and who are determined to be a
recipient/subrecipient, must comply with the following fiscal laws, rules and regulations:
Section 215.97, Fla. Stat.
Chapter 69I-5, Fla. Admin. Code
State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws, rules and regulations
19
ATTACHMENT III
RECEIPTS AND EXPENDITURE REPORT
FIXED CAPITAL OUTLAY
This Report Period:
RECIPIENT NAME, ADDRESS, PHONE# and FEID# Program Funding Source: FROM TO
Contract Period
General Revenue Contract #
Report #
CERTIFICATION : I certify to the best of my knowledge and belief that this report is complete and correct and all the
outlays herein are for the purposes set forth in the above contract.
Prepared by : Date : Approved by : Date
1. Approved 2. Actual Receipts 3. Total Receipts 4. Percent of
PART A: BUDGETED INCOME/ RECEIPTS Contract Budget for this Report Year to Date Approved Budget
1. State Funds .............................................. 0.00 0-00 0.00 #DIV/0!
2. Cash Match ............................................... 0.00 0.00 0.00 #DIV/O!
3. SUBTOTAL: CASH RECEIPTS ...................... 0.00 0.00 0.00 #DIV/01
4. Local and In-Kind Match ............................... 0.00 0.00 0.00 #DIV/o!
5. TOTAL RECEIPTS 0.00 0.00 0.00 #DIV/01
1. Approved Budget 2. Expenditures 3. Expenditures 4. Percent of
PART B : EXPENDITURES For This Report Year to Date Approved Budget
(Identify Line Item Categories from Approved Budget)
1. Site Work ........ •----• .................................... 0.00 0.00 0.00 #DIV/01
2.Interior ------------------------------------------------------ 0.00 0.00 0.00 #DIV/01
3. Exterior---------------------------------------------------- 0-00 0.00 0.00 #DIV/01
4. Fixtures----------------------.-..----..-.----.------------ 0-00 0.00 0.00 #DIV/01
5. Professional Service .................................... 0.00 0-00 0.00 #DIV10!
6. Other ....................................................... 0.00 0.00 0.00 #DIV/01
7. TOTAL EXPENDITURES 0.00 0.00 0.00 #DIV/01
PART C : OTHER (For tracking purposes only)
1. Match:
Local In-Kind Match .............................. 0.00 0.00 0.00 #DIV/01
Cash Match ........................................ 0.00 0.00 0.00 #DIV/01
2- Advance Recouped ..................................... 0.00 0.00 0.00 #DIV/01
3. Interest:
Earned on GR Advance ......................... 0.00 0.00 0.00 #DIV/01
Returned on Gr Advance ........................ 0.00 0.00 0.00 #DIV/01
4. TOTAL OTHER ...................................... 0.00 0-00 0.00 #DIV/O!
DOFA form 105f, May 2008
20
REQUEST FOR PAYMENT
FIXED CAPITAL OUTLAY
RECIPIENT NAME, ADDRESS, PHONE# and FEID# PAYMENT REQUEST : This Request Period :
From To
Regular Report #
Supplemental Contract #
Advance Contract Period
CERTIFICATION: I hereby certify that this request conforms with the terms of the above contract.
Prepared by: Date: Approved by: Date:
PART A: BUDGET SUMMARY FCO
1. Approved Contract Amount $
2. Previous Funds Received for Contract Period $
3. Contract Balance $
4. Previous Funds Requested for Contract Period $
5. Contract Balance $
PART B: CONTRACT FUNDS REQUEST
1. Anticipated Cash Needs (Attach Justification) $
2. Net Expenditures For Month (DOEA Form 105f, Part B Line 7) $
3. TOTAL $
PART C: NET FUNDS REQUESTED
1. Less Advance Applied $
TOTAL FUNDS REQUESTED $
(Part B, Line 3 minus Part C. line 1)
DOEA form 106f, May 2008
21
SENIOR CENTERS
STATEMENT OF USE OF FUNDS
Project Name:
Total Project Budget: $
TYPE AND SOURCE OF FUNDS Sr. Center
State
FCO
Funds
Matching
Funds Other
Non-FCO
Funds Total
Project
Funds
Federal Grant(s)
Other State Funds (i.e., DCA)
City/County Grant(s)
Senior Centers FCO Grant
Private Contributions/Donations
In-Kind Expenditure Credits
Total Funds Available From All Sources $ - $ -
-
Is
$ -
Parking Lot
Walks/Driveways
Awnings/Covered Walkways
Drainage/Retention Pond
Trees/Landscaping
Fencing
Signage
Other Please Specify)
Total $ - $ - $ - $ -
INTERIOR
Ins ulation/Weatherization
Plumbing
Heating/Air Conditioning
Electrical
Flooring
Masonry
Ceiling/Acoustics
Railing/Guards
Elevators
Other (Please Specify)
Total $ -
-
Is
$ -
$ -
Page 1 of 2
22
EXTERIOR
Roofin Siding
DoorsNVindows
Porches, Decks, Patios
Septic Tank
Sewer Hook-Up (City/County)
Generator (Gas Powered)
Other (Please Specify)
Total $ - $ - $ - $ -
FIXTURESIEQUIPMENTIAPPLIANCES
Security/Alarm System
Telephone System
Smoke Detectors
Emergency/First Aid Stations
Kitchen Appliances
Cabinets/Counter Tops
Bathroom Fixtures
