State Financial Assistance Agreement DEP No. LP13131 STATE FINANCIAL ASSISTANCE AGREEMENT
CITY OF MIANII BEACH
DEP AGREEMENT NO. LP13131
STATE OF FLORIDA
GRANT ASSISTANCE
PURSUANT TO LINE ITEM 1668A OF THE 2014-2015
GENERAL APPROPRIATIONS ACT
THIS AGREEMENT is entered into between the STATE OF FLORIDA
DEPARTMENT OF ENVIRONMENTAL PROTECTION, whose address is 2600 Blair Stone
Road, MS 3505, Tallahassee, Florida 32399-2400 (hereinafter referred to as the "Department")
and the CITY OF MIAMI BEACH, whose address is 1700 Convention Center Drive, Miami
Beach, Florida 33139 (hereinafter referred to as "Grantee"), a local government under the laws
of the State of Florida, to provide funds for the Miami Beach Force Main project. Collectively,
the Department and the Grantee shall be referred to as"Parties" or individually as a"Parry."
In consideration of the mutual benefits to be derived from this Agreement, the
Department and the Grantee do hereby agree as follows:
1. The Grantee does hereby agree to perform in accordance with the terms and conditions
set forth in this Agreement, Attachment A (Project Work Plan), and all attachments and exhibits
named and attached hereto, which are incorporated by reference.
2. This Agreement shall be effective on July 1, 2014 and end no later than June 30, 20165
inclusive. The Grantee shall be eligible for reimbursement for work performed on or after the
effective date through the expiration date of this Agreement. This Agreement may be amended
to provide for additional services if additional funding is made available by the Legislature.
3. A. As consideration for the services satisfactorily rendered by the Grantee under the
terms of this Agreement, the Department shall pay the Grantee on a cost reimbursement
basis an amount not to exceed $400,000 toward the total estimated project cost of
$400,000. The parties hereto understand and agree that this Agreement does not require
a match on the part of the Grantee. If the Grantee finds, after receipt of competitive bids,
that the work described in Attachment A cannot be accomplished for the current
estimated project cost, the parties hereto agree to modify the Project Work Plan described
in Attachment A, by amendment of this Agreement, to provide for the work that can be
accomplished for the funding identified above.
B. Prior written approval from the Department's Grant Manager shall be required for
changes between deliverable budget categories not to exceed 10% of the total deliverable
budget amount. The Department Grant Manager will transmit a copy of the written
approval and revised budget to the Department Contracts Disbursements Office for
inclusion in the Agreement file. Changes that exceed 10% of the total approved
deliverable budget will require a formal change order to the Agreement. Changes that
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transfer funds from one deliverable to another or that increase or decrease the total
deliverable funding amount will require a formal amendment to the Agreement.
C. The Grantee shall request reimbursement for all eligible project costs upon receipt
and acceptance of the deliverable(s) identified in Attachment A, utilizing a properly
completed Disbursement Request Package (provided as Attachment B). All bills for
amounts due under this Agreement shall be submitted in detail sufficient for a proper pre-
audit and post-audit thereof. A final Disbursement Request Package must be submitted
to the Department no later than September 30, 2016,to assure the availability of funds for
payment. The Disbursement Request Package must include:
(1) A completed Disbursement Request Form submitted by the Grantee's
Grant Manager. Such requests must be accompanied by sufficiently itemized
summaries of the materials, labor, or services to identify the nature of the work
performed; the amount expended for such work; and the person providing the
service or performing the work and proof of payment of the invoices; and,
(2) A certification signed by the Grantee's Grant Manager as to the current
cost of the Project; that the materials, labor, or services represented by the invoice
have been satisfactorily purchased or performed and applied to the project; that all
funds expended to date have been applied toward completing the Project; and,
(3) If construction is included in Attachment A, a certification by the
Engineer responsible for overseeing construction is necessary. The certification
must state that equipment, materials, labor and services represented by the
construction invoices have been satisfactorily invoiced, purchased, received,
approved and applied to the Project, as described in the Project Work Plan
(Attachment A), in accordance with construction contract documents; state that
payment is in accordance with construction contract provisions; state that
construction, up to the point of the request, is in compliance with the contract
documents; and identify all additions or deletions to the Project which have
altered the Project's performance standards, scope, or purpose since the issue of
the Department construction permit; and,
(4) Such other certificates or documents by engineers, attorneys, accountants,
contractors, or suppliers as may reasonably be required by the Department.
