Loading...
869-LIHEAP Mod. of AgreementIO0~ 'L~ / / A RESOLUTION OF THE CITY OF SANI~OKD, FLORiDA, AUTHOKIZING THE C[TY M AN AGEK OF THE, CITY Ot: SANFORD, 'FLORIDA TO EXECUTE TI-IE LOW INCOME HO.vvfE ENERGY ASSISTANCE PROGP-,AM AGREEMENT WITH TIlE FLORIDAD.~PJLP, TMENT OF COMMUNITY AFFAIRS FOR FISCAL YEAR 2001/02 WHEREAS, k is in the best interest ofthe. City of Saaford, Florida to enter imo a grant agreement wiih the Florida Department of Community Affairs for the Fiscal Year 2001/02 Lciw Income Home'Energy Assistanc~ Ih'ogram; and WB'~.REAS, the City of Sanford has adrninistcred the Low Income Home Energy Assistance Program successfull~ in the past and Wishes to continue to offer this benefit. NOW, THEREInORE, BE IT RESOLVED BY THE IPEOPEE OF ~ CITY OF SAI~FORD, FLORIDA: That the City ManaSer of the City of Sanford, Florida iS hereby authorized and empowered on behalf of the City to negotiate the terms for and to enter into and execute the above described a~ccment with the Florida lZ~pam~nt of Community Affairs, and to negotiate the terms for and to execute any and all related documcnt~ ,which are n~,~sary m effectuate the terms of said al~reement. PASSED AND ADOPTED this 18~ day ofDece, mber, A.D. 2000 ATTEST: As the City Commission of the City of Sanford, Florida t'd ~O~ ~VSE:OOOE-9~-~L FY 2001 WINTER CONlvINGENCY FUNDS PAGE 1 of__4 CONTRACT NO: 01EA-90-06-69-02-026 MOD. #01 P ,l o7 MODIFICATION OF AGREEMENT BETWEEN FLORIDA DEPARTMENT OF COMMUNITY AFFAIRS AND CITY OF SANFORD The agreement between the Department of Community Affairs and CITY OF SANFORD, bearing the above contract number is modified by mutual agreement of the parties as follows: Clause (3) PEPClOD OF AGREEMENT This Agreement shall begin on February L 2001, and shall end March 31, 2002 unless terminated earlier in accordance with the provisions of paragraph (9) of this Agreement. Clause (17) (a) and (b) FUNDING/CONSIDERATION (a) This is a cost-reimbursemetu Agreement. The Recipient shall be reimbursed for costs incurred in the satisfact6ry performance of work hereunder in an amount not to exceed $253,234, subject to the availability of cash and appropriate budget authority. The Recipient is authorized to incur costs in an amount not to exceed $154,625 until the Department receives the full budget authority. Upon Departant receipt of final budget authority and approved Recipient Performance Plan, the Department will authorize the Recipient to incur additional costs. This amount includes: 1. $154,625 Last Approved FY 2001-2002 LIHEAP Allocation 2. + $43,533 Increase in Base Allocation 3. + $551076 FY 2001 LIFIEAP Winter Contingency Funds (b) Any advance payment under this Agreement is subject to s. 216.181 (15), Florida Statutes. The mount which may be advanced may not exceed the expected cash needs of the Recipient within the first three (3) months, or 25 percent of the Agreement amount, whichever is less. For a federally funded contract, any advance payment is also subject to federal OMB Circulars A-102, A-110, A-122 and the Cash Management Improvement Act of 1990. If an advance payment is requested, the budget data on which the request is based and a justification statement shall be included in Justification of Advance Payment, AttachmentEofthisAgreement. AttachmentEwillspecifytheamountofadvancepaymentneededandprovideanexplanationof the necessity for and proposed use of these funds. 1. X No advance payment is requested. 2. __ An advance payment of $ is requested Attachment E - Justification of Advance Payment Attachment K - Budget Summary and Workplan All other provisions of the contract not in conflict with this modification remain in full force and effect. RECIPIENT STATE OF FLORIDA / DEPARTMENT OF COMMUNITY AFFAIRS By: By: I V d . y s, Acting Directo;(t''L~ ony an erworp~City Manager JosephF M er (Type Name and Title) Division of Housing and Community Development Date: / - ~x9 &' --~) / Date: 59-6000425 Federal Identification Number FY 2001 W TER CONTINGENCY FUNDS PAGE 2 of 4 IN MOD. #01 ATTACHMENT K LOW-INCOME HOME ENERGY ASSISTANCE PROGRAM (LIHEAP) AMENDED BUDGET SUMMARY AND WORKPLAN RECIPIENT: CITY OF SANFORD CONTRACT #: 01EA-90-06-69-02-026 I. BUDGET SUMMARY A. B. Co D. E. Last Approved Increase in Winter TOTAL LIHEAP FUNDS ONLY Budget Base Contingency Modified Amount Allocation Funds Budget L TOTAL FUNDS 154,625 43,533 55.076 253,234 2; Salaries including Fringe; Rent, Utilities, TraveI, Other ~ 11.596 ] 3.264 I 4,130 ] 18 , 990 OI.TRI': 't(ll I:XPI:NSI'. UI ,.":!: ,:::~::'ol t'xce,:d 157,, ~ffl.mc minu~ I .i:~ 2'1 3. Salaries including Fringe; Rent, Utilities, Travel, Other I 21,454 I 6,040 I 7,641 I 35,135 · '.~IRECTCLIENT ASSISTANCE · "' "' "' ""': · · ' 4. Home Energy Assist~ce (Columns B & C - Must be at le~t 25% of Linel) 45,000 10,884 55,884 5. Crisis Payments 73,482 23,345 96,827 6. Weather Related/Supply Shortage 3,093 0 43,305 46,398 7. Subtotal Direct Client Assist~ce (Lines 4+5+6) 121,575 34,229 43,305 19~,109 8. SUBTOTAL(Lines2+3+7) 154,625 43,533 55,076 253,234 :~:~:: ~::: 11. TOTALLEVE~GING (Lines 9+10) 12. G~NDTOTAL (Lines8+ll) 154,625 43,533 55,076 253,234 II. DIRECT CLIENT ASSISTANCE BUDGET DETAIL A~ WOR~LAN ] Estimated ~ of Households Estimated Cost Estimated Expenditures Type of Assistance to be Served Per (Amended Est. ~ of Households X Previous Amended Household Est. Cost Per Household) Home Energy 600.00 750.00 $74.51 $55,884 Crisis 450.00 600.00 $161.33 $96,827 Weather Related/Supply Shortage 16,00 240.00 $193.33 $46,398 ~VE~GING Crisis TOTAL LIHEAP A'!TACHMENT L IIL ADMINISTRATIVE AND OUTREACH EXPENSE BUDGET DETAIL (Lines Line Item . ' ' EXPENDITURE DETAIL LIItEAP'!rUNDS Num~r (R~und up llne items to dona~ Do not use.~,~ts sad · dccim~l~ ~ totals) 2, ' ' ADMINISTRATIVE EXPENSES C(INTRACTS COORDINATOi{ ~16,19o.00 46:1389~ of 28,04% OF TRAVEL .~4.gaMIL~@.29MILB XISROX $400,00 20.B0g~4 OF $1o9~7,00 Ol~Cl~ SUPPLIES $700.00 20% OF COPY CARTRIDGE8 Sl,1O0.00 u @ $1oo,OO F~CH. ~: OUTREACH EXPENSE~ CONTRACTS COORBINATOR $17,931.00 51.1005% ~f$35,089,67 ODTRF~.~ISP£C/ALI~T XEROX PO~TAGE $491.00 ~*/o OF OFFICE SUPPL/BS $600.00 20% OF $3,000.00 (aoueApV pa~,sanbal:t) $ = (g~') % g;: × $ uo!leoollV lelo/ :lunoLue aoueApe alp, ~0 uo!lelnoleO · aoueApe s!LI1 lnoql!t~.LueJBoJd aql a~,ejado ol alqe aq lou plno~ aAA 'luamd!nba pue sa!lddns dn 1Je),s aseqojnd pue SLUJO~ aleo!ldnp 'slue!lo ol sl~Jauaq pje~e '~els Aed o~ papaau aje SpUrLJ asaq,L · tueJBojd aql ~o sqluoLu aaJql lsJg aql ~o uo!~ejado eq~ Jo~' $ ~o eoueApe ue 6u!lsanbaJ aJe eAA QgJ,S:grlOg~l 9ONVA(]V [ ] 'A~oleq lunoLue eoueApe eli1 Jo uo!lelnoleo eql a3~eldLuoo osle lsnuJ noA 'eoueApe us 6u!lsanbaj a;e no/. Jl '~olaq sl~ioPJq e;e.udojdde eql u! X ue 6u!oeld Aq pelsenbeJ 6u!aq s! aoueApe ou J} Jo'aoueApe us 6u!lsanbaj a~e noA ~! eleo}pul ~N~]INAVd 9ONVAC]V dO NOIJ. VOIdlJ.Srlr 9 ,LNglNHOVJ_I.V dVgHI'I LIHEAP FY 200'1-2002 CONTRACT NUMBER: 01 EA-~'~-06-69-02-026 (March 1, 2001-March 31, 2002) CFDA NUMBER 93.568 LOW-INCOME HOME ENERGY ASSISTANCE PROGRAM FEDERALLY FUNDED SUBGRANT THIS Agreement is entered into by and between the State of Florida, Department of Community Affairs, with headquarters in Tallahassee, Florida (hereinafter referred to as the "Department"), and CiTY OF SANFORD, (hereinafter referred to as the "Recipient"). THIS AGREEMENT IS ENTERED INTO BASED ON THE FOLLOWING FACTS: A. WHEREAS, the Recipient represents that it is fully qualified, possesses the requisite skills, knowledge, qualifications and experience to provide the services identified herein, and does offer to perform such services, and B. WHEREAS, the Department has a need for such services and does hereby accept the offer of the Recipient upon the terms and conditions hereinafter set forth. C. WHEREAS, the Department has authority pursuant to Florida law to disburse the grant funds under this Agreement. NOW, THEREFORE, the Department and the Recipient do mutually agree as follows: (1) SCOPE OF WORK The Recipient shall fully perform the obligations in accordance with the Scope of Work, Attachment A of this Agreement. (2) INCORPORATION OF LAWS, RULES, REGULATIONS AND POLICIES Both the Recipient and the Department shall be governed by applicable State and Federal laws, rules and regulations, including but not limited to those identified in Program Statutes and Regulations, Attachment B of this Agreement. (3) PERIOD OF AGREEMENT This Agreement shall begin upon execution by both parties or March 1, 2001, whichever is later, and shall end March 31, 2002 unless terminated earlier in accordance with the provisions of paragraph (9) of this Agreement. 'al~!~ Jo 6u!solo Jamb SJ8s~ asJq] JoJ pau!a]oJ aq lls~s uo!~!s!nbos ~jadoJd lsoj o~ 6u]~BlaJ spjoo~ '~ 'uo!])sods!p leuU Ja~e sJes/~ s@Jq) .~oJ pau)e]a~ aq )leqs uo!l!s!nboe Jo e~)) eq] )e 9Jo~ Jo O00'g$ )e panleA ~adojd leuosjed ~lqepuadxa-uou Jo uq))sods)p BU) JoJ spjooe~ '; 'peAIossJ Ueeq aAeq spjOOeJ 8q~ BU~AIOAU) s6u)pug 1)pne Jo s~)elo 'uo)le6)l)l lie I))un psu)elu~e~ 9q II)~ spJooeJ eq) 'popad JeBX 9s~ql sq~ puoXsq spuelx8 pub po~ed JseX seJq) aq) jo uo~18J~dx8 8q) eJoJaq pe~e)s s) iipne Jo ~)~lo 'uo~l~6~l~) Xue Jl ' ~ :suo)~daoxe 6u~ol)oj 8q) ql)~ be~sl s) JeAeqo)q~ '~odeJ )no-esop )Bug BUt jo uo~ss)~qns Jo Jo )us~seJBV s)q) Jo uoI~eu~e~ Jo elep eq) 6u)~olioJ sJssX asJql ';' L e6 pus ~' ~e suo]~eln68~ uol~slnboV IaJepaj o] ]oe[qns eq Ileqs ~ualdpe~ S!q~ Jl ,,'Suo!~BZ!uB6JO ]~oJduoN JoJ saidpupa ]soD. '~; t-V 'oN JBInoJlO 8~0 Jo ,,'suo!~n]l]suI i~uo!~onp~ Joj sald!ou!jd ~soO,, 't~-V 'oN JBInoJ!O 8~0 ,,'s~ua~uJ~AoO I~oo~ pu~ a~8]g JoJ saldpu!Jd ]soD,, 'tg-V 'oN JBlnoJ!O 8~0 Jaq]~G DU~ .'SUO]~Z~USBJO ~gOJdUON Jaq]O pUS 'sls~dsoH 'uo!