Amendment No. 1 to the Agreement with the State of Florida Office of the Attorney General 2g
(320/ -01 •
2014/2015 ._
AGREEMENT BETWEEN THE STATE OF FLQ.RIPA.,
OFFICE OF THE ATTORNEY GENERAII� .r PIfI 10: S
AND �itA 'S OFC.
A0V3% .0 Y a GRANTS MGMT.
City of Miami Beach Police Department
AMENDMENT 1
GRANT NO. V091-14027
The Office of the Attorney General (the OAG)and the.City of Miami Beach Police
Department(the Provider), entered into an Agreement for the Provider to provide services for the
State under the Victims of Crime Act(VOCA) Grant Program for the fiscal year 2014/2015; and
WHEREAS,Article 24 specifically states,modification of any provision of this
Agreement must be mutually agreed upon by all parties, and requires a written amendment to
this Agreement; and
WHEREAS, the OAG wishes to modify the contract to include fiscal year 2015/2016;
and
WHEREAS, there is now a need to amend Article 3, Article 4 and Article 8.
NOW THEREFORE; the parties have mutually agreed to modify the Agreement as
follows:
1. Article 3 is hereby deleted and the following language is substituted:
ARTICLE 3. TIME OF PERFORMANCE
This Agreement shall become effective on October 1, 2014,or on the date when the
Agreement has been signed by all parties, whichever is later, and shall continue through
September 30, 2015 (Phase I). No costs incurred by the Provider prior to the effective date of
Phase I of the Agreement will be reimbursed and the Provider is solely responsible for any such
expenses. Phase II of the Agreement shall become effective on October 1, 2015 and will
continue through September 30, 2016.
The original signed Amendment must be returned to the OAG within 15 days of signature
by all parties, or the Amendment shall be voidable at the option of the OAG.
2. Article 4 is hereby deleted and the following language is substituted:
ARTICLE 4. AMOUNT OF FUNDS
The OAG agrees to reimburse the Provider for services completed um(geoardan tl e
terms and conditions of the Agreement. The total sum of monies reimbursed to te Provi er or
the costs incurred under this Phase I of the Agreement shall not exceed $?1;;131.31WVALsaSigyef
monies reimbursed to the Provider for the costs incurred under this Phait'iiiii;fihreAlgii8rattiGMT.
shall not exceed$71,131. The Provider agrees not to commingle grant funds with other personal
or business accounts. The U.S. Department of Justice,Office of Justice Programs, Financial
Guide does not require physical segregation of cash deposits or the establishment of any
eligibility requirements for funds which are provided to a recipient. However,the accounting
systems of Providers must ensure OAG funds are not commingled with funds on either a
program-by-program or a project-by-project basis. Funds specifically budgeted and/or received
for one project may not be used to support another. Where.a Provider's accounting.system
cannot comply with this requirement,the Provider shall establish a system to provide adequate
fund accountability for each project.
In accordance with the provisions of Section 287.0582, F.S. (2014),if the terms of this
Agreement and reimbursement thereunder extend beyond the current fiscal year,the OAG's
performance and obligation to reimburse under this Agreement are contingent upon an annual
appropriation by the Florida Legislature. This Agreement is contingent upon the OAG's Victims
of Crime Act award funded through the U.S. Department of Justice,Office for Victims of Crime
formula grant program.
3. Article 8 is hereby deleted and the following language is substituted:
ARTICLE 8. METHOD OF PAYMENT
Payments under this Agreement shall be made on a cost reimbursement basis.
Reimbursement shall be made monthly based on the Provider's submission and OAG approval
of a monthly invoice, monthly performance report,quarterly and annual performance reports and
all required supporting documentation.
In accordance with Section 215.971 F.S. (2013), financial consequences are described in
this Article of the Agreement. The Provider will be held responsible for maintaining a victim
services program that will be available to provide services to victims of crime that are identified
by the Provider and/or are presented to the Provider, and meeting the deliverables and the
performance standards as outlined in the 2014/2015 VOCA Grant Application and approved by
the OAG, incorporated herein by reference as Attachment "A,"unless otherwise approved by the
OAG in writing. At a minimum, the agency will provide services to no less than 80 percent of
the total number of projected victims. Both parties agree that damages resulting from failure to
follow this provision will result in ascertainable damages. Therefore, if the Provider does not
maintain a victim services program that will be available to provide services to victims of crime
and provide the anticipated total number of deliverables as outlined in Attachment"A,"without
an approved justification,the parties agree that the final payment for the grant will be reduced by
5% of the total award amount as listed in Article 4 as reasonable Iiquidated damages.
Monthly performance reports must be completed and received with the monthly invoice
•
to document the provision of the project deliverables. Reimbursement of a monthly invoice is
contingent upon OAG receipt of the corresponding monthly performance report,and approval of
the level of service provided during the report period.
The monthly invoice,the monthly performance report and all required supporting
documentation must be submitted to the OAG by the last day of the month immediately
following the month for which reimbursement is requested. The Provider shall maintain
documentation of all costs represented on the invoice. The OAG may require documentation of
expenditures prior to approval of the invoice, and may withhold reimbursement if services are
not satisfactorily completed or the documentation is not satisfactory. The final invoice is due to
the OAG no later than 45 days after the expiration or termination of the Agreement. If the
complete and correct invoices are not received within these time frames, all right to
reimbursement may be forfeited,the OAG may not honor any subsequent requests, and the OAG
may terminate the Agreement.
Any reimbursement due or any approval necessary under the terms of this Agreement
may be withheld until all evaluation, financial and program reports due from the Provider, and
necessary adjustments thereto,have been approved by the OAG. The Provider is required to
inform the OAG if they are being investigated by a state agency for financial or programmatic
issues. If it comes to the attention of the OAG that the Provider is being investigated, requests for
reimbursement may not be processed until the matter is resolved and approved by the OAG.
The Provider agrees to maintain and timely submit such progress, fiscal, inventory, and other
reports as the OAG may require pertaining to this grant. Payment for services shall be issued in
accordance with the provisions of Section 215.422, F.S. (2013).
The Provider is required to match the grant award as required in the VOCA Federal
Guidelines. Match contributions of 20% (cash or in-kind)of the total cost of each VOCA project
(VOCA grant plus match) must be reported monthly to the OAG. All funds designated as match
are restricted to the same uses as the VOCA victim assistance funds and must be expended
within the grant period. Unless otherwise approved by the OAG, match must be reported on a
monthly basis consistent with the amount of funding requested for reimbursement.
4. All other terms and conditions of the Contract shall remain in full force and effect.
Except as otherwise set forth herein,the terms and conditions contained in the Contract
remain unchanged. This Amendment, sets forth the entire understanding between the
Parties with regard to the subject matter hereof.