D. The State Chief Financial Officer requires detailed supporting documentation of
all costs under a cost reimbursement agreement. In accordance with the Attachment C,
Contract Payment Requirements, the Grantee shall comply with the minimum
requirements set forth therein. The Disbursement Request Package Form in
Attachment B shall be accompanied by supporting documentation and other
requirements as follows:
(1) Contractual (Subcontractors) - Reimbursement requests for payments to
subcontractors must be substantiated by copies of invoices with backup
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DEP Agreement No.LP13131,Page 2 of 10
documentation identical to that required from the Grantee. Subcontracts which
involve payments for direct salaries of the subcontractor's employees shall clearly
identify the personnel involved, salary rate per hour, and hours/time spent on the
project. All multipliers used (i.e. fringe benefits, overhead, and/or general and
administrative rates) shall be supported by audit. If the Department determines
that multipliers charged by any subcontractor exceeded the rates supported by
audit, the Grantee shall be required to reimburse overpayments resulting from use
of these excessive multipliers to the Department within thirty (30) days of written
notification. Interest on the excessive charges shall be calculated based on the
prevailing rate used by the State Board of Administration. For fixed price
(vendor) subcontracts, the following provisions shall apply:
a. The Grantee may award, on a competitive basis, fixed price
subcontracts to consultants/contractors in performing the work described
in Attachment A. Invoices submitted to the Department for fixed price
subcontracted activities shall be supported with a copy of the
subcontractor's invoice and a copy of the tabulation form for the
competitive procurement process (Invitation to Bid or Request for
Proposals)resulting in the fixed price subcontract.
b. The Grantee may request approval from the Department to award a
fixed price subcontract resulting from procurement methods other than
those identified in the paragraph above. In this instance, the Grantee shall
request the advance written approval from the Departments Grant
Manager of the fixed price negotiated by the Grantee. The letter of
request shall be supported by a detailed budget and Scope of Services to
be performed by the subcontractor. Upon receipt of the Department Grant
Manager's approval of the fixed price amount, the Grantee may proceed in
finalizing the fixed price subcontract.
C. All subcontracts are subject to the provisions of paragraph 13 and
any other appropriate provisions of this Agreement which affect
subcontracting activities.
(2) Equipment — (Capital outlay costing $1,000 or more) — The Grantee will
not be reimbursed for the purchase of non-expendable equipment costing $1,000
or more under the terms and conditions of this Agreement.
E. In addition to the invoicing requirements contained in paragraph 3.C. and 3.D.
above, the Department will periodically request proof of a transaction (invoice, payroll
register, etc.) to evaluate the appropriateness of costs to the Agreement pursuant to State
and Federal guidelines (including cost allocation guidelines), as appropriate. This
information when requested must be provided within thirty (30) calendar days of such
request. The Grantee may also be required to submit a cost allocation plan to the
Department in support of its multipliers (overhead, indirect, general administrative costs,
and fringe benefits).
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F. State guidelines for allowable costs can be found in the Department of Financial
Services' Reference Guide for State Expenditures at
http://www.fldfs.com/aadir/reference%5Fguide.
4. The State of Florida's performance and obligation to pay under this Agreement is
contingent upon an annual appropriation by the Legislature. The Parties understand that this
Agreement is not a commitment of future appropriations.
5. Progress Reports (Attachment D) shall be submitted quarterly describing the work
performed, problems encountered, problem resolution, schedule updates and proposed work for
the next reporting period. Reports shall be submitted to the Department's Grant Manager no
later than twenty (20) days following the completion of the reporting period. It is hereby
understood and agreed by the parties that the term "quarterly" shall reflect the calendar quarters
ending March 31, June 30, September 30 and December 31. The Final Project Report shall be
submitted no later than the completion date of the Agreement. The Department's Grant Manager
shall have ten(10) calendar days to review the required reports and deliverables submitted by the
Grantee.
6. RESERVED.
7. Each Party agrees that it shall be solely responsible for the negligent or wrongful acts of
its employees and agents. However, nothing contained herein shall constitute a waiver by either
Party of its sovereign immunity or the provisions of Section 768.28, Florida Statutes.
8. A. The Department may terminate this Agreement at any time in the event of the
failure of the Grantee to fulfill any of its obligations under this Agreement. Prior to
termination, the Department shall provide thirty (30) calendar days written notice of its
intent to terminate and shall provide the Grantee an opportunity to consult with the
Department regarding the reason(s) for termination.
B. The Department may terminate this Agreement for convenience by providing the
Grantee with thirty (30) calendar days written notice.
9. No payment will be made for deliverables deemed unsatisfactory by the Department. If a
deliverable is deemed unsatisfactory, the Grantee shall re-perform the services needed for
submittal of a satisfactory deliverable, at no additional cost to the Department, within ten (10)
days after notification that the deliverable was unsatisfactory. If a satisfactory deliverable is not
submitted within the specified timeframe, the Department may, in its sole discretion, either: 1)
terminate the Agreement for failure to perform, or 2) the Department Grant Manager may, by
letter specifying the failure of performance under the Agreement, request that a proposed
Corrective Action Plan (CAP) be submitted by the Grantee to the Department. All CAPs must
be able to be implemented and performed in no more than sixty (60) days after approval by the
Department.
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DEP Agreement No.LP13131,Page 4 of 10
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A. A CAP shall be submitted within ten (10) business days of the date of the letter
request from the Department. The CAP shall be sent to the Department Grant Manager
for review and approval. Within ten (10) business days of receipt of a CAP, the
Department shall notify the Grantee in writing whether the CAP proposed has been
accepted. If the CAP is not accepted, the Grantee shall have ten (10) business days from
receipt of the Department's letter rejecting the proposal to submit a revised proposed
CAP. Failure to obtain the Department's approval of a CAP as specified above shall
result in the Department's termination of this Agreement for cause as authorized in this
Agreement.