~onp3 J~6!H jo suo!]n~!]sul q]l~ s~u~a~J6v pu~ s~usjO,, '0 t t-V 'oN Js]~oJ!O 8~0 Jo '~6 pus 9Z '~Z ~d ~JO 9~ 'aln~ uo~oO ~] o] ]oG[qns ~q 118qs ]u~J6V s~q~ Japun ~ou~Jopad s,lu~dpa~ Gq~ '~iq~o!ldd8 ~1 (B) ' O0 t~*66e~ ~p!JolJ 'aaSseqellBZ Bul~unoooV pub ~OUBU~J sJ~a~V ~un~o3 Jo ~us~sdsO :ssajppB 6u]~olloJ 9q~ Is ~uB~BdB0 ~ o~ Xlpaj~p Psl~8~ pub '.BJ~V ~]un~moO Jo ]UB~BdBQ. jo Japjo ~q] o~ 91qeX8d sps~ 9q o~ 9Je ~u~agJOV s]q~ )spUn ~us~sdaQ 9q~ o] spem aq o] s]uB~BdBJ Jo spu~Bj IIV '~ua~G~J6V s~q~ Jo IBu~O~Jo Bq] o~ pBqOB~B pUB 'O~aJBq Sg~d 9q~ Jo qOe9 ~q pgU6~s ~inp '6u]lp~ o~ paonpaj ugq~ Xluo p~I~A 9q 118qs uodn pagJ68 ~llsn]n~ ~J~ qo~q~ sa6uBqO lug~99JOV s~) Jo suo~s~AoJd 9q] jo uo~g]pom ~sgnbgj As~ ~ad Jaq~]3 (c) Al~rec~rds~inc~udingsupp~rtin~d~cumentati~n~failpr~gramc~sts~hal~besufficientt~ · determine compliance with the requirements and objectives of the Budget Summary and Workplan. Attachment K of this Agreement and all other applicable laws and regulations. (d) The Recipient, its employees or agents, including all contractors or consultants to be paid from funds provided under this Agreement, shall allow access to its records at reasonable times to the Department. its employees, and agents. "Reasonable" shall be construed according to the circumstances but ordinarily shall mean during normal business hours of 8:00 a.m. to 5:00 p.m., local time, on Monday througt~ Friday. "Agents" shall include, but not be limited to. auditors retained by the Department. (e) Any additional terms and conditions pertaining tO Property Management and Procu rement are set forth in Attachment G of this Agreemerit. · (~) REPORTS (a) At a minimum, the Recipient shall provide the Department with quarterly reports, and a close-out report. (b) Quarterly reports are due to be received by the Department no later than the twenty-first (21st) of the month following the last month of the reporting pedod, and shall continue to be submitted each quarter until submission of the close-out report. The ending dates for each quarter of the program are June 30, September 30, December 30. and March 30. Activities paid for with these funds during March, 2001, are to be reported in the program report for the quarter ending June 30, 2001. (c) The close-out report is due 45 days after termination of this Agreement or upon completion of the activities contained in this Agreement. (d) If all required reports and copies, prescribed above. are not sent to the Department or are not completed in a manner acceptable to the Department. the Department may withhold further payments until they are completed or may take such other action as set forth in paragraph (9). The Department may terminate the Agreement with a Recipient if reports are not received within 30 days after written notice by the Department. "Acceptable to the Department" means that the work product was completed in accordance with generally accepted principles and is consistent with the Budget Summary and Workplan, Attachment K of this Agreement. (e) Upon reasonable notice, the Recipient shall provide such additional program Updatesor information as may be required by the Department. (f) The Recipient shall provide additional reports and information as identified in Attachment D, (7) MONITORING The Recipient shall constantly monitor its performance under this Agreement to ensure that time schedules are being met, the Budget Summary and Workplan is being accomplished within specified time periods, and other performance goals are being achieved. Such review shall be made for each function or activity set forth in Attachment K of this Agreement. (8) LIABILITY (a) Except as otherwise provided in subparagraph (b) below, the Recipient shall be solely responsible to parties with whom it shall deal in carrying out the terms of this Agreement, and shall save the Department harmless against all claims of whatever nature by third parties arising out of the performance of work under this Agreement. For purposes of this Agreement. the Recipient agrees that it it not an employee or agent of the Department. but is an independent contractor. (b) Any Recipient who is a state agency or subdivision, as defined in Section 768.28, Fla.. Slat., agrees to be fully responsible for its negligent acts or omissions or tortious acts which result in claims or suits against the Department, and agrees to be liable for any damages proximately caused by said acts or omissions. Nothing herein is intended to serve as a waiver of sovereign immunity by any Recipient to which sovereign immunity applies. Nothing herein shall be construed as consent by a state agency or subdivision of the State of Florida to be sued by third parties in any matter arising out of any contract. (9) DEFAULT, REMEDIES, TERMINATION (a) If the necessary funds are not available to fund this agreement as a result of action by Congress, the state Legislature, the Office of the Comptroller or the Office of Management and Budgeting, or if any of the following events occur ("Events of Default"). all obligations on the part of the Department te make any further payment of funds hereunder shall, if the Department so elects, terminate, and the Department may at its option exercise any of its remedies set forLh herein; but the Department may make any payments or parts of payments after the happening of any Events of Default without thereby waiving the fight to exercise such remedies, and without becoming liable to make any further payment: 1. If any warranty or representation made by the Recipien.t in this Agreement or any previous Agreement with the Department shall at any time be false or misleading in any respect, or if the Recipient shall fail to keep, observe or perform any of the terms or covenants contained in this Agreement or any previous Agreement with the Department and has not cured such in timely fashion, or is unable or unwilling to meet its obligations thereunder. 2. If any material adverse change shall occur in the financial condition of the Recipient at any time during the term of this Agreement froin the financial condition revealed in any reports filed or to be filed with the Department, and the Recipient fairs to cure said matedal adverse change within thirty (30) days from the time the date that the wdtten notice is sent by the Department. 3. If any reports required by this Agreement have not been submitted to the Department or have been submitted with incorrect. incomplete or insufficient information. 4. If the Recipient has failed to perform and complete in timety fashion any of the services required under the Scope of Work, attached hereto as Attachment A. (b) Upon the happening of an event of default, the Department may, at its option, upon written notice to the Recipient and upon the Recipient's faiture to timely cure, exercise any one or more of the following remedies, either concurrently or consecutively, and the pursuit of any one of the foilowing remedies shalt not preclude the Department from pursuing any other remedies contained herein or otherwise provided at law or in equity: 1. Terminate this Agreement, provided that the Recipient is given at least thirty (30) days prior written notice of such termination. The notice shalt be effective when placed in the United States mail, first class mail, postage prepaid, by registered or certified mail-return receipt requested, to the address set forth in paragraph (10) herein; (10) NOTICE AND CONTACT (a) All notices provided under or pursuant to this Agreement shall be in writing, either by hand delivery or first class, certified mail, return receipt requested, to the representative identified below and said notification attached to the odginal of this Agreement. (b) The Department contract manager responsible for this Agreement is: Ms. Hilda Frazier, Planning Manager Florida Department of Community Affairs Division of Housing & Community Development Bureau of Community Assistance 2555 Shumard Oak Boulevard Tallahassee, FL 32399-2100 Email: hilda.frazier@dca.state.fi.us (c) ThenameandaddressoftherepresentatiVeoftheRecipientresponsiblefor administration of this Agreement is stated in Recipient Information, Attachment J 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, title and address of the new representative will be rendered as provided in (10)(a) and/or (c) above. (11) OTHER PROVISIONS (a) The validity of this Agreement is subject to the truth and accuracy of all the information, representations, and materials submitted or provided by the Recipient in this Agreement, in any subsequent submission or response to Department request, or in any submission or response to fulfill the requirements of this Agreement, and such information, representations, and materials are incorporated by reference. The lack of accuracy thereof or any material changes shall, at the option of the Department and with thirty (30) days written notice to the Recipient, cause the termination of this Agreement and the release of the Department from all its obligations to the Recipient. (b) This Agreement shall be construed under the laws of the State of Florida, and venue for any actions arising out of this Agreement shall lie in Leon County. If any provision hereof is in conflict with any applicable statute or rule, or is otherwise unenforceable, then such provision shall be deemed null and void to the extent of such conflict, and shall be deemed severable. but shall not invalidate any other provision o~' this Agreement. (c) No waiver by the Department of any dght or remedy granted hereunder or failure to insist on stdct performance by the Recipient shall affect or extend or act as a waiver of any other right or remedy of the Department hereunder. or affect the subsequent exercise of the same dght or remedy by the Department for any further or subsequent default by the Recipient. Any power of approval or disapproval granted to the Department under the terms of this Agreement shall survive the terms and life of this Agreement as a whole. (d) The Agreement may be executed in any number of counterparts. any one of which may be taken as an original. (el The Recipient