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IN WITNES WHEREOF,the OFFICE OF THE ATTORNEY GENERAL and the City
of Mia' i Beach Po ,ce Department have executed this amendment to the Agreement.
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Auth Ai izi .alTa�� I irector o 1 inistration
Z i vim L. Mo RA LgS Bonnie Rogers
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2014t2015
AGREEMENT BETWEEN THE STATE 9, nO E r HL'S Q F C.
OFFICE OF THE ATTORNEY GENE 141 Y&GR AN I'S MGM.
AND
•
City of Miami Beach Police Department
GRANT NO. V091-14027
THIS AGREEMENT is entered into in the City of Tallahassee,Leon County,Florida by
and between the State of Florida,Office of the Attorney General,the pass-through agency for the
Victims of Crime Act(VOCA),Catalog of Federal Domestic Assistance(CFDA)Number-
16.575,hereafter referred to as the OAG,an agency of the State of Florida with headquarters
located at PL-01,The Capitol,'Ihilahassee,Florida 32399-]050,and the City of Miami Beach
Police Department, 1100 Washington Avenue,Miami Beach,Florida 33139-4612,hereafter
referred to as the Provider. The parties hereto mutually agree as follows:
ARTICLE 1. ENGAGEMENT OF TIM PROVIDER
The GAG hereby agrees to engage the Provider and the Provider hereby agrees to
perform services as set forth herein. The Provider understands and agrees all services are to be
performed solely by the Provider and may not be subcontracted or assigned without prior written
consent of the OAG. The Provider agrees to supply the OAG with written notification of any
change in the appointed representative for this Agreement. This Agreement shall be performed
in accordance with the Victims of Crime Act(VOCA),Victim Assistance Grant Final Program
Guidelines,Federal Register,Vol.62,No.77,April 22,1997,pp. 19607-1962I and the U.S.
Department of Justice,Office of Justice Programs,Financial Guide,incorporated herein by
reference.
ARTICLE 2. SCOPE OF WORK
For the 2014/2015 grant period,the Provider will maintain a victim services program that
will be available to provide services to victims of crime that are identified by the Provider and/or •
are presented to the Provider,as outlined in the 2014/2015 grant application approved by the
OAG,incorporated herein by reference,unless otherwise approved by the OAG in writing.
ARTICLE 3. TIME OF PERFORMANCE
This Agreement shall become effective on October 1,2014,or on the date when the
Agreement has been signed by all parties,whichever is later,and shall continue through
September 30,2015. No costs incurred by the Provider prior to the effective date of said
Agreement will be reimbursed and the Provider is solely responsible for any such expenses.
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ARTICLE 4. AMOUNT OF FUNDS
The OAG agrees to reimburse the Provider for services completed in accordance with the •
terms and conditions of the Agreement. The total sum of monies reimbursed to the Provider for •
the costs incurred under this Agreement shall not exceed$71,131. The Provider agrees not to
commingle grant funds with other personal or business accounts. The U.S.Department of
Justice,Office of Justice Programs,Financial Guide does not require physical segregation of
cash deposits or the establishment of any eligibility requirements for funds which are provided to
a recipient. However,the accounting systems of Providers must ensure OAG funds are not
commingled with funds on either a program-by-program or a project-by-project basis. Funds
specifically budgeted and/or received for one project may not be used to support another. Where
a.Provider's accounting system cannot comply with this requirement,the Provider shall establish
a system to provide adequate fund accountability for each project.
In accordance with the provisions of Section 287.0582,F.S.(2013),if the terms of this
Agreement and reimbursement thereunder extend beyond the current fiscal year,the OAG's
performance and obligation to reimburse under this Agreement arc contingent upon an annual
appropriation by the Florida Legislature. This Agreement is contingent upon the OAG's Victims
of Crime Act award funded through the U.S.Department of Justice,Office for Victims of Crime
formula grant program.
ARTICLE 5. REGISTRATION REQUIREMENTS
Prior to execution of this Agreement,the Provider shall be registered electronically with •
the State of Florida at MyFloridaMarketPlace.com. If the parties agree that exigent
circumstances exist that would prevent such registration from taking place prior to execution of
this Agreement,then the Provider shall so register within twenty-one(21)days from execution.
The online registration can be completed at
httpi/dms.mvforida.com/dms/purchasing/mvfloridamarketplace.
The Provider agrees to comply with the applicable requirements regarding registration
with the System for Award Management(SAM)(or with a successor government-wide system
officially designated by OMB and OJP),and to acquire and provide a Data Universal Numbering
System(DUNS)number.The Provider also agrees to applicable restrictions on subrecipients that
do not acquire and provide a DUNS number.The details of Provider obligations are posted on .•
the Office of Justice Programs web site at http://www.ojp.gov/fundine/sam.htm(Award
condition:Registration with the System for Award Management and Universal Identifier
Requirements),and are incorporated by reference here.This special condition does not apply to
an award to an individual who received the award as a natural person(i.e.,unrelated to any
business or non-profit organization that be or she may own or operate in his or her name).
ARTICLE 6. AUTHORIZED EXPENDITURES
Only expenditures which are detailed in the approved budget of the grant application,a
revised budget,or an amended budget approved by the OAG are eligible for reimbursement with
grant funds. Any modification to the budget must be requested in writin g to the OAG and will
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require prior approval by the OAG. Modification approval is at the discretion of the OAG. The
Provider acknowledges and agrees any funds reimbursed under this Agreement must be used in •
accordance with the Victims of Crime Act,Victim Assistance Grant Final Program Guidelines,
Federal Register,Vol.62,No.77,April 22, 1997,pp. 19607-19621,and the U.S.Department of
Justice,Office of Justice Programs,Financial Guide incorporated herein by reference.For
• example,all grant-related purchases,including telephones and computers,must be used solely
for VOCA-funded activities in equal proportion to the VOCA funded staff utilizing the item.
The Provider and the OAG agree VOCA funds cannot be used as a revenue generating
source and crime victims cannot be charged either directly or indirectly for services reimbursed
with grant funds. Third party payers such as insurance companies,Victim Compensation,
Medicare or Medicaid may not be billed for services provided by.VOCA funded personnel to
clients. Grant funds must be used to provide services to all crime victims,regardless of their
financial resources or availability of insurance or third party reimbursements. The OAG and the
Provider further agree that travel expenses reimbursed with grant funds will be in accordance
with all Section 112.061,F.S.(2013)requirements.
Expenditures of state financial assistance must be in compliance with all laws,rules and
regulations applicable to expenditures of State funds,including,but not limited to,the Reference
Guide for State Expenditures.
Only allowable costs resulting from obligations incurred during the term of the
Agreement are eligible for reimbursement,and any balances of unobligated cash that have been
advanced or paid that are not authorized to be retained for direct program costs in a subsequent
period must be refunded to the State.Any funds paid in excess of the amount to which the
Provider is entitled under the terms of the Agreement must be refunded to the State.