B. Upon the Department's notice of acceptance of a proposed CAP, the Grantee shall
have ten (10) calendar days to commence implementation of the accepted plan.
Acceptance of the proposed CAP by the Department does not alter or amend the
Grantee's obligations under this Agreement. If the CAP fails to correct or eliminate
performance deficiencies by the Grantee, the Department shall retain the right to require
additional or further remedial steps, or to terminate this Agreement for failure to perform.
No actions approved by the Department or steps taken by the Grantee shall serve to
condone, forgive or estop the Department from asserting subsequent deficiencies in
performance. The Grantee shall continue to implement the CAP until all deficiencies are
corrected. Reports on the progress of the CAP will be made to the Department as
requested by the Department Grant Manager.
C. Failure to respond to the Department's request for a CAP or failure to correct a
deficiency in the performance of the Grantee as specified by the Department may result
in termination of this Agreement.
The remedies set forth above are not exclusive and the Department reserves the right to
exercise other remedies in addition to or in lieu of those set forth above.
10. This Agreement may be unilaterally canceled by the Department for refusal by the
Grantee to allow public access to all documents, papers, letters, or other material made or
received by the Grantee in conjunction with this Agreement, unless the records are exempt
pursuant to Section 24(a) of Article I of the State Constitution, Section 119.07(1), Florida
Statutes, or other statute.
11. The Grantee shall maintain books, records and documents directly pertinent to
performance under this Agreement in accordance with generally accepted accounting principles
consistently applied. The Department, the State, or their authorized representatives_shall have
access to such records for audit purposes during the term of this Agreement and for five(5)years
following Agreement completion. If any work is subcontracted, the Grantee shall similarly
require each subcontractor to maintain and allow access to such records for audit purposes.
12. A. In addition to the requirements of the preceding paragraph, the Grantee shall
comply with the applicable provisions contained in Attachment G, Special Audit
Requirements, attached hereto and incorporated herein by reference. Exhibit 1 to
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DEP Agreement No.LP13131,Page 5 of 10
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Attachment G summarizes the funding sources supporting the Agreement for purposes
of assisting the Grantee in complying with the requirements of Attachment G. A revised
copy of Exhibit 1 must be provided to the Grantee for each amendment which authorizes
a funding increase or decrease. If the Grantee fails to receive a revised copy of Exhibit
1, the Grantee shall notify the Department's Grants Manager identified in paragraph 18
of this Agreement.
B. The Grantee is hereby advised that the Federal and/or Florida Single Audit Act
Requirements may further apply to lower tier transactions that may be a result of this
Agreement. The Grantee shall consider the type of financial assistance (federal and/or
state) identified in Attachment G,Exhibit 1 when making its determination. For federal
financial assistance, the Grantee shall utilize the guidance provided under OMB Circular
A-133, Subpart B, Section .210 for determining whether the relationship represents
that of a subrecipient or vendor. For state financial assistance, the Grantee shall utilize
the form entitled "Checklist for Nonstate Organizations Recipient/Subrecipient vs.
Vendor Determination" (form number DFS-A2-NS) that can be found under the
"Links/Forms" section appearing at the following website:
https://apps.fldfs.com/fsaa
The Grantee should confer with its chief financial officer, audit director or contact
the Department for assistance with questions pertaining to the applicability of these
requirements.
13. The Grantee may subcontract, assign, or transfer any work under this Agreement without
the written consent of the Department's Grant Manager, except as provided in paragraph
3.D.(1)b. Regardless of any subcontract, the Grantee is ultimately responsible for all work to be
performed under this Agreement. The Grantee shall submit a copy of the executed subcontract
to the Department within ten (10) business days after execution. The Grantee agrees to be
responsible for the fulfillment of all work elements included in any subcontract and agrees to be
responsible for the payment of all monies due under any subcontract. It is understood and
agreed by the Grantee that the Department shall not be responsible to any subcontractor for any
expenses or costs incurred under the subcontract and that the Grantee shall be solely responsible
to the subcontractor for all expenses and costs incurred under the subcontract.
14. The Department of Environmental Protection su pp orts diversity in its procurement
program and requests that all subcontracting opportunities afforded by this Agreement embrace
diversity enthusiastically. The award of subcontracts should reflect the full diversity of the
citizens of the State of Florida. A list of minority owned firms that could be offered
subcontracting opportunities may be obtained by contacting the Florida Department of
Management Services, Office of Supplier Diversity, at(850) 487-0915.
15. In accordance with Section 216.347, Florida Statutes, the Grantee is hereby prohibited
from using funds provided by this Agreement for the purpose of lobbying the Legislature, the
judicial branch or a state agency.
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DEP Agreement No.LP13131,Page 6 of 10
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16. The Grantee shall comply with all applicable federal, state and local rules and regulations
in providing services to the Department under this Agreement. The Grantee acknowledges that
this requirement includes, but is not limited to, compliance with all applicable federal, state and
local health and safety rules and regulations. The Grantee further agrees to include this
provision in all subcontracts issued as a result of this Agreement.