Lighting Fixtures
Other (Please Specify)
Total $ - $ - $ - $ -
PROFESSIONAL SERVICES
Architect/ Engineer/ Special Consultant
Schematic Design Phase
Design Development Phase
Construction Document Phase
Bidding
Construction Administration
Total $ - $ - $ - $ -
OTHER (Please Specify)
Total $ - $ - $ - $
TOTAL PROJECT COST $ - $ - $ - $ -
Page 2 of 2
23
ATTACHMENT IV
IN THE CIRCUIT COURT OF THE SIXTH JUDICIAL CIRCUIT IN AND FOR
PINELLAS COUNTY, FLORIDA
PROPERTY AGAINST WHICH
LIEN PLACED: City of Clearwater
The Aging Well Center
LIENHOLDER: STATE OF FLORIDA NOTICE OF LIEN
DEPARTMENT OF ELDER AFFAIRS
NOTICE IS HEREBY GIVEN that the State of Florida, Department of Elder Affairs, pursuant
to applicable Florida Law, does hereby give notice of and assert a lien in the amount of
$727.500.00 against the following described property:
LEGAL DESCRIP'T'ION:
24
ALSO DESCRIBED AS:
This lien is asserted pursuant to applicable Florida law and the Memorandum of
Understanding entered into on or about , 2009, by and between City of
Clearwater (Recipient) and the State of Florida, Department of Elder Affairs.
The State of Florida, Department of Elder Affairs, has a financial interest in the above-
described property equal to a pro rata portion of the State's original investment in the
25
then-fair-market value for renovations, or its proportionate share of the cost of the
construction as compared to the then-fair-market value of the property upon the
completion of the renovations or construction, which interest is in the amount of
$727,500.00 as set out above.
The interest of the State of Florida, Department of Elder Affairs, is to be proportionately
reduced and subsequently vacated of a 20-year period of depreciation unless this lien is
satisfied before that time. As a condition of receipt of State funding for this construction
or renovation, the recipient has agreed pursuant to Section I, Subsection M of the
aforesaid Memorandum of Understanding, that if it disposes of the property before the
Interest of the State of Florida, Department of Elder Affairs, is vacated, the recipient will
refund the proportionate share of the State's investment, as adjusted by depreciation.
Dated this - day of .2009.
ON BEHALF OF THE STATE OF FLORIDA
DEPARTMENT OF ELDER AFFAIRS
E. Douglas Beach, PhD., Secretary
Department of Elder Affairs
STATE OF FLORIDA
COUNTY OF
Sworn and subscribed before me this _ day of , 2009, by
who is personalty known to me.
NOTARY
THIS DOCUMENT PREPARED BY.
Dean Kowalchyk, General Counsel
Department of Elder Affairs
4040 Esplanade Way
Tallahassee, FL 32399-7000
26
ATTACHMENT V
SENIOR CENTER
FIXED CAPITAL OUTLAY (FCO) GRANT
MONTHLY STATUS REPORT
Project Name: MOU #
Report Date: Report #
Section A - Budget
A.1 Discuss any changes to project budget, or indicate not applicable.
A.2 Provide a revised Statement of Source and Use of Funds report reflecting changes to project budget.
Section B - Project Milestones
B.1 Discuss project milestones achieved for this report period.
B.2 Discuss project obstacles encountered during this report period.
B.3 Provide a revised Work Plan, if appropriate, or indicate not applicable.
Section C - Funding Projection
CA Current Invoice
Report Period: Amount:
C.2 Anticipated Fundine Request
Month 1 (Mo/Yr): Amount: Provide a brief description of projected activities:
Month 2 (Mo/Yr): Amount: Provide a brief description of projected activities:
Month 3 (Mo/Yr): Amount: Provide a brief description of projected activities:
27
RESTRICTIVE COVENANT
THESE COVENANTS are entered into this day of , 2009 by
, Owner, hereinafter referred to as the Grant Recipient, and State of Florida,
Department of Elder Affairs, 4040 Esplanade Way, Tallahassee, Leon County, Florida and shall be
effective for a period of five (5) years from the date of recordation of this Covenant by the Clerk of Court.
Whereas, the Grant Recipient, is to receive state funds in the form of a fixed capital outlay grant in
the amount of to construct, repair or maintain its senior center in accordance with the
terms of a Memorandum of Understanding executed by the parties on
Now therefore, as part of the consideration for the award of state funds, the Grant Recipient, as a
political subdivision, hereby makes and declares the following restrictive covenants which shall run with
said property and be binding on the Grant Recipient and its successors or assigns in interest, if any, for the
period stated above.