The Provider shall reimburse the OAG for all unauthorized expenditures and the Provider
shall not use grant funds for any expenditures made by the Provider prior to the execution of this
Agreement or after the termination date of the Agreement. If the Provider is a unit of local or •
state government,the Provider must follow the written purchasing procedures of the government
agency. If the Provider is a non-profit organization,the Provider agrees to obtain a minimum of
three(3)written quotes for all single item grant-related purchases equal to or in excess of one
thousand dollars($1,000)unless it is documented that the vendor is a sole source supplier.
The Provider understands and agrees that it cannot use any federal funds(including
VOCA),either directly or indirectly,in support of any contract or subaward to either the
Association of Community Organizations for Reform Now(ACORN)or its subsidiaries,without
the express prior written approval of the'U.S.Department of Justice,Office of Justice Programs.
Providers must report suspected fraud,waste and abuse to the OAG,the Office of
Inspector General at 850-414-3300.
•
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ARTICLE 7. PROGRAM INCOME
Providers must provide services to crime victims,at no charge,through the VOCA
funded project Upon request,the Provider agrees to provide the OAG with financial records
and internal documentation regarding the collection and assessment of program income,
including but not limited to victim compensation,insurance,restitution and direct client fees.
ARTICLE 8. METHOD OF PAYMENT
Payments under this Agreement shall be made on a cost reimbursement basis.
Reimbursement shall be made monthly based on the Provider's submission and OAG approval
of a monthly invoice,monthly performance report and all required supporting documentation.
In accordance with Section 215.971 F.S.(2013),financial consequences are described in
this Article of the Agreement.The Provider will be held responsible for maintaining a victim
services program that will be available to provide services to victims of crime that are identified
by the Provider and/or are presented to the Provider,and meeting the deliverables and the
performance standards as outlined in the 2014/2015 VOCA Grant Application and approved by
the OAG,incorporated herein by reference as Attachment"A,"unless otherwise approved by the
OAG in writing.At a minimum,the agency will provide services to no less than 80 percent of
• the total number of projected victims.If the Provider does not maintain a victim services
program that will be available to provide services to victims of crime and provide the anticipated
total number of deliverables as outlined in Attachment"A,"without an approved justification,
the final payment for the grant will be reduced by 5%of the total award amount as listed in
Article 4.
Payment for services shall be issued in accordance with the provisions of Section 215.422,
F.S.(2013).
Monthly performance reports must be completed and received with the monthly invoice
to document the provision of the project deliverables. Reimbursement of a monthly invoice is
contingent upon OAG receipt of the corresponding monthly performance report,and approval of
the level of service provided during the report period.
The monthly invoice,the monthly performance report and all required supporting
documentation must be submitted to the OAG by the last day of the month immediately
following the month for which reimbursement is requested. The Provider shall maintain
documentation of all costs represented on the invoice. The OAG may require documentation of
expenditures prior to approval of the invoice,and may withhold reimbursement if services are
not satisfactorily completed or the documentation is not satisfactory. The final invoice is due to
the OAG no later than 45 days after the expiration or termination of the Agreement. If the
complete and correct invoices are not received within these time frames,all right to
reimbursement may be forfeited,the OAG may not honor any subsequent requests,and the OAG
may terminate the Agreement
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Any reimbursement due or any approval necessary under the terms of this Agreement
may be withheld until all evaluation,financial and program reports due from the Provider,and
necessary adjustments thereto,have been approved by the OAG.The Provider is required to
inform the OAG if they are being investigated by a state agency for financial or programmatic
issues.If it comes to the attention of the OAG that the Provider is being investigated,requests for
reimbursement may not be processed until the matter is resolved and approved by the OAG.
The Provider agrees to maintain and timely submit such progress,fiscal,inventory,and other
reports as the OAG may require pertaining to this grant.
The Provider is required to match the grant award as required in the VOCA Federal
. . Guidelines. .Match.contributions of 20%(cash or in-kind)of the total cost of each VOCA project
(VOCA grant plus match)must be reported monthly to the OAG. All funds designated as match
are restricted to the same uses as the VOCA victim assistance funds and must be expended
within the grant period. Unless otherwise approved by the OAG,match must be reported on a
monthly basis consistent with the amount of funding requested for reimbursement.
ARTICLE 9. VENDOR OMBUDSMAN
Pursuant to Section 215.422(7),F.S.(2013),the Department of Financial Services has
established a Vendor Ombudsman,whose duties and responsibilities are to act as an advocate for
vendors who may have problems obtaining timely payments from state agencies. The Vendor
Ombudsman may be reached at(850)413-5516.
ARTICLE 10. LIABILITYAND ACCOUNTABILITY
The Provider,if a non-profit entity,agrees to provide continuous and adequate director,
officer,and employee liability insurance coverage against any personal liability or accountability
by reason of actions taken while acting within the scope of their authority during the existence of
this Agreement and anyrenewal(s)and extension(s)thereof. Such coverage may be provided by
a self-insurance program established and operating under the laws of the State of Florida
ARTICLE 11. INDEPENDENT CONTRACTOR
The Provider agrees that it is an independent contractor and not an officer,employee,
agent,servant,joint venture or partner of the State of Florida,except where the Provider is a state
Agency.Neither the Provider nor its agents,employees,subcontractors or assignees shall
represent to others that the Provider has the authority to bind the OAG.This Agreement does not
create any right to any state retirement,leave or other benefits applicable to State of Florida
personnel as a result of the Provider performing its duties or obligations under this Agreement.
The Provider agrees to take such actions as may be necessary to ensure that each subcontractor
of the Provider will be deemed an independent contractor and will not be considered or permitted
to be an employee,agent;servant,joint venturer,or partner of the State of Florida.The OAG will
not furnish services of support(e.g.,office space,office supplies,telephone service,secretarial or
clerical support)to the Provider,or its subcontractor or assignee,unless specifically agreed in
writing by the OAG.
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.
All deductions for social security,withholding taxes,income taxes,contributions to
unemployment compensation funds and all necessary insurance for the Provider,the Provider's
officers,employees,agents,subcontractors,or assignees shall be the sole responsibility of the
Provider.
ARTICLE 12. DOCUMENTATION AND RECORD RETENTION
The Provider shall maintain books,records,and documents(including electronic storage
media)in accordance with generally accepted accounting procedures and practices which
sufficiently and properly reflect all revenues and expenditures of grant funds.
The Provider shall maintain a file for inspection by the OAG or its designee,Chief
Financial Officer,or Auditor General that contains written invoices for all fees,or other
compensation for services and expenses,in detail sufficient for a proper pm-audit and post-audit.