17. An notices between the Parties shall be considered delivered when posted b Certified
Y P Y
Mail, return receipt requested, overnight courier service, electronic mail (e-mail) or delivered in
person to the Grant Managers at the addresses below.
18. The Department's Grant Manager for this Agreement is identified below.
David O'Brien
State Revolving Fund Management
Florida Department of Environmental Protection
2600 Blair Stone Road,MS 3505
Tallahassee, Florida 32399-2400
Phone: (850) 245-8367
Fax: (850) 245-8411
Email: David.Obrien@dep.state.fl.us
Any changes to the contact information shown above must be reduced to writing in the
form of a Change Order to this Agreement.
19. The Grantee's Grant Manager for this Agreement is identified below.
Judy Hoanshelt
City of Miami Beach
1700 Convention Center Drive
Miami Beach,Florida 33139
Phone: (305) 673-7510
Fax: (786)394-4675
Email: judyhoanshelt@miamibeachfl.gov
Any changes to the contact information shown above must be reduced to writing in the
form of a Change Order to this Agreement.
20. To the extent required by law, the Grantee will be self-insured for worker's
compensation, or will secure and maintain during the life of this Agreement, Workers'
Compensation Insurance for all of Grantee's employees connected with the work of this project
and, in case any work is subcontracted, the Grantee shall require the subcontractor similarly to
provide Workers' Compensation Insurance for all of its employees unless such employees are
covered by the protection afforded by the Grantee. Any self-insurance program or insurance
coverage shall comply fully with the Florida Workers' Compensation law. In case any class of
employees engaged in hazardous work under this Agreement is not protected under Workers'
Compensation statutes, the Grantee shall provide, and cause each subcontractor to provide,
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DEP Agreement No.LP13131,Page 7 of 10
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adequate insurance satisfactory to the Department, for the protection of those employees not
otherwise protected.
21. The Grantee warrants and represents that it is self-funded for liability insurance,
appropriate and allowable under Florida law, and that such self-insurance offers protection
applicable to the Grantee's officers, employees, servants and agents while acting within the scope
of their employment with the Grantee.
22. The Grantee covenants that it presently has no interest and shall not acquire any interest
that would conflict in any manner or degree with the performance of services required.
23. RESERVED.
24. The Department may at any time, by written order designated to be a change order, make
any change in the Grant Manager information or task timelines within the current authorized
Agreement period. All change orders are subject to the mutual agreement of both parties as
evidenced in writing. Any change, which causes an increase or decrease in the Grantee's cost or
time, shall require formal amendment to this Agreement.
25. RESERVED.
26. RESERVED.
27. A. No person, on the grounds of race, creed, color, national origin, age, sex, or
disability, shall be excluded from participation in; be denied the proceeds or benefits of,
or be otherwise subjected to discrimination in performance of this Agreement.
B. An entity or affiliate, as defined in section 287.134, Florida Statutes, who has
been placed on the discriminatory vendor list may not submit a bid on a contract to
provide 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 award or perform work
as a contractor, supplier, subcontractor, or consultant under contract with any public
entity, and may not transact business with any public entity. The Florida Department of
Management Services is responsible for maintaining the discriminatory vendor list and
intends to post the list on its website. Questions regarding the discriminatory vendor list
may be directed to the Florida Department of Management Services, Office of Supplier
Diversity, at(850) 487-0915.
28. A. The accounting systems for all Grantees must ensure that funds awarded by this
grant are not commingled with funds from other agencies. Funds from each agency must
be accounted for separately. Grantees are prohibited from commingling funds on either a
program-by-program or a project-by-project basis. Funds specifically budgeted and/or
received f6r one project may not be used to support another project. Where a Grantee's,
or subrecipient's, accounting system cannot comply with this requirement, the Grantee, or
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DEP Agreement No.LP13131,Page 8 of 10
subrecipient, shall establish a system to provide adequate fund accountability for each
project it has been awarded.
B. If the Department finds that these grant funds have been commingled, the
Department shall have the right to demand a refund, either in whole or in part, of the
funds provided to the Grantee under this Agreement for non-compliance with the
material terms of this Agreement. The Grantee, upon such written notification from the
Department shall refund, and shall forthwith pay to the Department,the amount of money
demanded by the Department. Interest on any refund shall be calculated based on the
prevailing rate used by the State Board of Administration. Interest shall be calculated
from the date(s)the original payment(s) are received from the Department by the Grantee
to the date repayment is made by the Grantee to the Department.
C. If the Grantee recovers costs, incurred under this Agreement and reimbursed by
the Department, from another source(s), the Grantee shall reimburse the Department for
all recovered funds originally provided under this Agreement. Interest on any refund
shall be calculated based on the prevailing rate used by the State Board of
Administration. Interest shall be calculated from the date(s) the payment(s) are
recovered by the Grantee to the date repayment is made to the Department by the
Grantee.