1. The Grant Recipient agrees to continue to operate, maintain and repair the property in
accordance with the terms of the memorandum of understanding and the purposes for which the funds were
originally appropriated.
2. In the event the Grant Recipient fails to maintain ownership of the senior center as provided,
fails to operate the facility as a senior center, or otherwise violates the terms of this covenant, the recipient
agrees to reimburse the Department any portion of the funds received, proportionally amortized over the
period of five (5) years, upon 60 days notice by the Department of the violation.
3. The covenant shall terminate at the end of the aforesaid amortization period, and the parties
shall record a notice of termination of the covenant in the public records of the county in which the
covenant is recorded.
4. The Grant Recipient agrees to file these covenants with the Clerk of the Circuit Court in the
county where the property is located and shall pay any and all expenses associated with the filing and
recording.
5. The Grant Recipient agrees that the Department shall incur no tax liability as a result of these
restrictive covenants.
Witness Signature Grant Recipient Signature/Title
Witness Name Printed
Grant Recipient Name Printed
Grant Recipient Address
STATE OF FLORIDA
COUNTY OF
The foregoing instrument was acknowledged before me this - day of . 2009 by
who is personally known to me or has produced
Name/Title
as identification and did/did not take an oath.
Notary Public
SEAL My Commission Expires:
Revised August 2007
Attestation Statement
Agreement/Contract Number.
Amendment Number
(Recipient/Contractor representative)
attest that no changes or revisions have been made to the
content of the above referenced agreement/contract or amendment between the Department of Elder Affairs
and
(Recipient/Contractor name)
The only exception to this statement would be for changes in page formatting, due to the differences in
electronic data processing media, which has no affect on the agreement/contract content.
Signature of Recipient/Contractor representative
Date
DOEA Contract Manager to initial and date indicating signatures/initials appropriate on all documents; ready
for DOEA Secretary/designee signature
initial date
Revised August 2007
Lmte: January '2010 !
Subject: Pgyment Processing Advisory
ELDER Dew Provider.
AFFAIRS
,STATE & FLORIDA Please ncotc the enclosed contract between your or.ganizanon and the Department of 1"'Ider
Aflfairs (D ji A). ?lithough the payment terms for services rendered are cove reki extensively in
L'Ft<<at.t..EF t'tz1r
the contract, we want to cull to your attc~rtiticm audrt.prcxetlures hu the. Department offinancull.
Scrviccs (DIFS) that could effect the timely processing of your invoice or request for payment.
When DOE.A receives a request for payment. the eonlrat t manager reviews the request ano
vr:-rific.q that the servic" rendered are in compliance will. ccmtr;act terms, Apraymenr
authoriration is tnnvaarded to the DFS (fbimerly the comptroller's office) for review and check,
processing. DFS has advised state agencies that payment requests will be randomly selected and
subjected to aan "t:xpandrd pre-audit." An expanded pre-audit requires that. ?upponing
documentation verifying actual cotits be provided bGfcare the selected payment is prm",;,ed. The
requitement applies to all contracts, regardless cif the type of method of pay meor (e,g.
deliverables, cost: reimbursements, fixed cost. etc.). Since numv at om providers utilize
4?< t)raa_'s:t.,,ws ttE::+t;tt, t'tt,W, atatotxaatc:d tai aa+aantirtg soifwarc to track ;yid aveamulatc actual cost. this requi.rtrmcm may he
"Af{V
sirtnply a by-product of the provider's financial reporting sysrern. if you do naat have such .a
svstean< you should implement. appropriate procedures to capture actual t:o,Eis anal expenditures
for each Contract award,
.DFS has made it clear that when it request for supporting cost documentation haM been initiated,
and no resporse is received, current or ulasequertt payments may be voithhaOd- Exan7.ple;? of
documentation regUCsted by DFS &Wing prior N'e.a:rs related to expran ed pi'e-rtuditt irtclucled the
following:
s T'inteshect.r, pavrolt rccnrdstspht-fundingscheddlis1
• Client service logs and sign-in registers
+ 151voices. rcceiv°irwg reports. etc.
• t``om. space.sharl]V, agreements and compilations
r Ot.hcr documentation evidencing actual costs
We holac this irttC]TTTic`alwn well aSsrst you in, t aintaminq uppropri.mc cast doc,umesntatio n and
records cif .services rendered. and thereby' avoid anv delay acs p aKessirig Payments (6t,
c npendmirvs selected for :audit by staw or fedc-ra.l officials. Please feel Cret to contact
Nichols, our ccnnmac.t administrator at (S50) 414.2040( ihould you have questiq..ti,
We took f nr? and ro working wvlrh you.
5ITICereiv.
LZ...
4040 FSvLA1VADF WAY Carol Carr
TALLAHASSEE Nvisictn of Administrative Ser?,icvs
FLORIDA. 32399-7000
pr,,:, F RM4'1*7400
?a:, &5t7.414.?00d
TOO 850.414.7001
Yrttp:.f,1eldgraffairs.statr+.fl.ars