This includes the nature of the services performed or expenses incurred,the identity of the
person(s)who performed the services or incurred the expenses,the daily time and attendance
records and the amount of time expended in performing the services(including the day on which
the services were performed),and if expenses were incurred,a detailed itemization of such
expenses. Documentation,including audit working papers,shall be maintained at the office of
the Provider for a period of five years from the termination date of the Agreement,or until the
audit has been completed and any findings have been resolved,whichever is later.
The Provider shall give authorized representatives of the OAG the right to access,receive
and examine all records,books,papers,case files,documents,goods and services related to the
grant. If the Provider fails to provide access to such materials,the OAG may terminate this
Agreement. Section 119.071,and Section 960.15 F.S.(2013),provides that certain records
received by the OAG are exempt from public record requests,and any otherwise confidential
record or report shall retain that status and will not be subject to public disclosure. The Provider,
by signing this Agreement specifically authorizes the OAG to receive and review any record
reasonably related to the purpose of the grant as authorized in the original grant application and
or the amendments thereto. Failure to provide documentation as requested by the OAG shall
result in the suspension of further reimbursements to the Provider until requested documentation
has been received,reviewed,and the costs are approved for reimbursement by the OAG.
The Provider shall allow public access to all documents,papers,letters,or other materials
•
made or received in conjunction with this Agreement,unless the records are exempt under one of
the provisions mentioned in the paragraph above,or are exempt from Section 119.071 F.S.
(2013)or Section 24(a)of Article I of the State Constitution and Chapter 119,Florida Statutes.
Failure by the Provider to allow the aforementioned public access constitutes grounds for
unilateral cancellation by the OAG at any time,with no recourse available to the Provider.The •
Provider shall also maintain all public records consistent with the State of Florida's record
retention schedule.
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•
ARTICLE 13. VICTIM ADVOCATE DESIGNATION
The Provider agrees to have at least one staff member complete training through the
OAG's Victim Services Practitioner Designation Training.
ARTICLE 14. PROPERTY
The Provider agrees to be responsible for the proper care and custody of all property
purchased with grant funds and agrees not to sell,transfer,encumber,or otherwise dispose of
property acquired with grant funds without the written permission of the OAG. If the Provider is
no longer a recipient,all property acquired by grant funds shall be subject to the provisions of the
U.S.Department of Justice,Office.of Justice Programs,Office of the Comptroller Financial
Guide.
ARTICLE 15. AUDITS
The administration of funds disbursed by the OAG to the Provider may be subject to
audits and or monitoring by the OAG,as described in this section.
This part is applicable if the Provider is a State or local government or a non-profit
organization as defined in OMB Circular A-133,as revised. In the event another OMB Guidance
Circular supersedes OMB Circular A-133,the information,guidance and requirements for audits
provided in the newer circular will be applicable to this Agreement.
1. . In the event the Provider expends$300,000($500,000 for fiscal years ending after
December 31,2003)or more in Federal awards of any type in its fiscal year,the
Provider must have a single or program-specific audit conducted in accordance
with the provisions of OMB Circular A-133,as revised. Article 4 to this
Agreement indicates the amount of Federal funds disbursed through the OAG by
this Agreement. In determining the Federal awards expended in its fiscal year,the
Provider shall take into account all sources of Federal awards,including Federal
resources received from the OAG. The determination of amounts of Federal
awards expended should be in accordance with the guidelines established by
OMB Circular A-133,as revised. An audit of the Provider conducted by the
Auditor General in accordance with the provisions OMB Circular A-133,as
revised,will meet the requirements of this part.
2. In connection with the audit requirements addressed in this part,the Provider shall
fulfill the requirements relative to auditee responsibilities as provided in Subpart
C of OMB Circular A-133,as revised.
3. If the Provider expends less than$300,000($500,000 for fiscal years ending after
December 31,2003)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 the Provider expends less than$300,000($500,000 for
fiscal years ending after December 31,2003)in Federal awards in its fiscal year
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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 reimbursed from non-
Federal funds(i.e.,the cost of such an audit must be reimbursed from Provider
resources obtained from other than Federal entities).
ARTICLE 16. AUDIT REPORT SUBMISSION
Audits must be submitted no later than 180 days following termination or expiration of •
the Agreement,but may be submitted at a later date upon written approval of the OAG.
1. Copies of audit reports for audits conducted in accordance with OMB Circular A-
133,as revised,and required by this Agreement shall be submitted,when required
by Section.320(d),OMB Circular A-133,as revised,by or on behalf of the
Provider directly to each of the following:
A. Office of the Attorney General
Bureau of Advocacy and Grants Management
PL-01,The Capitol •
Tallahassee,Florida 32399-1050
B. The Federal Audit Clearinghouse designated in OMB CircularA-133,as
revised(the number of copies required by Sections.320(d),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 10t Street
Jeffersonville,IN 47132
C. Other Federal agencies and pass-through entities in accordance with -
Sections.320(e)and(f),OMB CircularA-133,as revised.
2. In the event that a copy of the financial reporting package for an audit required by
Article 15 of this Agreement and conducted in accordance with OMB Circular A-
133,as revised,is not required to be submitted to the OAG for the reasons
pursuant to Section.320(e)(2),OMB Circular A-133,as revised,the Provider
shall submit the required written notification pursuant to Section.320(eX2)and a
copy of the Provider's audited schedule of expenditures of Federal awards directly
to the OAG.
3. Any reports,management letters,or other information required to be submitted to
the OAG pursuant to this Agreement shall be submitted timely in accordance with •
• OMB Circular A-133,as revised,as applicable.
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1
4. Providers should indicate the date the financial reporting package was delivered
to the Provider in correspondence accompanying the financial reporting package.
ARTICLE 17. MONITORING
In addition to reviews of audits conducted in accordance with OMB CircularA-133,as
revised,monitoring procedures may include,but not be limited to,on-site visits by OAG staff or
its designee,limited scope audits as defined by OMB Circular A-133,as revised,and/or other
procedures. By entering into this Agreement,the Provider agrees to comply and cooperate with
any monitoring procedures/processes deemed appropriate by the OAG. The Provider further
agrees to comply and cooperate with any inspections,reviews,investigations,or audits deemed
necessary by the OAG,Chief Financial Officer,Auditor General.or the U.S.Department of
Justice.
The Provider may not accept duplicate funding for any position,service or deliverable
funded by the OAG. Duplicative funding is defined as more than 100%payment from all
funding sources for any position,service or deliverable. If there are multiple funding sources
and a program is funded by the OAG,the OAG or its designee has the right to review all
documents related to those funding sources to determine whether duplicative funding is an issue.
If duplicate funding is found,the Agreement may be suspended,terminated or both while the
extent of the overpayment is determined.Failure to comply with state law,or the U.S.