29. Land acquisition is not authorized under the terms of this Agreement.
30. This Agreement has been delivered in the State of Florida and shall be construed in
accordance with the laws of Florida. Wherever possible, each provision of this Agreement shall
be interpreted in such manner as to be effective and valid under applicable law, but if any
provision of this Agreement shall be prohibited or invalid under applicable law, such provision
shall be ineffective to the extent of such prohibition or invalidity, without invalidating the
remainder of such provision or the remaining provisions of this Agreement. Any action hereon
or in connection herewith shall be brought in Leon County, Florida.
31. This Agreement represents the entire agreement of the parties. Any alterations,
variations, changes, modifications or waivers of provisions of this Agreement shall only be valid
when they have been reduced to writing, duly signed by each of the parties hereto, and attached
to the original of this Agreement, unless otherwise provided herein.
REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
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DEP Agreement No.LP13131,Page 9 of 10
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IN WITNESS WHEREOF, the parties have caused this Agreement to be duly executed,
the day and year last written below.
CITY OF MIAMI BEACH STATE OF FLORIDA DEPARTMENT OF
ENVIRONMENTAL PROTECTION
By: By:
+Ma Progra dministrator
State Revolving Fund
Date: 1 Date: AUG 0 7 2014
/Jul
David O'Brien, DEP Grant Manager
FEID No.:—,—, _ L ��Z
Approved as to form and legality:
APPROVED AS TO
FORM & LANGUAGE \
&FOR EXECUTION DEP Atto e
4- UU
City Attorney j We
List of attachments/exhibits included as part of this Agreement:
Letter/
Specify Type Number Description(include number of pages)
Attachment A Project Work Plan(2 Pages)
Attachment B Disbursement Request Package (3 Pages)
Attachment C Contract Payment Requirements(1 Page)
Attachment D Progress Report Form(1 Page)
Attachment E Reserved
Attachment F Reserved
Attachment G Special Audit Requirements(5 Pages)
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DEP Agreement No.LP13131,Page 10 of 10
ATTACHMENT A
PROJECT WORK PLAN
MIAMI BEACH
LP13131
Project Title: Miami Beach Force Main
Project Location: Miami-Dade County Water and Sewer Department force main on Commerce
Street to the City um station on I I�' Street Miami Beach, Miami-Dade County.
Project Background: An existing 54-inch diameter force main currently carries 22MGD of
sanitary sewer waste from the Flamingo Park neighborhood, south to the City's South Pointe
neighborhood and ultimately to the Miami-Dade County Water and Wastewater Central District
Wastewater Treatment Plant. The existing force main has been identified via a condition
assessment analysis to have multiple distressed locations. In order to repair the distresses,the City
will need to construct a redundant 54-inch sanitary sewer force main from the City's Pump Station
#1 on 11 th Street and Jefferson Avenue to the Miami-Dade County Water and Sewer Department
60-inch PCCP force main on Commerce Street and Washington Avenue. The Flamingo Park
neighborhood is a low-moderate income neighborhood, with a density of 50-70% low moderate
income persons. Failure of the existing 54-inch force main would result in potential nutrient
loading from the domestic wastewater to neighboring water bodies such as the Biscayne Bay
Aquatic Preserve. In addition, damage or breakage to this line would result in the City's inability
to properly dispose of sanitary sewer wastewater. Upon completion of this project, the City will
provide the State's residents, businesses, and visitors a healthier and safer environment. This
project will also protect the Biscayne Bay Aquatic Preserve (designated as an Outstanding Area
Water) and the City's beaches from significant pollution. Pollution of the beaches would impact
tourism significantly not only in Miami Beach and the surrounding coastal cities but also
statewide.
Project Description:
1.Task: Construction of a 54" force main from City's Pump Station#1 to the existing 60"PCCP
force main located at the intersection of Commerce Street and Washington Ave. The project is
proposed to be constructed via open cuts at the tie-in locations and via micro-tunnel otherwise.
The project will include 3-4 shaft used to launch and retrieve the micro-tunneled pipe.
Deliverables: Bid tab, copy of contract, schedule of values, and photos of construction progress
with reports
Timeline for completion: June 30, 2016
Budget Information:
Salaries: N/A
Fringe Benefits: N/A
Travel: N/A
Contractual: Contractual Services, $400,000
Equi pment: N/A
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DEP Agreement LP13131,Attachment A,Page 1 of 2
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Supplies/Other Expenses: N/A
Land: N/A
Indirect: N/A
Performance Standard: The DEP Grant Manager will review the deliverables to ensure all
backup material is submitted and supports the request.
Total Budget by Task and Deliverables:
Local Funds and Source
Tasks DEP-Funding Local Funds Source of Funds
1 Construction $4005000 Not Required City of Miami Beach
Total: $4009000
The FY2014-15 GAA did not require a match for these projects.
