Okaloosa County BOCC — December 4, 2012 — FDEP SO619 Grant Agreement — reading text

No. S0619, Attachment A, Page 7 of 7 ATTACHMENT B PAYMENT REQUEST SUMMARY FORM Grantee: Grantee's Grant Manager: Mailing Address: Payment Request No.: DEP Agreement No.: Date Of Request: Neighboring County: Amount Requested:$ GRANT EXPENDITURES SUMMARY SECTION {Effective Date of Grant through End-of-Grant Period] AMOUNT OF THIS REQUEST TOTAL CUMULATIVE CATEGORY OF EXPENDITURE PAYMENTS Neighboring County Collection 75% of total cost Salaries Fringe Benefits Contractual Services Supplies/Other Expenses Al Al Al wl w Ail Al Al Bl] w Travel Host County Allocation Up to $10K/county Salaries Fringe Benefits Contractual Services Supplies/Other Expenses Travel (if authorized) Equipment ALA Al Ali Al Al wH TOTAL AMOUNT AGREEMENT AMOUNT Less Total Cumulative Payments of: Al Al Al Al HA] | Hl SH] wm] w TOTAL REMAINING IN GRANT GRANTEE CERTIFICATION The undersigned certifies that the amount being requested for reimbursement above was for items that were charged to and utilized only for the above cited grant activities. Grantee's Grant Manager’s Grantee's Fiscal Agent Signature Print Name Print Name Telephone Number Telephone Number DEP Agreement No. S0619, Attachment B, Page | of 2 INSTRUCTIONS FOR COMPLETING ATTACHMENT C PAYMENT REQUEST SUMMARY FORM GRANTEE: Enter the name of the Grantee’s agency. MAILING ADDRESS: Enter the address that you want the state warrant mailed to. DEP AGREEMENT NO.: This is the number identified on the first page of this Agreement. DATE OF REQUEST: This is the date you are submitting the request. AMOUNT REQUESTED: This should match the amount on the “TOTAL AMOUNT” line for the “AMOUNT OF THIS REQUEST” column. GRANTEE’S GRANT MANAGER: This should be the person identified as grant manager in this Agreement. PAYMENT REQUEST NO.: This is the number of your payment request, not the quarter number. NEIGHBORING COUNTY: A separate Payment Request Summary Form must be submitted for each neighboring county under this Agreement, identify the neighboring county for this payment request. GRANT EXPENDITURES SUMMARY SECTION: “AMOUNT OF THIS REQUEST” COLUMN: Enter the amount that was expended for the deliverable for which you are requesting reimbursement. This must agree with the budget category as in the currently approved budget in the current Grant Work Plan of this Agreement. Do not claim expenses in a budget category that does not have an approved budget. Do not claim items that are not specifically identified in the current Grant Work Plan. Enter the column total on the “TOTAL AMOUNT” line. Enter the amount of the Agreement on the “AGREEMENT AMOUNT” line. Enter the total cumulative amount of this request and all previous payments on the “LESS TOTAL CUMULATIVE PAYMENTS OF” line. Deduct the “LESS TOTAL CUMULATIVE PAYMENTS OF” from the “AGREEMENT AMOUNT” for the amount to enter on the “TOTAL REMAINING IN GRANT” line. “TOTAL CUMULATIVE PAYMENTS” COLUMN: Enter the cumulative amounts that have been claimed to date for reimbursement by budget category. The final report should show the total of all payments; first through the final payment (this amount cannot exceed the approved budget amount for that budget category). Enter the column total on the “TOTALS” line. Do not enter anything in the shaded areas. GRANTEE CERTIFICATION: Must be signed by both the Grantee’s Grant Manager as identified in the grant agreement and the Grantee’s Fiscal Agent. NOTE: If claiming reimbursement for travel, you must include copies of receipts and a copy of the travel reimbursement form approved by the Department of Financial Services, Chief Financial Officer. DEP Agreement No. S0619, Attachment B, Page 2 of 2 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. $0619, Attachment C, Page | of 1 ATTACHMENT D PROGRESS REPORT FORM DEP Agreement No.: | S0619 Grantee Name: Grantee Address: Grantee’s Grant Manager: | Telephone No.: | Quarterly Reporting Period: Project Number and Title: Provide the following information for all tasks and deliverables identified in the Grant Work Plan: a summary of project accomplishments to date; a comparison of actual accomplishments to 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 and attach copies of any deliverables being submitted for the project for this reporting period (Deliverables should be labeled by task and deliverable number as identified in the Grant Work Plan). NOTE: The progress identified in this report should agree with the payment request. Use as many pages as necessary to cover all tasks/deliverables in the Grant Work Plan. The following format should be followed: Task 1: Progress for this reporting period: Identify any delays or problems encountered: Deliverables being submitted: This report is submitted in accordance with the reporting requirements of DEP Agreement No. S0619 and accurately reflects the activities and costs associated with the subject project. Signature of Grantee’s Grant Manager Date DEP Agreement No. $0619, Attachment D, Page 1 of 1 ATTACHMENT E 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 Attachment 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 I, 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/cfda/cfda.html. DEP 55-215 (03/09) DEP Agreement No. S0619, Attachment E, Page 1 of 5 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.