Department of Justice Programs,Financial Guide,may also result in the suspension,termination
or both of the Agreement while the extent of the overpayment is determined.Absent fraud,in the
event that there has been an overpayment to a Provider for any reason,including the afore-
mentioned,if the amount of the overpayment cannot be determined to a reasonable degree of
certainty,both parties agree that the Provider shall reimburse to the OAG one half of the monies
previously paid to the Provider for that line item for the grant year in question.
ARTICLE 18. RETURN OF FUNDS
The Provider shall return to the OAG any overpayments made to the Provider for
unearned income or disallowed items pursuant to the terms and conditions of this Agreement. In
the event the Provider or any outside accountant or auditor determines that an overpayment has
been made, the Provider shall immediately return to the OAG such overpayment without prior
notification from the OAG. In the event the OAG discovers that an overpayment has been made,
the contract manager, on behalf of the OAG, will notify the Provider and the Provider shall
forthwith return the funds to the OAG. Should the Provider fail to immediately reimburse the
OAG for any overpayment,the Provider will be charged interest at the lawful rate on the amount
of the overpayment or outstanding balance thereof.
9 of 16
ARTICLE 19. PUBLIC ENTITY CRIME
Pursuant to Section 287.133,F.S.(2013),the following restrictions are placed on persons
convicted of public entity crimes to transact business with the OAG:When a person or affiliate
has been placed on the convicted vendor list following a conviction for a public entity crime,
he/she 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 the 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 any public entity,and may not transact business with any public entity in excess -
of the threshold amount provided in Section 287.017,F.S.(2013),for CATEGORY TWO for a
period of thirty-six(36)months from the.date of being placed on the convicted vendor list.
ARTICLE 20. GRATUITIES
The Provider agrees that it will not offer or give any gift or any form of compensation to •
any OAG employee. As part of the consideration for this Agreement,the parties intend that this
provision will survive the Agreement for a period of two years.In addition to any other remedies
available to the OAG,any violation of this provision will result in referral of the Provider's name
and description of the violation of this term to the Department of Management Services for the
potential inclusion of the Provider's name on the suspended vendors list for an appropriate period.
The Provider will ensure that its subcontractors,if any,comply with these provisions.
ARTICLE 21. PATENTS,COPYRIGHTS,AND ROYALTIES
The Provider agrees that 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 discovery or invention shall be deemed transferred to and owned by the State of
Florida. Any and all patent rights accruing under or in connection with the performance of this
Agreement are hereby reserved to the State of Florida.
In the event that any books,manuals,films,or other copyrightable materials are
produced,the Provider shall identify all such materials to the Agency.Any and all copyrights •
accruing under or in connection with performance under this Agreement are hereby reserved to
the State of Florida.
The Provider shall indemnify and hold the OAG and its employees harmless from any
claim or liability whatsoever, including costs and expenses,arising out of any copyrighted,
patented,or unpatented invention,process,or article manufactured or used by the Provider in the
performance of this Agreement. The Provider shall indemnify and hold the OAG and its
employees harmless from any claim against the OAG for infringement of patent,trademark,
copyright or trade secrets. The OAG will provide prompt written notification of any such claim.
During the pendency of any claim of infringement,the Provider may,at its option and expense,
procure for the OAG,the right to continue use of,or replace or modify the article to render it
non-infringing.lithe Provider uses any design,device,or materials covered by letters patent,or
copyright,it is mutually agreed and understood without exception the compensation paid
10 of 16
pursuant to this Agreement includes all royalties or costs arising from the use of such design,
device,or materials in any way involved in the work contemplated by this Agreement.
Subcontracts must specify that all patent rights and copyrights are reserved to the State of
Florida.
ARTICLE 22. INDEMNIFICATION
.•
To the extent permissible under Florida law,the Provider shall be liable for and indemnify,
defend,and hold the OAG and all of its officers,agents,and employees harmless from all claims,
suits,judgments,or damages,including attorneys'fees and costs,arising out of any act or
omission or neglect by the Provider and its agents,employees and subcontractors during the
performance or operation of this Agreement or any subsequent modifications or extensions
thereof
The Provider's evaluation or inability to evaluate its liability shall not excuse the
Provider's duty to defend and to indemnify the OAG within seven(7)days after notice by the
OAG. After the highest appeal taken is exhausted,only an adjudication or judgment specifically •
finding the Provider not liable shall excuse performance of this provision. The Provider shall •
pay all costs and fees including attorneys'fees related to these obligations and their enforcement
by the OAG. The OAG's failure to notify the Provider of a claim shall not release the Provider
from these duties. The Provider shall not be liable for any sole negligent acts of the OAG.
ARTICLE 23. TERMINATION OF AGREEMENT
This Agreement may be terminated by the OAG for any reason upon five(5)days written
notice via certified mail.
In the event this Agreement is terminated,the Provider shall deliver documentation of
ownership or tide,if appropriate for all supplies,equipment and personal property purchased
with grant funds to the OAG,within 30 days after termination.Any finished or unfinished
documents,data,correspondence,reports and other products prepared by or for the Provider
under this Agreement shall be made available to and for the exclusive use of the OAG.
Notwithstanding the above,the Provider shall not be relieved of liability to the OAG for
damages sustained by the OAG by virtue of any termination or breach of this Agreement by the
Provider. In the event this Agreement is terminated,the Provider shall be reimbursed for
satisfactorily performed and documented services provided through the effective date of
termination.
ARTICLE 24. AMENDMENTS
Except as provided under Article 6,Authorized Expenditures,modification of any
• provision of this Agreement must be mutually agreed upon by all parties,and requires a written
amendment to this Agreement.
11 of 16
ARTICLE 25. NONDISCRIMINATION
Recipients of federal financial assistance must comply with applicable federal civil rights
laws,which may include the Omnibus Crime Control and Safe Streets Act of 1968(42 U.S.C.§
3789d);the Victims of Crime Act(42 U.S.C.§10604(e));The Juvenile Justice and Delinquency
Prevention Act of 2002(42 U.S.C. §5672(b));Title VI of the Civil Rights Act of 1964(42 U.S.C.
§2000d);Section 504 of the Rehabilitation Act of 1973(29 U.S.C.§7 94),Title II of the
Americans with Disabilities Act of 1990(42 U.S.C.§ 12131-34);Title IX of the Education
Amendments of 1972(20 U.S.C.§§1681,1683, 1685-86);the Age Discrimination Act of 1975
(42 U.S.C.§§6101-07);and Exec.Order 13279(67 Fed.Reg.241).
Pursuant to applicable federal laws and Section 760,F.S.(2013),the Provider agrees not
to discriminate against any client or employee in the performance of this Agreement or against
any applicant for employment because of age,race,religion,color,disability,national origin,
marital status or sex.The Provider further assures that all contractors,subcontractors,sub-
grantees,or others with whom it arranges to provide services or benefits to clients or employees
in connection with any of its programs and activities are not discriminating against those clients
or employees because of age,race,religion,color,disability,national origin,marital status or
sex.