agrees to comply with the Americans with Disabilities Act (Public Law 101-336, 42 U.S.C. Section 12101 et sect.), if applicable, which prohibits discrimination by public and private 'entities on the basis of disabifity in the areas of employment, public accommodations, transportation, State and local government services, and in telecommunications. (t~ A person or affiliate who has been placed on the convicted vendor list following a conviction for a public entity 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, may 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 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 a public entity, and may not transact business with any public entity in exces.s of Category Two for a period of 36 months from the date of being placed on the convicted vendor list or discriminatory vendor list. (12) CERTIFICATION REGARDING DEBARMENT, SUSPENSION, AND OTHER RESPONSIBILITY MATTERS By signing this agreement, the Recipient certifies to the best of its knowledge and belief, that it and its principals: (a) are not presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily e×ciuded from covered transactions by a Federal department or agency; (b) have not within a three-y.ear pedod preceding this proposal been convicted of er had a civil judgement rendered against them for commission of fraud or a cdminal offense in connection with obtaining, attempting to obtain. or performing a public (Federal, State or local) transaction or contract under public transaction; violation of Federal or State antitrust statutes or commission of embezzlement, theft, forgery, bdbery. falsification or destruction of records, making false statements, or receiving stolen property; (c) are not presently indicted or otherwise cdminally or civilly charged by a governmental entity (Federal, State or local) with commission of any of the offenses enumerated in paragraph (1)(b) of this certification; and (d) have not within a three-year period preceding this agreement had one or more public transactions (Federal, State or local) terminated for cause or default. Whera the Recipient is unable to certify to any of the statements in this certification, such Recipient. shall attach an explanation to this agreement. (13) AUDIT REQUIREMENTS (a) The Recipient agrees to maintain financial procedures and support documents, in accordance with generally accepted accounting principles, to account for the receipt and expenditure of funds under this Agreement. (b) These records shall be available at all reasonable times for inspection, review, or audit by state personnel and other personnel duly authorized by the Department. "Reasonable" shall be construed according to circumstances, but ordinarily shall mean normal business hours of 8:00 a.m. to 5:00 p.m., local time, Monday through Friday. (c) The Recipient shall also provide the Department with the records, reports or financial statements upon request for the purposes of auditing and monitoring the funds awarded under this Agreement. (d) tn the event that the Recipient expends $300.000 or more in Federal awards in its fiscal year, the Recipient must have a single or program-specific audit conducted in accordance with the provisions of OMB Circular A-133, as revised. Section (17) Fundine/Consideration, indicates Federal funds awarded through the Department by this agreement. In determining the Federal awards expertdad in its fiscal year, the Recipient shall consider all sources of Federal awards, including Federal funds received from the Department. The determination of amounts of Federal awards expended should be in accordance with the guidelines established by OMB Cimular A-133, as revised. An audit of the Recipient conducted by the Auditor General in accordance with the provisions OMB Cimular A-133, as revised, will meet the requirements of this part. in connection with the above audit requirements, the Recipient shall fulfill the requirements relative to auditee responsibilities as provided in SUbpart C of OMB Circular A-133, .as revised. If the Recipient expends less than $300,000 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 $300.000 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 ravised, the cost of the audit must be paid from non-Federal funds (i.e., the cost of such an audit must be paid from Recipient funds obtained from other than Federal entities). 1. The annual financial audit report shall include all management letters and the Recipient'~ response to all findings, including corrective actions to be taken. 2. The annual financial audit report shall include a schedule of financial assistance specifically identifying all Agreement and other revenue by sponsoring agency and Agreement number. 3. Copies of audit reports for audits conducted in accordance with OMB Circular A-133, as revised, and required by subparagraph (d) above shall be submitted, when required by Section .320 (d), OMB Circular A-133, as revised, by or on behalf of the Recipient directly to each of th~ following: a. The Department at each of the following addresses: Department of Community Affairs Office of Audit Services 2555 Shumard Oak Boulevard Tallahassee. Flodda 32399-2100 and State of Florida Auditor General Attn: Ted J. Sauerbeck Room 574, Cl~u. de Pepper Building 111 West Madison Street Tallahassee, Florida 32302-1450 b. 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 10th Street JeffersonviHe, IN 47132 c. Other Federal agencies and pass-through entities in accordance with Sections .320 (e) and (f), OMB CiroularA-133. as revised. ' 4. In the event that a copy of the audit report for an audit required by subparagraph (d) above and conducted in accordance with OMB Circular A-133, as revised, is not.__required to be submitted to the Department for the reasons pursuant to Section .320(e)(2), OMB Circular A-133, as revised, the Recipient shall submit the required Wdtten notification pursuant to Section ,320(e)(2) and a copy of the Recipient's audited schedule of expenditures of Federal awards directly to each of the following (If the State agency, pursuant to Section .320¢). OMB Circular A-133, wants a copy of the reporting package described in Section .320(c) and/or a management letter, the State agency should replace the above language with the following language) Pursuant to Section .320(f), OMB Circular A-133, as revised, the Recipient shall submit a copy of the reporting package described in Section .320(c), OMB Circular A-133, as revised, and any management letters issued by the auditor, to the Department at the following program'address: Department of Community Affairs 2555 Shumard Oak Boulevard Tallahassee, Flodda 32399-2100 (e) In the event the audit shows that the entire funds disbursed hereunder, or any portion thereof, were not spent in accordance with the conditions of this Agreement, the Recipient shall be held liable for reimbursement to the Department o~ all funds not spent in accordance with these applicable regulations and Agreement provisions within thirty (30) days after the Department has notified the Recipient of such nOn-compliance. (f) The Recipient shall retain all financial records, supporting documents, statistical records, and any other documents pertinent to this contract for a period of three years after the date of Submission of the final expenditures report. However, if litigation or an audit has been initiated prior to the expiration of the three-year period, the records shall be retained until the litigation pr audit findings have been resolved. (g) The Recipient shall have all audits completed by an independent certified public accountant (IPA) who shall either be a certified public accountant or a public accountant licensed under Chapter 473, Fla. Stat. The IPA shall state that the audit complied with the applicable provisions noted above. (h) The audit is due seven (7) months after the end of the fiscal year of Recipient or by the date the audit report is issued by the state Auditor General, whichever is later. (14) SUBCONTRACTS If the Recipient subco~trac~ any or all of the work required under this Agreement, a copy of the executed subcontract musf~ be forWarded to 'the Department within thirty (30) days after execution the subcontract. The Recipient agrees to include in the subcontract that (i).the subZrecipient is bound by all applicable state and federal laws and regulations, and (ii) the sub-recipient shall hold the Department and Recipient harmless against all claims of whatever nature arising out of the sub-recipient's performance of work under this Agreement, to the extent allowed and required by law. (15) TERMS AND CONDITIONS This Agreement contains all the terms and conditions agreed upon by the parties. (16) A'i'FACHMENTS (a) All attachments to this Agreement are incorporated as if set out fully heroin. (b) In the event of any inconsistencies or conflict between the language of this Agreement and the attachments heret0, the language of such attachments shall be controlling, but only to the extent of such conflict or inconsistency. (c) This Agreement has the following attachments: A. Scope of Work B. Program Statutes and Regulations C. Recordkeeping D. Reports E. Justification of Advance Paymen{ F. Copyright, Patent and Trademark G. Prdperty Management and Procurement H. Statement of Assurances I. Special Conditions J. Recipient Information K. Budget Summary and Workplan L. Budget Detail M. Multi-County Fund Distribution 12 (17) FUNDING/CONSIDERATION (a) This is a cost-reimbursement Agreement. The Recipient shall be reimbursed for costs incurred in the satisfactory performance of work hereunder in an amount not to exceed $154,625, subject to the availability of cash and appropriate budget authority. The Recipient is authorized to incur costs in an amount not to exceed $77,313 until the Department receives the full budget authority. Upon Department receipt of final budget authority and approved Recipient Performance Plan, the parties shall amend the Agreement to authorize the Recipient to incur additional costs. (b) Any advance payment under this Agreement is subject to s. 216.181 (15), Flodda Statutes. The amount which may be advanced may not exceed the expected cash needs of the Recipient within the first three (3) months, or 25 percent of the Agreement amount, which ever is less. For a fedemily funded contract, any advance payment is also subject to federal OMB Circulara A-102, A* 110, A-122 and the Cash Management Improvement Act of 1990. If an advance payment is requested, the bu.dget data on which the request is based and a justification statement shall be included in Justification of Advance Payment, Attachment E of this Agreement. Attachment E will specify the amount of advance payment needed and provide an explanation of the necessity for and proposed use of these funds. 