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DEP Agreement LP 13131,Attachment A,Page 2 of 2
ATTACHMENT B
Disbursement Request Package
Legislative Projects (LP)Grants
1. Grantee/Recipient Miami Beach
2. Project Number LP13131 Date of Request
3. Disbursement Request Number Required Match%
4. Type of Request: Partial ❑ Final ❑
5. Federal Employer Identification Number
6. Task/Deliverable No.
7. Mail ❑ EFT ❑ Send Remittance to:
Disbursement Details
(cumulative amounts rounded to the nearest dollar)
Amount this Total
NOTE: Can only claim expenses in approved budget. Request Cumulative
1. Contractual Services
2. Total
3. Disbursements previously requested
4. Amount Requested for Disbursement(line#minus#)
SUBMIT ONE ORIGINAL COPY OF THIS FORM AND SUPPORTING DOCUMENTATION FOR
EACH DELIVERABLE TO:**
Florida Department of Environmental Protection
State Revolving Fund Management MS 3505
2600 Blair Stone Road
Tallahassee,Florida 32399-2400
or email your request to:
SRF_Reporting @dep.state.fl.us
DEP Agreement No.LP13131,Attachment B,Page 1 of 3
1
Grant Manager's Certification
of Disbursement Request
(name of Grantee's Grant Manager designated in the Agreement)
on behalf of ,do hereby certify that:
(name of Grantee/Recipient)
1. The disbursement amount requested on Page 1 of this form is for allowable costs for the project described
in Attachment A of the Agreement,
2. All costs included in the amount requested have been satisfactorily purchased,performed,received,and
applied toward completing the project;such costs are documented by invoices or other appropriate
documentation as required in paragraph 313;
3. The Grantee has paid such costs under the terms and provisions of contracts relating directly to the
project;and the Grantee is not in default of any terms or provisions of the contracts;
4. If funds were advanced,all funds received to date have been applied toward completing the project;and
5. All permits and approvals required for the construction which is underway have been obtained.
(Signature of Grant Manager)
I
(Date)
III
DEP Agreement No.LP13131,Attachment B,Page 2 of 3
Engineer's Certification
of Disbursement Request
ONLY SUBMIT IF CONSTRUCTION IS PART OF THE PROTECT
I, ,being the Professional Engineer retained by
(name of Professional Engineer)
am responsible for overseeing construction of the
(name of Grantee/Recipient)
project described in the Agreement and do hereby certify that:
1. Equipment,materials,labor,and services represented by the construction invoices have been satisfactorily
purchased or received and applied to the project in accordance with construction contract documents filed
with and previously approved by the Department of Environmental Protection;
2. Payment is in accordance with construction contract provisions;
3. Adequate construction supervision is being provided to assure compliance with construction
requirements and Florida Administrative Code Chapter 62-600 or Chapter 62-604,as appropriate;
4. Construction up to the point of this disbursement is in compliance with the approved plans and permits;
5. All changes,additions,or deletions to the construction contract(s)have been documented by change order
and all change orders have been submitted to the Department;and
6. All additions or deletions to the Project which have altered the Project's performance standards,scope,or
purpose(since issue of the pertinent Department permit)have been identified in writing by amendment to
this Agreement.
Signature of Professional Engineer
Firm or Affiliation
(Date) (P.E.Number)
DEP Agreement No.LP13131,Attachment B,Page 3 of 3
ATTACHMENT C
Contract Payment Requirements
Florida Department of Financial Services,Reference Guide for State Expenditures
Cost Reimbursement Contracts
Invoices for cost reimbursement contracts must be supported by an itemized listing of expenditures by category
(salary,travel,expenses,etc.). Supporting documentation must be provided for each amount for which reimbursement
is being claimed indicating that the item has been paid. Check numbers may be provided in lieu of copies of actual
checks. Each piece of documentation should clearly reflect the dates of service. Only expenditures for categories in
the approved contract budget should be reimbursed.
Listed below are examples of the types of documentation representing the minimum requirements:
(1) Salaries: A payroll register or similar documentation should be submitted. The payroll register
should show gross salary charges, fringe benefits, other deductions and net pay. If an
individual for whom reimbursement is being claimed is paid by the hour, a document
reflecting the hours worked times the rate of pay will be acceptable.
(2) Fringe Benefits: Fringe Benefits should be supported by invoices showing the amount paid on behalf of the
employee (e.g., insurance premiums paid). If the contract specifically states that fringe
benefits will be based on a specified percentage rather than the actual cost of fringe
benefits,then the calculation for the fringe benefits amount must be shown.
Exception: Governmental entities are not required to provide check numbers or copies
of checks for fringe benefits.
(3) Travel: Reimbursement for travel must be in accordance with Section 112.061, Florida Statutes,
which includes submission of the claim on the approved State travel voucher or electronic
means.
(4) Other direct costs: Reimbursement will be made based on paid invoices/receipts. If nonexpendable property
is purchased using State funds, the contract should include a provision for the transfer of
the property to the State when services are terminated. Documentation must be provided
to show compliance with Department of Management Services Rule 60A-1.017, Florida
Administrative Code,regarding the requirements for contracts which include services and
that provide for the contractor to purchase tangible personal property as defined in Section
273.02,Florida Statutes,for subsequent transfer to the State.
(5) In-house charges: Charges which may be of an internal nature(e.g.,postage,copies,etc.)may be reimbursed
on a usage log which shows the units times the rate being charged. The rates must be
reasonable.