The Provider must have policies and procedures in place for responding to complaints of
discrimination that employees and beneficiaries file directly with the Provider.Information
provided by the Department of Justice,Office of Justice Programs,to assist with policy and
procedure development is available at http://4jp.gov/about/offices/ocr.htm.
In the event a Federal or State court or Federal or State administrative agency makes a
finding of discrimination after a due process hearing on the grounds of race,color,religion,
national origin,or sex against the Provider,the Provider will forward a copy of the findings to
the Office of Justice Programs,Office for Civil Rights and the Florida OAG. •
As clarified by Executive Order 13166,Improving Access to Services for Persons with
Limited English Proficiency,and resulting agency guidance,national origin discrimination
includes discrimination on the basis of limited English proficiency(LEP). To ensure compliance
with the Safe Streets Act and Title VI of the Civil Rights Act of 1964,the Provider must take
reasonable steps to ensure that LEP persons have meaningful access to its programs and
activities.Meaningful access may entail providing language assistance services,including oral
and written translation,where necessary.The Provider is encouraged to consider the need for
language services for LEP persons served or encountered both in developing its budgets and in
conducting its programs and activities. Additional assistance and information regarding your
LEP obligations can be found at littp://www.lep.gov.
In accordance with federal civil rights laws,the Provider shall not retaliate against
individuals for taking action or participating in action to secure rights protected by these laws.
All Providers must complete a review of the Office of Justice Programs,Office for Civil •
Rights training modules and confirm compliance with this requirement to the OAG through self-
I
•
12 of 16
reporting by December 31,2014.The training modules are available at -
http://ojp.gov/about/ocr/assistance.htrn.
Pursuant to Section 287.134,F.S.(2013),an entity or affiliate on the Florida Department
of Management Services'discriminatory vendor list may not transact business with any public
•
_ entity.
The OCR issued an advisory document for recipients on the proper use of arrest and
•
conviction records in making hiring decisions.See Advisory for Recipients of Financial •
Assistance from the U.S.Department of Justice on the U.S.Equal Employment Opportunity
Commission's Enforcement Guidance:Consideration of Arrest and Conviction Records in
EmploymentDecisions Under Title VII of the Civil Rights Act of 1964(lune 2013),available at
httpJ/wwwojp.usdoi.gav//aboutl ocr/pdfs/UseofConvictionAdvisorypdf.Recipients should be
mindful that the misuse of arrest or conviction records to screen either applicants for
employment or employees for retention or promotion may have a disparate impact based on race
or national origin,resulting in unlawful employment discrimination.In light of the Advisory,
recipients should consult local counsel in reviewing their employment practices.If warranted,
recipients should also incorporate an analysis of the use of arrest and conviction records in their
Equal Employment Opportunity Plans(EEOPs).
ARTICLE 26. NONDISCRIMINATION IN PROGRAMS INVOLVING STUDENTS
The Provider shall not use award funding to discriminate against students that are
participating in(or benefiting from)programs that are funded by those same federal funds.For
example,the Provider cannot use VOCA funding to treat a Catholic student differently than a
non-Catholic student when both are applying for,or receiving benefits from,the VOCA program.
This same protection also applies to the students'parents or legal guardians.
ARTICLE 27. ACKNOWLEDGMENTS
All publications,advertising or written descriptions of the sponsorship of the program
shall state: "This project was supported by Award No.V011.1qpriawarded by the Office for •
Victims of Crime,Office of Justice Programs. Sponsored by(name of Provider)and the State of •
Florida."
The Provider is required to display a civil rights statement prominently on all
publications,websites,posters and informational materials mentioning USDOJ programs in bold -
print and no smaller than the general text of the document. The full civil rights statement must
be used whenever possible. Single page documents that do not have space for the full civil rights
statement may contain a condensed version in a print size no smaller than the text used
throughout the document. If the civil rights statement is missing on a publication,the statement
must be included the next time the publication is revised or reprinted and printed copies of the
statement must be attached to the current supply of the publication until the next revision is •
reprinting.
Full Civil Rights Statement In accordance with federal law and U.S.Department of
Justice policy,this organization is prohibited from discriminating on the basis of race,color,.
13of16
national origin,religion,sex,age,or disability.To file a complaint of discrimination,call the
Department of Legal Affairs,Federal Discrimination Complaint Coordinator,PL-01 The Capitol, •
Tallahassee,Florida,32399,or call 850-414-3300,or write Office for Civil Rights,Office of
Justice Programs,U.S.Department of Justice,810 7th Street,NW,Washington,DC 20531 or call
202-307-0690(Voice)or 202-307-2027(TDD/TYY).Individuals who are hearing impaired or
have speech disabilities may also contact OCR through the Federal Relay Service at 800-877-
8339 CITY),877-8774982(Speech),or 800-845-6136(Spanish).
Condensed Civil Rights Statement: The <organization name> is an equal opportunity
provider and employer.
The Provider is required to display the OAG's"Civil Rights Fact Sheet"at locations open
to the public.The"Civil Rights Fact Sheet"will be provided by the OAG.
ARTICLE 28. EMPLOYMENT
'd a violation of
The employment of unauthorized aliens by the Provider is considered
Section 274A(e)of the Immigration and Nationality Act. If the Provider knowingly employs
unauthorized aliens,such violation shall be cause for unilateral cancellation of this Agreement.
Any services performed by any such unauthorized aliens shall not be paid.
The Provider shall utilize the U.S.Department of Homeland Security's E-Verify System
to verify the employment eligibility of all persons hired during the Agreement term.
ARTICLE 29.ADMINISTRATION OF AGREEMENT
All approvals referenced in this Agreement must be obtained from the parties'.contract
administrators or their designees.The OAG's contract administrator is Christina F.Harris.All
notices must be given to the parties'contract administrator.
ARTICLE 30. TEXT MESSAGING
Pursuant to Executive Order 13513,"Federal Leadership on Reducing Text Messaging
While Driving,"74 Fed.Reg.51225(October 1,2009),the U.S.Department of Justice
encourages subrecipients(Providers),to adopt and enforce policies banning employees from text •
messaging while driving any vehicle during the course of performing work funded by this grant,
and to establish workplace safety policies and conduct education,awareness,and other outreach
to decrease crashes caused by distracted drivers.
ARTICLE 31. SECTION 539 OF THE CONSOLIDATED AND FURTHER CONTINUING
APPROPRIATIONS ACT,2013,COMPUTER NETWORK REQUIREMENT
Section 539 of the Consolidated and Further Continuing Appropriations Act,2013(which
includes the Department of Justice Appropriations Act,2013)provides:-
f
14 of 16
(a)None of the funds made available in this Act may be used to
maintain or establish a computer network unless such network
blocks the viewing,downloading,and exchanging of pornography.