1. ~ No advance payment is requested. ,?: 2. __ An advance payment of $ is requested. (c) After the initial advance, if any, payment shall be made on a reimbursement basis. The Recipient agrees to expend funds in accordance with the Scope of Work, Attachment A of this Agreement. (d) Recipients shall invest cash advances in compliance with section .21 (h) (2) (i) of the Common Rule and section .22 of OMB Circular A-110 as revised. Interest earned shall be reflected on the monthly financial status report as earned income. (18) STANDARD CONDITIONS The Recipient agrees to be bound by the following standard conditions: (a) The State of FIorida'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. Fla. Stats. or the Florida Constitution. (b) If otherwise allowed under this Agreement, the Agreement may be renewed on a yeady basis for a pedod of up to two (2) years after the initial agreement or for a period no longer than the term of the original agreement, whichever pedod is longer, specifying the terms under which the cost may change as determined in the invitation to bid, request for proposals, or pertinent statutes or regulations. (c) All bills for fees or other compensation for services or expenses shall be submitted in detail sufficient for a proper preaudit and postaudit thereoff (d) If otherwise allowed under this Agreement. all bills for any travel expenses shall be submitted in accordance with s, 112.061, Fla. Star. (e) The Department of Community Affairs reserves the right to unitaterally cancel this Agreement for refusal by the Recipient to allow public access to all documents, papers, litters or other material s.ubject to ~he provisions of Chapter 119, Fla. Stat, and made or received by the Recipient in conjunction with the Agreement. (f) If the Recipient is allowed to temporarily invest any advances of funds under this Agreement, any interest income shall either be returned to the Department or be applied against the Department's obligation to pay the contract amount. (g) The State of Flodda will not intentionally award publicly-funded contracts to any contractor who knowingly employs unauthorized alien workers, constituting a violation of the employment arovisions contained in 8 U.S.C. SeCtion 1324a(e) [Section 274A(e) of the Immigration and Nationality Act (INA]. The Department shall consider the employment by any contractor of unauthorized aliens a violation 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 the Department. (19) LOBBYING PROHIBITION (a) No funds or other resources received from the Department in connection with this Agreement may be used directly or indirectly to influence legislation or any other official action by the Flodda Legislature or any state agency. 14 (b) The Recipient certifies, by its signature !o this Agreement, that to the best of his or her knowledge and belief: 1. No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any state or federal agency, 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, and the extension, continuation, renewal, amendment or modification of any Federal contract, grant, loan or cooperative Agreement. 2. If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan or cooperative Agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. 3. The undersigned shall require that the language of this certification be included in the :...: award documents for all subawards at all tiers (including subcontracts, subgrants, and contracts under grants, loans, and cooperative agreements) and that all subrecipients shall Certify and disclose accordingly. This certification is a material representative of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by Section 1352, Title 31, U.S. Code. Any person who fails to file the required certification ~hall be subject to a civil penalty of not less than $10,000 and not more than $100,000 for each such failure. (20) COPYRIGHT, PATENT AND TRADEMARK if applicable to this Agreement, refer to Attachment F for terms and conditions relating to copyrights, patents and trademarks. 15 ' (21) VENDOR PAYMENTS Pursuant to Section 215.422, Fla. Stat., the Department shall issue payments to vendors within 40 days after receipt of an acceptable invoice and receipt, inspection, and acceptance of goods and/or services provided in accordance with the terms and conditions of the AgreemenL Failure to issue the warrant within 40 days shall result in the Department paying interest at a rate as established pursuant to Section 55.03(1) Fla. Stats. The interest penalty shall be paid within 15 days after: issuing the warrant, Vendors experiencing problems obtaining timely payment(s) from a state agency may receive assistance by contacting the Vendor Ombudsman at (850) 488-2924 or by calling the state Comptroller's Hotline at 1-800-848-3792. (22) BUDGET SUMMARY AND SCOPE OF WORK CERTIFICATION The ReCipient certifies that the data in Attachment K of this Agreement and its various sections, including budget data, are true and correct to the best of its knowledge and that the filing of this attachment has been duly authorized and understands that it wilt become part of the Agreement between the Departrhent and the Recipient. (23) LEGAL AUTHORIZATION The Recipient certifies with respect to this Agreement that it possesses the legal authority to receive the funds to be provided under this Agreement and that, if applicable, its governing body has authorized, by resolution or otherwise, the execution and acceptance of this Agreement with all covenants and assurances contained heroin. The Recipient also certifies that the undersigned possesses the authority to legally execute and bind Recipient to the terms of this Agreement. (24) ASSURANCES The Recipient shall comply with any Statement of Assurances incorporated as Attachment H of this Agreement. IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed by their undersigned officials as duly authorized. /Nam!:OF ANFORD RECI ~ STATE OF FLORIDA DEPARTMENT OF COMMUNITY AFFAIRS BY: Tony Vanderworp, City Manager BY: ' (Type Name and Title) ~ Joseph F. Myers, d/ ~jY~F~ Acting Director o / o si g o nity Date Federal I~en~i~ati~ ~e~ LIHEAP ATTACHMENT A SCOPE OF WORK The Recipient shall uffiize the funds provided under this Agreement to: A. Conduct outreach activities designed to ensure that eligible households, especially households with elderly individuals or handicapped individuals, or both, are made aware of the assistance available under this Agreement. B. Coordinate services between programs for potential clients, living in the service area, with the Department's Weathedzation Assistance Programs and Emergency Home Energy Assistance for the Elderly Program (EHEAP) providers. C. Previd.e assistance to clients in completing state provided applicafions for assistance and determining D. Make home visits or conduct telephone interviews to home-bound clients, especially the elderly or disabled, for completion of the program application or eligibility determination when o~her assistance is not adequate. E. Make LIHEAP payments based on a state-provided payment matrix and worksheet F. Make vendor payments directly to fuel providere or recipients on behalf of eligible clients, or in instances where vendor agreements cannot be negotiated, make payments directly to clients in the form of a one or two party check. G. Determine the correct amount of each cdsis benefit based on the minimum necessary to resolve the crisis, but not more than the maximum per household and maximum per item limits set by the Department. H. Establish Memoranda of Agreement with sep/ice area Emergency Home Energy Assistance for the Eldedy Program (EHEAP) providers. The Agreement will ensure coordination of serviceS, avoid duplication of assistance, and increase the quality of services provided to eldgrly participants . 17 LIHEAP ATTACHMENT A SCOPE OF WORK · L Check LIHEAP records and Emergency Home Energy Assistance for the Elderly Program (EHEAP) · records (for households with eldedy members) to avoid duplicate crisis assistance payments dudng the same heating or cooling season. J. When the applicant is not in a life threatening situation, take actions that will resolve an emergency within 48 hours of the application approval for a crisis benefit. K. When the applicant is in a life threatening situation, take actions that will resolve an emergency situation within 18 hours of the application approval for a crisis benefit· L. The Recipient will make home energy payments within 45 days of the date all requested information is received. M. The Reci~ient wi~~~ within15 w~rking days ~f receiving the c~ient~s app~icati~n~ furnish in writing t~ all applicants a Notice of Approval which includes the type and amount of assistance to be paid on their behalf or a Notice of Denial which includes appeal information. N. Recipients are required to have written applicant appeal procedures. Any applicant denied LIHEAP services must be provided a written notice of the denial which includes the appeal process and the reason(s) for the denial At a minimum, the written Notice of Denial and Appeals shall contain the reason for the denial, under what circumstances the client may reapply, what information or documentation is needed for the person to reapply, the name and address to whom the re-application or appeal should be sent, and the phone number of the Recipient. Appeal provisions must be posted in a prominent place within the office where it is on view for all applicants. O. The Recipient will make payments to those applicants with the "highest home energy needs and lowest household income," which will be determined by taking into account both the energy burden and the unique situation of such households that results from having members of vulnerable populations, including very young children, the disable, and frail older individuals. 