(6) Indirect costs: If the contract specifies that indirect costs will be paid based on a specified rate,then the
calculation should be shown.
Contracts between state agencies, and or contracts between universities may submit alternative documentation to
substantiate the reimbursement request that may be in the form of FLAIR reports or other detailed reports.
The Florida Department of Financial Services, online Reference Guide for State Expenditures can be found at this
web address: http://www.fldfs.com/aadir/reference guide.htm
DEP 55-219(05/2008)
DEP Agreement No.LP13131,Attachment C,Page 1 of 1
ATTACHMENT D
PROGRESS REPORT FORM
DEP Agreement No.: LP 13131
Grantee Name: Miami Beach
Grantee Address:
Grantee's Grant Manager: I Telephone No.:
Reporting Period:
Project Number and Title:
Provide the following information for all tasks and deliverables identified in the Project
Work Plan: a summary of project accomplishments for the reporting period; a comparison
of actual accomplishments to goals for the period; if goals were not met, provide reasons
why; provide an update on the estimated time for completion of the task and an explanation
for any anticipated delays and identify by task.
NOTE: Use as many pages as necessary to cover all tasks in the Project Work Plan.
The following format should be followed:
Task 1:
Progress for this reporting period:
Identify any delays or problems encountered:
This report is submitted in accordance with the reporting requirements of DEP Agreement No.
LP 13 13 1 and accurately reflects the activities associated with the proj ect.
Signature of Grantee's Grant Manager Date
DEP Agreement No.LP13131,Attachment D,Page 1 of 1
ATTACHMENT G
SPECIAL AUDIT REQUIREMENTS
The administration of resources awarded by the Department of Environmental Protection (which may be referred to
as the "Department", "DEP", "FDEP"or"Grantor",or other name in the contract/agreement)to the recipient(which
may be referred to as the "Contractor", Grantee"or other name in the contract/agreement)may be subject to audits
and/or monitoring by the Department of Environmental Protection,as described in this attachment.
MONITORING
In addition to reviews of audits conducted in accordance with OMB Circular A-133 and Section 215.97, F.S., as
revised(see"AUDITS"below),monitoring procedures may include,but not be limited to,on-site visits by Department
staff,limited scope audits as defined by OMB Circular A-133,as revised,and/or other procedures. By entering into
this Agreement, the recipient agrees to comply and cooperate with any monitoring procedures/processes deemed
appropriate by the Department of Environmental Protection. In the event the Department of Environmental Protection
determines that a limited scope audit of the recipient is appropriate,the recipient agrees to comply with any additional
instructions provided by the Department to the recipient regarding such audit.The recipient further agrees to comply
and cooperate with any inspections,reviews,investigations,or audits deemed necessary by the Chief Financial Officer
or Auditor General.
AUDITS
PART I: FEDERALLY FUNDED
This part is applicable if the recipient is a State or local government or a non-profit organization as defined in OMB
Circular A-133,'as revised.
1. In the event that the recipient expends $500,000 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. EXHIBIT 1 to this Agreement indicates Federal funds awarded through the Department
of Environmental Protection by this Agreement. In determining the Federal awards expended in its fiscal
year, the recipient shall consider all sources of Federal awards, including Federal resources received from
the Department of Environmental Protection. The determination of amounts of Federal awards expended
should be in accordance with the guidelines established by OMB Circular A-133,as revised.An audit of the
recipient conducted by the Auditor General in accordance with the provisions of OMB Circular A-133, as
revised,will meet the requirements of this part.
2. In connection with the audit requirements addressed in Part 1, paragraph 1, the recipient shall fulfill the
requirements relative to auditee responsibilities as provided in Subpart C of OMB Circular A-133,as revised.
3. If the recipient expends less than $500,000 in Federal awards in its fiscal year, an audit conducted in
accordance with the provisions of OMB Circular A-133, as revised, is not required. In the event that the
recipient expends less than$500,000 in 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 an audit must be paid from recipient resources obtained from
other than Federal entities).
4. The recipient may access information regarding the Catalog of Federal Domestic Assistance(CFDA)via the
internet at http://12.46.245.173/efda/cfda.html.
DEP 55-215(03/09)
DEP Agreement No.LP 13 13 1,Attachment G,Page 1 of 5
I
I
PART II: STATE FUNDED
This part is applicable if the recipient is a nonstate entity as defined by Section 215.97(2)(m),Florida Statutes.
1. In the event that the recipient expends a total amount of state financial assistance equal to or in excess of
$500,000 in any fiscal year of such recipient,the recipient 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 1 to this Agreement indicates state financial
assistance awarded through the Department of Environmental Protection by this Agreement. In determining
the state financial assistance expended in its fiscal year, the recipient shall consider all sources of state
financial assistance, including state financial assistance received from the Department of Environmental
Protection, 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.
2. In connection with the audit requirements addressed in Part II,paragraph 1;the recipient shall ensure that the
audit complies with the requirements of Section 215.97(7),Florida Statutes. This includes submission of a
financial reporting package as defined by Section 215.97(2), Florida Statutes, and Chapters 10.550 (local
governmental entities)or 10.650(nonprofit and for-profit organizations),Rules of the Auditor General.