(b)Nothing in subsection(a)shall limit the use of funds necessary
for any Federal,State,tribal,or local law enforcement agency or •
any other entity carrying out criminal investigations,prosecution,
or adjudication activities.
Any Provider that falls within the types of entities described in Section 539(b)is exempt
from this requirement. Any Provider that did not fall under the exemption must comply with the
requirement. Attachment"B"Section 539 Certification Form(Victims of Crime Act(VOCA)
Special Conditions Certification.Form)is hereby incorporated by reference.
ARTICLE 32. ASSURANCES
Attachment"C"Assurances is hereby incorporated by reference.
ARTICLE 33. CERTIFICATION FORM
Attachment"D"Certification Form is hereby incorporated by reference.
ARTICLE 34. CONTROLLING LAW AND VENUE
This Agreement shall be governed by the laws of the State of Florida. Any and all
litigation arising under the Agreement shall be instituted in the appropriate court in Leon County, •
Florida.
ARTICLE 35. AGREEMENT AS INCLUDING ENTIRE AGREEMENT
This instrument and the grant application embody the entire Agreement of the parties.
There are no provisions,terms,conditions,or obligations other than those contained herein. This
Agreement supersedes all previous communications,representations or Agreements on this same
subject,verbal or written,between the parties.
The Provider's signature below specifically acknowledges understanding of the fact that
the privilege of obtaining a VOCA grant is not something this or any Provider is entitled to
receive. This Agreement is for one time funding only. There is absolutely no expectation or
guarantee, implied or otherwise,the Provider will receive VOCA funding in the future. The
OAG strongly encourages the Provider to secure funding from other sources if the Provider
anticipates the program will continue beyond the current grant year.
•
•
(
15 of 16
IN WITNESS WHEREOF,the OFFICE OF THE ATTORNEY GENERAL and the City
of Miami Beach Poll Department,have executed this Agreement
•
0h
Auth■\ ing 0 Icial Director of Administration
19 L . M c'rale s SQ ra_h Jor4 /iç
Print Name Print Name
/SC' III' /0/7/
Date Date
596000372
FEID#of Provider
SAMAS Code
APPROVED AS TO
FORM&LANGUAGE
&FOR EXECUTION
City A • `_ Dote
. i
16 of 16
f
AAttachment A 1
Agency Name: City of Miami Beach Police Department •
VICTIMS SERVED AND TYPES OF SERVICES
Indicate the number of victims provided services by VOCA-funded and matching staff during the grant period.The figures
I indicated are projections based on historical data and/or the anticipated need of the population served through the VOCA
project.It is anticipated that the categories indicated for victim populations and/or services provided may be expanded or •
narrowed depending on the needs of the victims identified during the grant period. At a minimum,the agency will provide
services to no less than 80 percent of the total number of projected victims.
Each victim should be counted only once unless there is a separate instance of victimization.For example,a victim of spouse .
abuse assault should be counted one time during the grant period unless he/she is victimized as a result of a separate and `
unrelated crime.
2014-2015 VOCA GrantAwand I $71,131
(froni the Budget Summary Page) _
.v of vied Type of Victim $Amount %of Total IM of Other'Types. For other types of crimes,Identify and .
to be per Grant of Victims to be list each separately below.
•
served Category Amount Served
•
5 Child Physical Abuse $484 1.00%` 20 Battery(not domestic violence)
o Child Sexual Abuse 50._ 0.00% 20 Felony Battery(not domestic violence) .
O DUUDWI Crashes $0 0.00% 10 Simple Assault
590 Domestic Violence $54,716 77.00% 5 Stelking/Harrassment(not domestic violence) ,
10 Adult Swami Abuse $927 1.00% 6 Threets/Aftisyilmtimadatton
O Eider Abuse 50 0.00% 2 Attempted Murder .
o Adults Molested as Children 50 0.00%
5 Survivors d Homicide Victims $464 1.00%
100 Robbery 89,274, 13.00%
O Assault
$0 0.00% .
r . t, . 767 $71,131 r 100.00% 57 :_4';1•,,,.i.-I ' $5,298 7.40%
is E: -..''`'.' )?•ti's; -
,: of Victim Type of Service 0 of Other Types of For other types of services,Identify
to be Services to be and list each separately below.
Served , ' Provided •
45 Crisis Counseling _ .
700 Follow-up Contacts
0 Thera
O Support Groups .
o Crisis Hotline Couneeting
o Shetterl8efehrsuse _ .
60 Information and Referral(In-Person)
50 • Criminal Justice SuppatAdvocacy •
0 Emergency Financial Assistance •
80 Emerpeney Legal Advocacy
• - 787 Assistance Fllin•Corn•-.,-.:on Claims-Mends .
120 Personal Advocacy
290 Telephone Contests 0 o' 'r„ ;*r '�"s�
,,} • ;r:, 2,082 .,/5 r �, Afic;
10:.- . ,13- -;' ati °;� ' I'•-._ .t'.'i'r .ini; .
.
tt
1
I •
1
Attachment B
Victims of Crime Act(YOGA)Section 539, Consolidated and Further •
Continuing Appropriations Act,2013, Special Conditions Certification Form
Please complete the information below and return this document to the Office of the Attorney General .
with the signed VOCA Agreement and other Attachments. .
Section 539 of the Consolidated and Further Continuing Appropriations Act,2013 provides the following
• requirement: •
Computer Network Requirement
The recipient understands and agrees that:
a) No award funds may be used to maintain or establish a computer network system unless such •
• . . --network.biocks the viewing,.downloading,.and exchanging of pornography,and
b) Nothing In Item(a)limits the use of funds necessary for any Federal,State,tribal,or local law
• enforcement-agency or any other entity carrying out criminal investigations,prosecution,or
adjudication activities.
• Each VOCA subgrantees must have some type of blocking software,if their networks are
supported(°maintained')by VOCA funds: . .
• This includes the purchase of new computer equipment(computers,monitors and printers),
or software of any kind(new andtor updates)for the computer network system. 1
AGENCY CERTIFICATION:
yi, VOCA funding is NOT USED to maintain or establish a computer network system.