18 LIHEAP ATTACHMENT A SCOPE OF WORK P. Recipients serving multi-county areas must provide the Department with a description of how direct client assistance funds will be allocated among the counties. The allocation methodology must be based at least in port on poverty population within each of the counties served. This information must be reported in Attachment M to this Agreement. Q. When LIHEAP funds are not available or are insufficient to meet the emergency home energy needs of an applicant, the Recipient will assist the applicant to secure help through other community resources. R. The Recipient shall agree to treat ~Nners and renters equitably under the agreement. S. TheRecipientshallberesponsibleforentedngintowrittenagreementswithhomeenergy suppliers which include all of the following requirements: (1) Provisions to assure that no household receiving assistance will be treated adversely because of such assistance under applicable provisions of state law or public regulatory requirements. (2) Any home energy supplier receiving direct poyments agrees not to discriminate, either in the cost of gcx:~ds supplied or the services provided, against the eligible household on whose behalf payments are made. (3) Only energy related elements of a utility bill are to be paid. In no instance may water and sewage charges be paid except if required by the vendor under the cdsis category to meet the requirement of resolving the crisis. Vendors must be made aware that those charges are the responsibility of the client. (4) The Recipient shall make vendors aware that when the benefit amount to the client does not pay for the complete charges owed by a client, that the client is responsible for the remaining amount T. CLIENT ELIGIBILITY REQUIREMENTS The Recipient will be responsible for determining the eligibility of the clients applying for the LtHEAP program and its crisis components. Client eligibility is based on the fotlowing eight factors: 19 LIHEAP ATTACHMENT A SCOPE OF WORK (1) The Recipient may only assist households who are or were residing in their LIHEAP service area at the time the home energy costs were incurred, (2) The client must complete an application and return all required information and verification to the Recipient while funds remain available. (3) The client must provide a fuel bill for home energy or provide other documentation proving an obligation to pay for home energy costs. (4) The client must have a total household income (less exclusions) of not more than 125% of the OMB federal poverty level for their household's size. (5) The client must have a verifiable home energy crisis (crisis component). (6) The client must not live in government subsidized housing projects where home heating and cooling costs are totally included in their rent and they have no obligation to pay any portion of the home heating and cooling costs. (7) The client must not reside in a group living facility or a home where the cost of residency is at least partially paid through any foster care or residential program administered by the state. (8) The client must not be a student living in a dormitory. U. OTHER SPECIAL REQUIREMENTS (1) The Recipient shall ensure that no person shall be excluded from participation in any activity of the program on the grounds of race, color, national odgin. sex or age, and such person shall not be subjected to discrimination under any activity funded in whole or in part with these funds. (2) The Recipient will define what cdteda and verification will be used in its local area to determine if a household is in danger of losing home energy. This criteria must be set in a manner to encourage households to seek assistance pdor to incurring non-energy penalties such as disconnect/reconnect fees, additional deposit, interest or late payment penalties, etc. (3) The Recipient will not charge applicants a fee or accept donations from an applicant to provide LIHEAP benefits. 20 LIHEAP A'I'I'ACHMENT A SCOPE OF WORK (4) The Recipient will be in a location and operate during hours available to clients. (5) The Recipient will refund, with non-federal funds, to the Department all funds incorrectly paid on behalf of clients that cannot be collected from the client. (6) The Recipient will have appmpriata staff attend training sessions. as scheduled by the Department to cover LIHEAP policies and procedures. (7i The Recipient will furnish training for all staff members assigned responsibilities for the pmgram. (8). The Recipient will add information such as the Recipient's name, address, and times of operation to the forms provided by the Department or similar Recipient-developed forms and duplicate as needed. (9) The Recipient will provide in'formation to local media and agencies in contact with low- income individuals announcing the beginning of both the crisis program component and the heating and cooling assistance program with information stating how. where, and when to apply, as well as the benefits available and eligibility criteria. (10) The Recipient will take applications when it has a signed Agreement and adequate funding, and continue taking applications until the Agreement expires or funds are exhausted. (11) The Recipient must have adequate procedures in place to ensure that LIHEAP funds are appropriately budgeted and expended to sufficiently allow for energy assistance benefits in both the heating and cooling seasons. (12) The Recipient will operate both program components in a manner that makes them available to all potentially eligible clients in their service area. (13) Prior to April 1. 2001, the Recipient shall submit to the Department a Performance Plan. This plan shall include performance measures, performance goals. specific actions to be taken by the Recipient to achieve these goaEs, and identify data sources and methods for measuring the results for the 21 LIHEAP ATTACHMENT A SCOPE OF WORK contract period. Once approved by the Department, the Performance Plan shall beCome part of th s.. Agreement. No more than 50% of ~his Agreement allocation shall be provided to the Recipient pdor to Department approval of the Recipient's Performance Plan. (14) By July 1, 2001, the Recipient shall secure intemet computer services and notify the Department of their e-mail address. sql qiSnojql aoue2~s!sse leJ@pa_-I 6U]A!aC)aJ SLUSJJ]OJd J@pun UO!leU!LU!JOS!pUON - 09 1Jed 'g eoeld)JjoM gaJ-t-BnJO '=11JedqnS ~DUEJS!SSV le!oueu!=i JoJ/q!l!q!6!iq woJJ uo!sugdsnS pue ;ugwJeqaO - 9Z ~Jed @jnpggojd slegddV lueJ9 lewjoJul - gZ ~ed uo~logllog s~glO - 0g pjeo8 gjegddv lueJ9 lug~sdgQ - g :iug~ggJSe s~ql Jgpun glq~ofidde osle gje suo~tein6g~ 18JapgJ jo gpoO aN1Jo g~ glI~L u~ pgg~po3 suo~lelnBgJ sgo~gS uemnH pue qllegH jo Iug~edga I8JgpgJ Bu~MolloJ gqL 'lenue~ dV]HI] gql pu~ p8pug~e se (gg-Z6 Ms~ o~lqnd '~g6~ Jo IoV uo~le~iPuoog~ lgBpn8 snq~umO gql jo IA~ ~11~) ~g6 ~ jo lay gou8ls~sgV ~Bjgu] g~oH g~OOUI'MO] '~' ~g6 pug ~' ~ suo~leln6g~ uo~l}g~nboV iejsPgJ log[qns gq Ileqs lug~dpg~ gql 's~seq lug~asJnq~gJ-lsog e uo uo~lez~ueBJo (lgoJddoJ) gps~ s~ 1ug~ggJBV g~l ~1 ~'guo~lez]u~jO lgoJd-uoN pue 'SlUg~UJgAO9 Je303 'SglglS JO sl~pnV. '~ ~-V JelngJ~O 8~O pue .,'suo~lez~uBSJO IBoJduoN JoJ sgldpupd 1soD,, '~-V 'oN JelnoJ~O ~O Jo .'sua~lnl~lsul i~uo~18onpB JoJ ggldpupd lsoO,, ' L~-V 'oN JelnoJ~g e~O ,,'SlUg~UJgAO9 I~°] pue g181S JoJ sold~oupd lsOO., 'Zg-V 'oN JelngJ~O 8~O Jgql~g pus ,,'suoJigz~ue6JO lgoJduoN Jg~O pus 'slel~dsoH Jg~B~H Jo suo~inJ~JsuI NI~M slus~ggJ6V pue slus~9,, '0 ~ ~-V 'oN JelnoJ~O 8~O Jo '~6 pue gZ g~ 'gln~ uo~oO ~1 u~ gje suo]lelnSgJ UO~g~AOJd gD~gg ~U~UJgAO6 slug~noop giq~ldde gqL SBlgl]Od QNV SNOI~R9]~ 'SB~ 'SM~ ~O NOI~Od~OONI 'V suo~g~AoJd JgqlO 8~oguI ~JDoJd Aguo~ lejgPgj ql~M~ed Jo alo~ u~ pgpunj s~eJDoJd Jo sgp~lod pue suo~]elnbg~ 'sgln~ 'sMe] Jo uo~JgJodJoouI ~ ~N]~NOV~V dVBHI1 LIHEAP ATTACHMENT B PROGRAM STATUTES AND REGULATIONS Department of Health and Human Sen4ces (HHS) effectuation of Title VI of the Civil Rights Act of 1964, 6.Part 81 - Practice and procedure for hearings under Part 80 of this title. 7. When the applicant is not in a life threatening situation. take actions that will resolve an emergency within 48 hours of the application approval for.a cdsis benefit, 8. Part 84 - Nondiscdminafion on the basis of handicap in programs and activities receiving Federal financial assistance. 9.Part 86 - Nondiscrimination on the basis of sex in education programs and activities receiving · Federal financial assistance 10. Part 91 - Nondiscrimination on the basis of age in HHS programs or activities receiving Federal financial assistance 11, Part 93 - New restrictions on lobbying 12. Part 96 - Block Grants, is 13. Consolidation of grants to the insular areas B. PROJECTS OR PROGRAMS FUNDED IN WHOLE OR PART VV]TH FEDERAL MONEY The Recipient assures, as stated in Section 508 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 Federal money, all grantees receiving Federal funds, including but not limited to State and local governments and recipients of Federal research grants, shall clearly state: (1) the percentage of the total costs of the program or project which will be financed with Federal money, (2) the dollar amount of Federal funds for the project or program, and (3) percentage and dollar amount of the total costs of the project or program that will be financed by non-governmental sources. 