3. If the recipient expends less than$500,000 in state financial assistance in its fiscal year,an audit conducted
in accordance with the provisions of Section 215.97,Florida Statutes,is not required. In the event that the
recipient 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 non-state entity's resources(i.e.,the cost of such an audit must be paid from the recipient's
resources obtained from other than State entities).
4. For information regarding the Florida Catalog of State Financial Assistance(CSFA),a recipient should access
the Florida Single Audit Act website located at https://Wps.fldfs.com/fsaa for assistance. In addition to the
above websites, the following websites may be accessed for information: Legislature's Website at
http://www.leg.state.fl.us/Welcome/index.cfm, State of Florida's website at http://www.myflorida.com/,
Department of Financial Services' Website at http://www.fldfs.com/and the Auditor General's Website at
http://www.state.fl.us/audgen.
PART III: OTHER AUDIT REQUIREMENTS
(NOTE: This part would be used to specify any additional audit requirements imposed by the State awarding entity
that are solely a matter of that State awarding entity's policy(i.e., the audit is not required by Federal or State laws
and is not in conflict with other Federal or State audit requirements). Pursuant to Section 215.97(8),Florida Statutes,
State agencies may conduct or arrange for audits of State financial assistance that are in addition to audits conducted
in accordance with Section 215.97, Florida Statutes. In such an event, the State awarding agency must arrange for
funding the full cost of such additional audits.)
PART IV: REPORT SUBMISSION
1. Copies of reporting packages for audits conducted in accordance with OMB Circular A-133,as revised,and
required by PART I of this Attachment 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 the following:
DEP 55-215(03/09)
DEP Agreement No.LP13131,Attachment G,Page 2 of 5
A. The Department of Environmental Protection at one of the following addresses:
By Mail:
Audit Director
Florida Department of Environmental Protection
Office of the Inspector General,MS 40
3900 Commonwealth Boulevard
Tallahassee,Florida 32399-3000
Electronically:
FDEPSingleAudit(ddep.state.fl.us
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
Jeffersonville,IN 47132
Submissions of the Single Audit reporting package for fiscal periods ending on or after January 1,
2008,must be submitted using the Federal Clearinghouse's Internet Data Entry System which can
be found at htt]2:Hharvester.census.gov/fac
C. Other Federal agencies and pass-through entities in accordance with Sections.320(e)and(f),
OMB Circular A-133,as revised.
2. 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 of Environmental Protection at the following address:
By Mail:
Audit Director
Florida Department of Environmental Protection
Office of the Inspector General,MS 40
3900 Commonwealth Boulevard
Tallahassee,Florida 32399-3000
Electronically:
FDEPSin leAudit dep.state.fl.us
3. Copies of financial reporting packages required by PART II of this Attachment shall be submitted by or on
behalf of the recipient directly to each of the following:
A. The Department of Environmental Protection at one of the following addresses:
By Mail:
Audit Director
Florida Department of Environmental Protection
Office of the Inspector General,MS 40
3900 Commonwealth Boulevard
Tallahassee,Florida 32399-3000
Electronically:
FDEPSin leg Audit(a,dep.state.fl.us
DEP 55-215(03/09)
DEP Agreement No.LP13131,Attachment G,Page 3 of 5
B. The Auditor General's Office-at the following address:
State of Florida Auditor General
Room 401,Claude Pepper Building
111 West Madison Street
Tallahassee,Florida 32399-1450
4. Copies of reports or management letters required by PART III of this Attachment shall be submitted by or
on behalf of the recipient directly to the Department of Environmental Protection at one of the following
addresses:
By Mail:
Audit Director
Florida Department of Environmental Protection
Office of the Inspector General,MS 40
3900 Commonwealth Boulevard
Tallahassee,Florida 32399-3000
Electronically:
FDEPSin leg_Audit(dWep.state.fl.us
5. Any reports,management letters,or other information required to be submitted to the Department of
Environmental Protection pursuant to this Agreement shall be submitted timely in accordance with OMB
Circular A-133,Florida Statutes,or Chapters 10.550(local governmental entities)or 10.650(nonprofit and
for-profit organizations),Rules of the Auditor General,as applicable.
6. Recipients,when submitting financial reporting packages to the Department of Environmental Protection 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 recipient in correspondence accompanying the reporting package.
PART V:RECORD RETENTION
The recipient shall retain sufficient records demonstrating its compliance with the terms of this Agreement for a period
of 5 years from the date the audit report is issued,and shall allow the Department of Environmental Protection,or its
designee,Chief Financial Officer,or Auditor General access to such records upon request.The recipient shall ensure
that audit working papers are made available to the Department of Environmental Protection, or its designee, Chief
Financial Officer, or Auditor General upon request for a period of 3 years from the date the audit report is issued,
unless extended in writing by the Department of Environmental Protection.
REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
DEP 55-215(03/09)
DEP Agreement No.LP13131,Attachment G,Page 4 of 5
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