- OR -
0 VOCA funding is USED to maintain or establish a computer network system.However,the
computer network system is(select one below):
o Is currently blocking the viewing,downloading,and exchanging of pornography,or
i
DIs not able to block the viewing,downloading and exchanging of pornography. •
Anticipated date of blocking software purchase, .(fill in date),or
O - -Exempt because organization is.a Federal,State,tribal,or local law enforcement agency,
or an entity carrying out criminal investigations,prosecutions,or adjudication activities. ,
Agency Name: e I 1 3 Ikk t CZKA C3€44.C.0/‘ .•
Name of Authorized Official: .iA M `'s L_ • M 0 C (C.5
Signature and Title of 1
Authorized Official: ` - $L. C141 ril 411 egy_1r
Date of Certification: I I y r/1 -f
'
OAG Staff Oily:
4 I Approved I I Not Approved
_La -a lD1` tY
Approved
roved
Approved.By
ATTACHMENT C
OMB APPROVAL NO.1121-0140 •
EXPIRES 06/30/2009
STANDARD ASSURANCES
The Applicant hereby assures and certifies compliance with all applicable Federal statutes,regulations,
policies,guidelines,and requirements,including OMB Circulars A-21,A-87,A-102,A-110,A-122,A-
133;Ex.Order 12372(ntergovernmental review of federal programs);and 28 C.F.R.pts.66 or 70
(administrative requirements for grants and cooperative agreements).The applicant also specifically
assures and certifies that
•
1.It has the legal authority to apply for federal assistance and the institutional,managerial,and financial
capability(including funds sufficient to pay any required non-federal share of project cost)to ensure
proper planning,management,and completion of the project described in this application.
2.It will establish safeguards to prohibit employees from using their positions for a purpose that
' constitutes or presents the appearance of personal or organizational conflict of interest,or personal gain.
3.It will give the awarding agency or the General Accounting Office,through any authorized
representative,access to and the right to examine all paper or electronic records related to the firumcial
assistance.
•
4.It will comply with all lawful requirements imposed by the awarding agency,specifically including
any applicable regulations,such as 28 C.F.R.pts. 18,22,23,30,35,38,42,61,and 63,and the award term in
2 C.F.R. § 175.15(b).
5.It will assist the awarding agency(if necessary)in assuring compliance with section 106 of the
National Historic Preservation Act of 1966(16 U.S.C.§470),Ex.Order 11593(identification and
protection of historic properties),the Archeological and Historical Preservation Act of 1974(16 U.S.C.§
469 a-1 et seq.),and the National Environmental Policy Act of 1969(42 U.S.C.§4321).
6.It will comply(and will require any subgrantees or contractors to comply)with any applicable
statutorily-imposed nondiscrimination requirements,which may include the Omnibus Crime Control and
Safe Streets Act of 1968(42 U.S.C.§3789d);the Victims of Crime Act(42 U.S.C.§10604(e));The
Juvenile Justice and Delinquency Prevention Act of 2002(42 U.S.C.§5672(b));the Civil Rights Act of
1964(42 U.S.C.§2000d);the Rehabilitation Act of 1973(29 U.S.C.§7 94);the Americans with
Disabilities Act of 1990(42 U.S.C.§ 12131-34);the Education Amendments of 1972(20 U.S.C.§§1681,
1683,1685-86);and the Age Discrimination Act of 1975(42 U.S.C.§§6101-07);see Ex.Order 13279
(equal protection of the laws for faith-based and community organizations).
7.If a governmental entity—
a)it will comply with the requirements of the Uniform Relocation Assistance and Real Property
Acquisitions Act of 1970(42 U.S.C.§4601 et seq.),which govern the treatment of persons displaced as a
result of federal and federally-assisted programs;and
b)it will comply with requirements of 5 U.S.C.§§ 1501-08 and§§7324-28,which limit certain
political activities of State or ,cal government employees whose principal employment is in connection
with an activity manced in ole or in part by federal assistance.
11Z1b1
Signature Date Date
I
ATTACHMENT D
CERTIFICATION FORM
Compliance with the Equal Employment Opportunity Plan(EEOP)Requirements
Please read carefully the Instructions(see below)and then complete Section A or Section B or Section C,not all three.
Reci•ient's Name: i u. “PRIVIMPIIIIIIIIIIMMI D U N S Number:0 -0 5 •6 s3
Address: •r IWE I a 4Q t -.:.. :. _
Grant Title: V QS.A ' Grant Number: Award Amount: ),L, 1 3 r
Name and Title of Contact Person: T 1. A ' `e e
.. a • c�.
Tele shone Number: 0 — . �S 10 E-Mail Address. 1., +L •_!
Section A—Declaration Claiming Complete Exemption from the EEOP Requirement
Please check all the following boxes that apply:
• a Recipient has less than fifty employees. a Recipient is an Indian tribe. a Recipient is a medical institution.
. a Recipient is'a nonprofitarganizaiim. o Recipient is an educational institution. a Recipient.is receiving an award less than$25,000.
I _ [responsible official],
certify that [recipient)is
not required to prepare an EEO?for the reason(s)checked above,pursuant to 28 C.F.R§42.302.
I further certify that [recipient]
will comply with applicable federal civil rights laws that prohibit discrimination in employment and in the delivery of �ll
services.
.
Print or Type Name and Title Signature Dale
Section B'---Declaration Claiming Exemption from the EEOP Submission Requirement and Certifying
That an EEOP is on File for Review
If a recipient agency has fifty or more employees and is receiving a single award or subaward of$25,000 or more,but less than$500,000,then the
recipient agency does not have to submit an EEOP to the OCR for review as long as it certifies the following(42 CF.R§42.305):
I, �t net vw
L . Mo row l e. S [responsible official],
•
certify that i {•, a , • [recipient], 1
1
which has fifty or m c re e s•ployees and is receiving a single award or subaward for $25,000 or more, but less than
$500,000, has formulated an EEOP in accordance with 28 CFR pt. 42, subpt. E. I further certify that within the last
twenty-four months,the proper authority has formulated and signed into effect the EEC)?and,as required by applicable .
federal law,it is available for review by the public,employees,the appropriate state planning agency,and the Office for .
Civil�ts,OM of Justice Programs,U.S.Department of Justice. The EEOP is on file at the following office:
L- I 1 A' , , - t, ; , _ L. [organization],
' [address].
. 1 i �1; , / : • .
;1114 WI • 1 i to Ci4 ,e 111M11 .
Print or Type N me and Title Si: • re 0•to
Section C--Declaration Stating that an EEOF Utilization Re ort Has Been Submitted.to the Office for _
Civil Rights for Review
if a recipient agency has fifty or more employees and is receiving a single award or subaward of$500,000 or more,then the recipient agency must
send an EEOP Utilization Report to the OCR for review.
I,
[responsible official],
certify that [recipient],
which has fifty or more employees and is receiving a single award of$500,000 or more,has formulated an EEOP in
accordance with 28 CFR pt.42,subpt.E,and sent it forreview on [date]to the
Office for Civil Rights,Office of Justice Programs,U.S.Department of Justice. .
Print or Type Name and Title Signature Dade
OMB Approval No.1121-0340 Expiration Date:05131/14