24 LIHEAP A'I'FACHMENT B PROGRAM STATUTES AND REGULATIONS C. PROGRAM INCOME The Recipient may reapply program income for eligible program projects or objectives. The amount of program income and its disposition must be reported to the Department at the time of submission of the final close-out report. D. MODIFICATIONS (1) The Department shall not. be obligated to reimburse the Recipient for outlays in excess of the funded amount Of this Agreement unless and until the Department officially approves such expenditures by executing a written modification to the original Agreement. (2) Either party may request modification of the provisions of this Agreement. Changes which are mutually agreed upon, with the exception of the items listed in (3) below, shall be valid only when reduced to writing, duly signed by each of the parties hereto, and attached to the original of this Agreement. (3) The line item budget, as given in Attachment K of this Agreement and reported on the quarterly financial status reports may not be altered without a written budget modification with the exceptions of the items listed below: (a) The Recipient may transfer unobligated budgeted line items within a budget category as long as the budget category subtotal remains the same. Each line item must meet all contractual budget requirements. For the purpose of transferring funds, the following are considered budget categories: Administrative Expenses, Outreach Expenses, Direct Client Assistance, and Leveraging Expenses. (b) Any and all Administrative Expenses and Outreach Expenses may be transferred to any Direct Client Assistance line item without additional written authorization. Each line item must meet all contractual budget requirements. (c) A letter of explanation and a revised budget summary and workplan page must be provided to the Department for any line item changes prior to the submission of a financial status report in which the changes are implemented. This is not a formal modification. but will provide the Department 25 LIHEAP ATTACHMENT B PROGRAM STATUTES AND REGULATIONS with advance notice and a descdption of information concerning your budget revisions. (d) None of the budget transfers may violate thiS Agreement or OMB Circulars A-110, COmmon Rule, A-121 or A-87. Your information will be reviewed by the D~partment for compliance with these circulars. (4) All requests for format modifications must be submitted to the Department for approval in writing at least thirty (30) days pdor to the anticipated implementation date.. The Recipient must use a LIHEAP modification package, approved by the Department, which incIudes an amended budget summary and workplan Page and amended budget detail page. (5) Only unobligated funds may be transferred from one line item to another line item. E. MONITORING (1) The Recipient shall allow the Department to carry out monitoring, evaluation and technical assistance and shall ensure the cooperation of its employees, and of any subrecipients with whom the Recipient contracts to carry out program activities. (2) Training and technical assistance shall be provided by the Department, within limits of staff time and budget, upon request by the Recipient and/or upon determination by the Department of Recipient need. F. OTHER PROVISIONS (1) The Recipient must budget a minimum of twenty-five (25) percent of the total Agreement funds allocation for Home Energy Assistance. (2) The Recipient must budget a minimum of two (2) percent of the total Agreement funds for Weather Related/Supply Shortage emergency assistance. These funds must be held in this budget line item category until December 15 of the program year for use in response to a possible disaster. These funds will only be used during state or federal emergencies declared by the President, the Governor or the Secretary of the Department as he/she deems necessary. In the event of an LIHEAP ATTACHMENT B PROGRAM STATUTES AND REGULATIONS emergency being officially declared, if the Recipient or the Department finds that two percent of the budget is not Sufficient to meet the emergency, the Recipient may draw on other Agreement cetegodes, up to fifty percent (50%) of the total Agreement budget, without additional written authorization. After December 15, if no emergency has been declared, the Recipient may allocate these funds to the cdsis or the home energy category of the program without additional wdften authorization from the Department. When funds are disthbuted for a weather-related/supply shortage emergency, the Department will provide binding directives as to the allowable expenditures of the funds. The Recipient will comply with these directives or agree that these funds will remain with the Department. (3) In addition to the audit and record keeping requirements contained in Section (12) of this Agreement, the books, records, and documents required under this Agreement must also be available for copying and mechanical reproduction on or off the premises of the Recipient. (4) If the U.S. Department of Health and Human Services initiates a hearing regarding the expenditure of funds provided under this Agreement, the Recipient shall cooperate with, and upon written request, participate with the Department in the hearing. 27 · luaLu~edaO aql ,~q pau]elaj sjol!pne 'o1 pa~!LU!I aq ]ou lnq 'apnpu! Ileqs ,,slua6V. 'Xep!Jsl q6noJql Xepuo~ uo 'a~l leaoJ "~'d O0:g ol '~'e O0:g jo gnoq ssau~snq ie~jou 6u~Jnp ue8~ ileqs Xipeu~pjo lnq seouelsmnojp eql ol Bu~pjooae panjlsuo3 aq Ileqs ..elqeuoseaW.. 'slua6e pue 'saeXold~a sl~ 'Iua~eCaa aql oj sa~l alqeuoseaJ le spjooaj sl~ ol ssasse Molle IJeqs 'lue~e~J6V s~ql Japun pap~AoJd spunj ~oJj p~ed eq ol slu~llnsuos Jo slua~dpeJqns lie 6u~pnpu] 'slua6e Jo saa~old~a sl~ 'lua~dpe~ eql 'a 'suo~lein68J pue sMel alqeo~ldde Jeqlo lie pue 'V luawqoe~V '~JoM Jo ~dosg a41Jo SaA~IOa[qO pus sluawaj~nbaJ ol luap~ns aq Ileqs 'slsoo ~ej~ojd iie ~o uo~leluamnoop 6u~oddng 6U~pnpu ~o 6u~sojg J~e SJES~ 88Jql Jo~ psu~el~J ~q Ileqs Uo~J~s~nboe ~sdojd le8j oi 6u~lejsj spJo38~ (~) :~.~ · uo~l[gods~p' leug J~e sjea~ ~ajql JO~ p~u~elaj aq liens uo~l~s~nbge le ajo~ Jo 000' ~$ le panleA ~adoJd leuogad alqepusdx~uou ~o uo~l~sods~p aql Jo~ spjoga~ (~) 'pSAJOSSJ U~Gq ~Aeq gpJOOSJ aql 6U]AIOAU~ S6U~pUB l~pne Jo s~ep 'uo~le6~l~l lie I~lun pau~elu~e~ aq II~M spJ~aJ aql 'popad Jes~ 88J~1 aql puoXaq spumxa pue popad JESA ~Jql aql ~o uo~lm~dxa aql 8jo~q ~els s~ l~pne Jo ~[el3 'uo~le6~l~l ~ue ~1 (~) ;suO~dagxa 6U~MOilO~ aql ql~M 'J~lel S~ JaA~qO~qM '~Od~J ln~solo leug aql ~o uolssl~qns ~o Jo lua~aaj6V slql ~o uoileu ~Jal Jo alep aql 8u MoJlo~ ~es~ 8~Jql Jo~ lu~dps~ 8~1 Xq psu~sJ 8q Ileqs lu~8~JSV s~ql '~'~6 pue ~'~ suo~leln~aW uo~g~nbgV leJapa~ aql 's~seq lua~asJnq~aJ-lso3 e uo uo~ez~ue~jo (lgoJd-Jo~) s~ql ~1 .,'suo~lez~ue~O lgojduoN Joj sald~oupd lsoO. '~-y 'oN Jelnoj~g 8~0 Jo ..'suo~lnl~lsul leuo~leonp] Jo~ sald~oupd lsog,. '~-~ 'oN JEjRoj~O ~0 .'SlUSmUJaAO9 'Zg-V 'ON JelnoJ~O 8~0 Jaql~a pue .,'suo~lez~ue6JO lMoJduoN JaqlO pue 'slel~dsoH 'uo~leonp] J~qS~H ~o suo[lnl~sul ql~M slua~aaJ~V pue slue~9., '0 ~ ~-V 'oN JelnoJ~g 8~0 Jo ~6 pue gZ '~Z ~ed W~O g~ 'aln~ uo~oO ~ m losFqns 8q Ileqs 1ua~aJ~V s~ J~pu~ ~ue~jopad sjua~dp~W '81q~ldde sV 'V 9NIdB~N a~O3~ 3 INB~H3V~V d~HI1 LIHEAP ATTACHMENT D REPORTS A. Annual reports - Within 45 days after the end of the contract the Recipient shall submit a LIHEAP Close. out Report, including the LIHEAP Final Financial Report, a refund check for any unspent funds, and the LIHEAP Final Program Report. B. Monthly rel3orts - The LIHEAP Monthly Financial Status Report must be provided to the Department by no later than the twenty-first (21st) o~each month following the end of the reporting month in which funds were expended. C. Quarterly Reports - For e~ch county the Recipient serves, the LIHEAP Household Quarterly Program Report must be provided {o the Department by no later than the twenty-first (21st) of the month following the end of the last month of the quarterly reporting period. D. Upon reasonable notice, the Recipient shall provide such additional program updates or information as may be required by the Department, including supporting or source documentation for any repor'Ls identified above in this section. The reports shah be submitted to: Ms. Hilda Frazier, Planning Manager Florida Department of Community Affairs Division of Housing & Community Development Bureau of Community Assistance 2555 Shumard Oak Boulevard Tallahassee, FL 32399-2100 LIHEAP ATTACHMENT E JUSTIFICATION OF ADVANCE PAYMENT Indicate if you are requesting an advance of if no advance is being requested by placing an X in the appropriate brackets below. If you are requesting an advance, you must also complete the calculation of the advance amount below. · [ ] ADVANCE R~:QUESTED * ' We are requesting an advance of $ __for the operation of the first three months of the program. These funds are needed to pay staff, award benefits to clients, duplicate forms and purchase start up supplies and equipment. We would not be able to operate the program ,without this advance. Calculation of the advance amount: Total Allocation $ X'25 % (.25) = $ (Requested Advance) ~ NO ADVANCE REQUESTED 30 LIHEAP ATTACHMENT F COPYRIGHT, PATENT AND TRADEMARK A. If the Recipient brings to the performance of this Agreement a pre--existing patent or copyright, the Recipient shall retain all rights and entitlements to that pre-existing patent or copyright unless the Agreement provides otherwise. B. If any discovery or invention arises or is developed in the course of or as a result of work or services performed under this Agreement, or in any way connected herewith, the Recipient shall refer the discovery or invention to the Department for a determination whether patent protection will be sought in the name of the State of Florida. Any and all patent dghts accruing under or in connection with the performance of this Agreement are hereby reserved to the State of Flodda. In the event that any books, manuals, films, or other copyright able material are produced, the Recipient shall notify the Department. Any and aIl copyrights accruing under or in connection with the performance under this Agreement are hereby reserved to the State of Flodda. C. Within thirty (30) days of execution of this Agreement, the Recipient shall disclose all intellectual properties relevant to the performance of this Agreement which he or she knows or should know could give rise to a patent or copyright. The Recipient shall retain all rights and entitlements to any pre-existing intellectual property which is so disclosed., Failure to disclose will indicate that no such property exists. The Department shall then, under Paragraph (b), have the right to all patents and copyrights which occur during performance of the Agreement. 31 LIHEAP A'R'ACHMENTG PROPERTY MANAGEMENT AND PROCUREMENT. A. All such property purchased under this Agreement shall be inventorled annually and an inventory report shall be submitted to the Department as part of the close-out repoit B. All property purchased under this Agreement shall be listed on the' property re~,ords of the Recipient. Said listing shall include a description of the property, model number, manufacturer's serial number, funding source, information needed to calculate the federal and/or state share, date of acquisition, unit cost, properbJ inventory number and information on the location, use and condition, transfer, replacement or disposition of the properby. C. Title (Ownership) to all nonexpendable property acquired with funds from this Agreement shall be vested in the Department upon completion or termination of the Agreement. D. Ti~e Recipient agrees to comply with Section 507 of Public Law 103-333. As stated in this section, it is the sense of Congress that, to the extent practicable, all equipment and products purchased with funds made available in this Act should be American made. 32 LIHEAP ATI'ACHMENT H STATEMENT OF ASSURANCES A. Interest of Certain Federal Officials. No member of or detegate to the Congress of the United · States, and no Resident Commissioner, shall be admitted to any share or part of this Agreement or to any benefit to adse from the same. B. Interest of Members, Officers, or Employees of Recipient, Members of Local Governina Body, or Other Public Officials. No member, officer, or employee of the Recipient, or its delegates or agents, no member of the governing body of the locality in which the program is situated, and no other public official of such locality or localities who exercises any functions or responsibilities with respect to the program during his tenure or for one year thereafter, shall have any interest, direct or indirect, in any contract 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 in all such Agreements, aprovisionprohibitingsuchinterestpursuanttothepurposesofthissubsection. Noboard 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. 112.9061, Florida Statutes. C. Nepotism. The Recipient agrees to abide by the provisions of s. 112.3125, FloddaStatutes, pertaining to nepotism in their performance under this Agreement. D. LIHEAP Assurances. The Recipient hereby assures and certifies as a condition of receipt of Low Income Home Energy Assistance Program funds, that it and its subrecipients will comply with the applicable requirements of Federal and State laws, rules, regulations, and guidelines. As part of its acceptance and use of LIHEAP funds, the Recipient assures and certifies that: (1) The Recipient possesses the legal authority to apply for the grant, and that the contract propc~sal has been approved by the Recipient's governing body, including all assurances contained herein. (2) The Recipient possesses the sound controls and fund accounting procedures necessary to adequately safeguard the assets of the agency, check the accuracy and reliability of accounting data, promote operating efficiency and maintain compliance with prescribed management policies of the agency. (3) The Recipient will permit and cooperate with Federal and State investigations designed to evaluate compliance with the law, 33 LIHEAP ATTACHMENT H STATEMENT OF ASSURANCES (4) The Recipient will give the Department, the Auditor General or any authorized representatives, complete access to examine all records, books, papers or documents related to all program operations of the grant, including those of any sub-recipient. (5) The Recipient will comply with non-discrimination provisions, in accordance with Florida Statutes; Section 677 of P.L. 97-35; Titles VI and VII of the Civil Rights Act of 1964; and 45 C.F.R. Parts 84, 86 and 90. (6) The Recipient will comply with section 680 of Public Law 97-35, as amended, which prohibits use of LIHEAP funds for purchase or improvement of land, or the purchase, construction, or permaneht improvement of any I~uilding or other facility. (7) The LIHEAP application and all its attachments, including budget data, are true and correct. (8) The Recipient will prohibit any political activities in accordance with Section 678F(b) of 42 USC 9918, as amended. (9) This Agreement has been approved by the Recipient's governing body by official action, and the officer who signs it is duly authodzed to sign this Agreement. (10) The Recipient agrees to comply with Public Law103-227, Part C, Environmental Tobacco Smoke, also known as the Pro-Children Act of 1994 (Act). This Act requires that smoking not be permitted in any portion of any indoor facility owned or leased or contracted for by an entity and used routinely or 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 programs either directly or through States or local governments. Federal programs include grants, cooperative agreements, loans or 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 inpatient drug and alcohol treatmgnt. The Recipient further agrees that 34 LIHEAP ATTACHMENT H STATEMENT OF ASSURANCES the above language will be included in any subawards which contain provisions for children's services and that all subrecipients Shall certify compliance accordingly. Failure to comply with 'the.provisions of this law may result in the imposition of a civil monetary penalty of up to $1,000 per day (11 ) The Recipient shall assure that all parts of their service area have toll-free telephone access to the agency dudng all normal working hours. ,This may be achieved by use of a published and publicized local outreach office number when the outreach office is open a minimum of 40 hours per week, or toll-free telephone number. 35 LIHEAP A'FFACHMENT I SPECIAL CONDITIONS A. The Recipient and its subrecip!ents shall comply with the following special conditions~ NONE B. Failure ~f the Recipient or its subrecipients to comply with the special conditions under this Agreement shall be cause for the immediate suspension of payments, and may be cause for the immediate termination of this Agreement. 36 LIHEAP A'FfACHMENT J ~ RECIPIENT INFORMATION FEDERAL YEAR: 0,!1 CONTRACT PERIOD: March t, 200'1 TO March 31, 2002 FOR DCA USE ONLY DATE RECEIVED: 12/21/00 CONTRACT NO: 01P-A- -06-69-02-026 REVISION(S): . N/A. \ GRANT TYPE: Low-Income Rome Energy Assistance Program DCA CONSULTANT:, Lethe Miller I, RECIPIENT CATEGORY: { } Non-Profit {X} Local Government COUNTIES TO BE SERVED WITH THESE FUNDS: SEMINOLE GENERAL ADMINISTRATIVE INFORMATION a. Nameof Recipient CITY OF SANFORD b. Name of Executive Director or Chief Administrator: CHARLES ROWE c, Recipient Fiscal Year:. From 10-1-00 to 9-30-01 d, Address: 300 N. PARK AVE. City] SANFORD , FL ZipCode: 32777 Telephone: ( )act g30-5665 County: SEMINOLE Fax: ( ) 407 330-5677 E-MailAddress: rower-~(,~ .~an~nra.f'l-Us e. Mailing Address (if different from above): P-O. BOX 1788 SANFORD , FL ZipCode: 32772-1788 f. Chief Bected Officia[ (For local governments) or President/Chairman of Board (for corporations): ..:~ Name: LARRY A. RAT,R Title: MAYOR Home or business address and telephone number other than Recipient's Mailing Address: , 300 N. PAR'K AVF.. SANFORD , FL Zip Code: 32771 Telephone( )407 330-5664 g, Official to Receive State Warrant: Name: DONNA WATT Title: FINANCE DIRECTOR Mailing Address: P.O. ROX' 17RR SANFORD , FL ZipCode: 32772-1788 h. Contact Person: Name: CHARLES ROWE Title: DIRECTOR OF COMHUNITY DEVELOPMENT Mailing Address: P.O. BOX 1788 SANFORD ,FL ZipCode: 32772-~7,R8 Telephone:( )407 330-5665 Fax: ( )407 ~0-~77 E-MailAddress: rowec~ci .aanford.fl.us i. Person(s) authorized to sign reports: CNART.F~ FmWF IV. AUDIT DUE DATE Agency Fiscal Year: 10-1-00 to 9-30-0 ] ~ Seven months from end of agency fiscal year: ~__ 37 hIV'Ia ]3MV3LSISSV dLM~FI3 3L3~'H](I 00'~zg'I ZI$ (94, sau!-l) ~I3NVISISSV &M~]['I3 ,LD~[ltlII q[VJ-OJ.~/I_S 7. 00'[60'E$ (I ~u!'IJo %E Ls'e~l le ~1 ~sn/AI) ~e~oqS tlddnS/p~leIoH -~o~t'o.,~A '9 00'Zg~'~L$ sxuom,(e~I s!s,u3 '~ 00'000'g~$ (I au!qio %gZ lreal m aq lsn/AI) smom,Cecl a~trels!ssV/~au~/amoH '~, ..................................... ; .................................................................................... I (~ aurI snurm [ ouz'IJo %~I p~'~xa loulr~ 00'96~'1 I$ ~oqlO 'I~AP-x~L 'soB!I.~FI 'luu~l 'o~u.ud ~u.vPulou.~ s~.LveI~S '~ { ~ 4',;~'4dX'.| '4.M.1.% .H I.'ml~'lt~,il'~ I ,.'~=~!~!~!L .'.. ', 7 ".'.'..'... '~,. "l '. .............' .........................._. '....!~ a~ I ,,. 'II')I&V (I..I.I..l~)O.'lil {A'1%70 ~,(1~:| 1,1%'.4|11'1 ~:tV~,~_d~ xa~hh"x ..... ' /~V'I,IHMOA~ (BIV AHVlg~S ~L~IDq~a H J.N]IAIHDV, LJ.V L. LItlEAP ATTACHMENT L IlL ADMINISTRATIVE AND OUTREACH EXPENSE BUDGET DETAIL (Lines 2-3) Line Item EXPENDITURE DETAIL LIHEAP FUNDS Number (Round up line items to dollars. Do not use cents and decimals in totals) 2. ADMINISTRATIVE EXPENSES CONTRACTS COORDINATOR $9,296.00 26.4921% of $35,089.67 TELEPHONE $500.00 28.04% OF $1,783.00 TRAVEL $100.00 344.82 MILES @ .29 MILE XEROX $300.00 15.098% OF $1,987.00 OFFICE SUPPLIES $600.00 20% OF $3,000.00 COPY CARTRIDGES $800.00 8 @ $100.00 EACH 3. OUTREACH EXPENSES CONTRACTS COORDINATOR $4,514.00 12.8641% of $35,089.67 OrjTREACH SPECIALIST $15,412, 00 100% OF $15,412.00 $300.00 OPERATING LIABILITY 16.01% OF $1,873.00 $300.00 XEROX 15.098% OF $1,987.00 POSTAGE $328100 20% OF $1,640.00 OFFICE SUPPLIES $600.00 20% OF $3,000.00 39 IV. MULTI-COUNTY FUND DISTRIBUTION N~'A In the form below, describe upon what basis you plan to equitably allocate LIHEAP resources to each of the counties you serve, This plan must be at least in pare based on the 125% poverty population of each county, Provide reasoning and humeric justification for distribution plan, COUNTY ALLOCATION % OF AGENCY'S BASIS FOR DISTRIBUTION/CALCULATION USED DIRECT CLIENT ' TO DETERMINE ALLOCATION ASSISTANCE DOLLARS ALLOCATED TO THIS COUNTY % % Total Budgeteel ;', . ,. · Direct Client ~ ,. :, ..: , ., ~..,.. . ~., Assistance ~ ": ~. "" ' 7. ' ' ........ , :.. :.~...:':'. ..'.~.. 40 I:\BCA~CAST~CSP_UNIT~2001LIHEAP~LICONT_2001 .wpd STATE OF FLORIDA DEPARTMENT OF COMMUNITY AFFAIRS "Dedicated to making Florida a better p/ace to call JEB BUSH STEVEN M, SEtBERT Govemor Secretary MEMORANDUM TO: Low-Income Home Energy Assistance Grantees Community Assistance Section DATE: December 15, 2000 SUBJECT: FY 2001 Low~Income Home Energy Assistance Program Contract Agreement Enclosed is your fully executed Low-Income Home Energy Assistance (LIHEAP) contract. The most recent OMB Poverty Income Guidelines as well as forrag for the monthly financial and quarterly reports required by the contract are also enclosed. Due to difficulty in securing adequate state budget authority after January 1, 2001, this contract was executed prior to the first of the year, but will not be effective until Mareh 1, 2001. At that time, the advances will be processed. If you need additional information, or if you have any questions regarding this agreement or any of its requirements, please contact your community assistance consultant at (850) 488-7541. HSF/hc/sl Enclosures 2555 SHUMARD OAK BOULEVARD oTALLAHASSEE, FLORIDA 32399-2100 Phone: (850) 488-8466/Suncorn 278-8466 FAX: (850) 921-0781/Suncorn 291-0781 Internet address: http://www.dca.state.fl.us ?' . LOW INCOME HOME ENERGY ASSISTANCE PROGRAM (LIHEAP) MONTHLY RNANC|AL STATUS REPORT FY 200'l(March 1, 2001 - March 31, 2002) FOR DCA USE ONLY GRANTEE APPROVED BY DATE CONTRACT # YTD DCA DISB $ PMT. # REPORTING MONTH · THIS PMT $ BAL $ LIHEAP FUNDS BUDGET Budget Current Total Unexpended CATEGORY Allocation Month To Date Balance A B C D (A-C) .: - . ,REVENUE A~ID FUNDIN(~ ""' "~" ·.. :'.' ' ' '." :;.. ',",: "' 1. LIHEAP Funds (No Leveraging Funds) I I ;.......,,, '," :: . :'GR~NTE~XDMII;IISThAlWE Ej~I~ENSE ~ :~ ":'~.::' "~:'~' ';" .:!~,~.".":': '.c'. ;". 2. Salaries including Fdnge, Rent, Utilities, Travel, Other I I I I Crotal cannot exceed 7.5% of Line 1) '' ~' ":."=' '.GleNTEE 0UT~EACH' EXPENSE ' ':' ' .: "':.: :~'.'" ""' .' :' ':;~'.'! '::'.'*:'. ~:' 'i" ":~' :~'::;; ':: "7,1'.i:':'' . ': ? i"'.:~:~:~:!;~,:'~,!''' iT :!.' :2.' :i!:.. 3. Salaries including Fdnge, Rent, Utilities, Travel, Other I I (Cannot exceed 15% of Line 1minus Line 2) .., ',' 'DIRECTCUEN;j'ABSlSTANCE ": '~:;. ',' · ' '. ,. '."' ', i ,~;"'..'~:. ::..';~:'.:;i:' '~:..:.,:"~:~".:~;: ~:'.;"':;'i:~'~'~:"'~' ,' :;:C,:~:, 4. Home Energy Assistance Payments (Must be at least 25% of Line 1) 5. Cdsis Benefits Payments 6, Weather Related/Supply Shortage (Must be at least 2% of Line 1) 7. SUBTOTAL (Lines 4-6) ' '; ......." ": ' ' ::..?!.?,:...,.... · ' .'~" , :". GRANTEE LEVERAGING EXp.ENSE :. ~..i :.'. :.,.. ~.;: .:~!,. ..... ~".~::' 8. Home Energy Assistance 9. Crisis Assistance 10. SUBTOTAL (Lines 8 + 9) t 1.GRAND TOTAL ALL EXPENSES (Lines 2 + 3 + 7 + '10) CASH POSITION 1. Total Receved from DCA ..................................................................................................$ 2. Plus: Interest Income .......................................................................................................$ 3. Program Income Received to Date: ................................................................................... $ 4. Amount of Reimbursement Requested .............................................................................. $ I certify that I am authorized to sign financial reports and the information provided herein is true and accurate to the best of my knowledge. Name and Title (please type or print) Signature Date Revised ~12f13to0 I:%BCA\CAST%CSP_UNIT%2.001 LiHEAPt2001 FSR.WPD ~,~ LOW INCOME HOME ENERGY ASSISTANCE PROGRAM (LIHEAP) ' QUARTERLY HOUSEHOLD REPORT Revised 12/14/00 GRANTEE: REPORTING QUARTER (CHECK ONE) CONTRACT#: 'l=Qtr. April t- June 30 * (See footnote) ~ 3" Qtr:Oct. 1-Dec. 31 COUNTY: __ 2"~ Qtr. July 1 - Sept. 30 __.4~' Qtr: Jan. 1 - March 31 ASSISTED HOUSEHOLD REPORT DIRECTIONS: Provide statistics on all households assisted through LIHEAP. This report is due quarterly by the 21" day of the month following the end of the quarter. For report purposes on this fc~,~p~ase use Total Gross Income reflected on the Worksheet under Section Number 6. Weather LEVERAGING ACTIVITIES ASSISTED HOUSEHOLD REPORT Home Energy Summer Winter Related / (REQUIRED DATA) Assistance Crisis Crisis Supply Shortage Home Energy Summer Winter Disaster Assistance Crisis Cdsis 1. Number of Households Assisted A. Under 75% poverty level B. 75% - 100% poverty level C. 101% - 125% pove~y level D. 125% - 150% poverty level E. Over 150% poverty level F. No income data available A. 60 years or older C. Age 5 years or under A. Birth to 2 years of age B. Age3-5 FAMILIES SERVED: Report total number of families receiving LIHEAP assistance for the first time this program year. Count each family only once during the program year. Quartarl: __ Quarter2:__ Quarter3: Quarter4:__ Total Unduplicated Households Served toDate: ~ APPLICANT HOUSEHOLD REPORT DIRECTIONS: Provide statistics on all households applying for LIHEAP assistance, whether they did or did not receive assistance. Weather LEVERAGING ACTIVITIES APPLICANT HOUSEHOLD REPORT Home Energy Summer Winter Related/Supply (REQUIRED DATA) Assistance Cdsis Crisis Shortage Home Energy Summer Winter Disaster Assistance Crisis Crisis ,:.:.,.:...... .. ..,=.. ......: ..,, ,... ......, :. .: A. Under 75% pove~ level B. 75% - 100% pove~y level C. 101% - 125% pove~ level D. 126% -150% pove~ level E. Over 150% pove~ level F. No In~me Data Available SIGNATURE: DATE: Monitor: Date:__} DCA TITLE: Data Entry: Date: __ } Only *The first quarter program report must include all progrsra activities for March 2001 that were paid for with FY 2001 (March ~, 200~ - March 31, 2002) funds. Do not include activities paid for with FY 2000 funds. 2000-2001 LIHEAP HOUSEHOLD POVERTY INCOME GUIDELINES Federal Register: February 15, 2000 (Vol. 65, Number 31 ) HOUSI=HOLD SIZE ?5% 100% '125% '150% 1 6,262 8,350 10,437 12,525 2 8,437 11,250 14,062 16,875 3 10,612 14,150 17,687 21,225 4 12,787 17,050 21,312 25,575 5 14,962 19,950 24,937 29,925 6 17,137 22,850 28,562 34,275 7 19,312 25,750 32,187 38,625 8 21,487 28,650 35,812 42,975 Add this amount for each additional member2,175 2,900 3,625 4,350 of family units with more than 8 members FFY 20002001 COMMUNITY SERVICES BLOCK GRANT PROGRAM AND LOW INCOME HOME ENERGY ASSISTANCE PROGRAM INCOME SOURCES ALLOWABLE UNALLOWABLE SOURCES OF INCOME SOURCES OF INCOME (Includes total annual cash receipts before taxes from all sources) - CAPITAL GAINS: Money wages and salaries before any Any assets drawu down as withdrawals from deductions a beuk, the sale of property, a house or a car Net receipts from non-farm employment - Tax refunds (receipts from a person's own unincorporoted _ Gifts business, professional enterprise, or - Loans partnership, after deductions for business - Lump-sum inheritances expenses) - One-time insurance payments Net receipts from farm self-employment - Compensation for injury (receipts from a farm which one operates as an owner, renter, or sharecropper, after - NON-CASH BENEFITS: deductions for farm operating expenses) Employer-paid or union paid portion of health REGULAR PAYMENTS FROM: insurance or other employee benefits Social Security Food or housing received in lieu of wages Railroad retirement Unemployment compensation The value of food and fuel produced and Strike benefits from union funds consumed on farms Worker's compensation Vetecon's payments The imputed value of rent from owner-occupied Public Assistance or Temperary Asslstanco for non-farm or farm housing Needy Families (TANF), Supplementel Federal naucnsh benefit programs such as Security Income, and non-federolly funded Medicore, Medicaid, food stamps, school General Assistance or General Relief money payments) lunches, housing assistance Training stipends Alimony Child Support Military family allotment or other regular support from a family member or someone not living in the household Private pensions Government employee pensions (including military retirement pay) Regular insurance or annuity payments College or university scholarships Grants Fellowships - Assistantship Dividends Interest Net rental income Net royalties Periodic receipts from estates or trusts Net gambling or lottery winnings I:XBCA\CASTxCSP_UNIT~2000LIHE\povguidelines.wpd NOTE: THE FY 2001-2002 POVERTY INCOME GUIDELINES WILL BE MAILED WHEN UPDATED IN FEBRUARY 2001