Special Contract Provisions_Attachments AA-AE_Final.pdf

ATTACHMENT AA

CERTIFICATION REGARDING LOBBYING

CERTIFICATION FOR CONTRACTS, GRANTS, LOANS AND AGREEMENTS

The undersigned certifies, to the best of his or her knowledge and belief, that:

(1) No federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned , to any person for influencing or attempting to influence an officer or employee of any state or federal agency, a member of congress, an officer or employee of congress, an employee of a member of congress, or an officer or employee of the state legislator, in connection with the awarding of any federal grant, the making of any federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any federal contract, grant, loan, or cooperative agreement.

(2) If any funds other than federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a member of congress, an officer or employee of congress, or an employee of a member of congress in connection with this federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form-LLL, "Disclosure Form to

Report Lobbying," in accordance with its instructions.

(3) The undersigned shall require that the language of this certification be included in the award documents for all sub awards at all tiers (including subcontracts, sub-grants, and contracts under grants, loans and cooperative agreements) and that all Subcontractors shall certify and disclose accordingly.

This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by section 1352, Title 31, U.S. Code. Any person who fails to file the required certification shall be subject to a civil penalty of not less than $10,000.00 and not more than $100,000.00 for each such failure.

Signature Date

Name of Authorized Individual Application or Agreement Number

Provider Name

DOEA Form I03 (Revised Nov 2002)

ATTACHMENT AB

CERTIFICATION REGARDING SCRUTINIZED COMPANIES LISTS

The undersigned, an authorized representative of the Provider named in the contract or agreement to which this form is an attachment, hereby certifies that:

(1) The Provider understands that pursuant to s. 287.135 F.S., any company at the time of bidding or submitting a bid/proposal for a new contract or renewal of an existing contract, that is on the "Scrutinized Companies with

Activities in Sudan List'' or the "Scrutinized Companies with Activities in the Iran Petroleum Sector List

(collectively , "the Lists") is ineligible for, and may not bid on, submit a proposal for, or enter into or renew a contract or agreement with the Area Agency on Aging of Palm Beach/Treasure Coast, Inc. for goods or services of $1million or more.

(2) The Provider understands that, pursuant to s. 287.135 F.S., any company that submits a false certification to the

Agency is subject to civil penalties, attorney's fees and costs and any costs for investigations that led to the finding of false certification.

(3) The Provider understands that the Agreement to which this form is an attachment, may be terminated by the

Agency if the Provider submits a false certification or has been placed on the Lists.

This certification, required by Florida law, is a material representation of fact upon which reliance was placed when this transaction was made or entered into Submission of this certification is a prerequisite for making or entering into this transaction.

Signature Date

(should match Contract signature)

Title

Area Agency on Aging of Palm Beach/Treasure Coast, Inc.

West Palm Beach, FL 33407

ATTACHMENT AC

CERTIFICATION REGARDING DAT A INTEGRITY COMPLIANCE FOR AGREEMENTS, GRANTS,

LOANS AND COOPERATIVE AGREEMENTS

The undersigned, an authorized representative of the Provider named in the contract or agreement to which this form is an attachment, hereby ce11ifies that:

(l) The Provider and any Subcontractors of services under this contract have financial management systems capable of providing certain information, including: (1) accurate, current, and complete disclosure of the financial results of each grant-funded project or program in accordance with the prescribed reporting requirements; (2) the source and application of funds for all Agreement suppo11ed activities; and (3) the comparison of outlays with budgeted amounts for each award. The inability to process information in accordance with these requirements could result in a return of grant funds that have not been accounted for properly.

(2) Management Information Systems used by the Provider, subcontractors, or any outside entity on which the Provider is dependent for data that is to be reported, transmitted or calculated, have been assessed and verified to be capable of processing data accurately, including year-date dependent data. For those systems identified to be non- compliant, Providers will take immediate action to assure data integrity.

(3) ff this Agreement includes the provision of hardware, software, firmware, microcode or imbedded chip technology, the undersigned warrants that these products are capable of processing year-date dependent data accurately. A II versions of these products offered by the Prov i de r (represented by the undersigned) and purchased by the Agency will be verified for accuracy and integrity of data prior to transfer.

In the event of any decrease in functionality related to time and date related codes and internal subroutines that impede the hardware or software programs from operating properly, the Provider agrees to immediately make required corrections to restore hardware and software programs to the same level offunctionality as warranted herein, at no charge to the Agency, and without interrnption to the ongoing business of the Agency, time being of the essence.

(4) The Provider and any subcontractors of services under this Agreement warrant their policies and procedures include a disaster plan to provide for service delivery to continue in case of an emergency including emergencies arising from data integrity compliance issues.

The Provider shall require that the language of this ce11ification be included in all subagreements, subgrants, and other agreements and that all subcontractors shall ce11ify compliance accordingly.

This certification is a material representation of fact upon which reliance was placed when this transaction was made or entered into. Submission of this certification is a prerequisite for making or entering into this transaction imposed by OMB Circulars A-102 and 2 CPR Part 215 (formerly OMB Circular A-110).

Signature

Name of Authorized Signer Provider Name

(Revised June 2008)

Title Date

ATTACHMENT AD

VERIFICATION OF EMPLOYMENT STATUS CERTIFICATION

As a condition of contracting with Palm Beach County Board of County Commissioners for the provision of services to the Division of Senior Services clients, the vendor(s) awarded this contract certifies the use of the US Department of Homeland Security’s E-Verify system to verify the employment eligibility of all new employees hired during the contract term to perform employment duties pursuant to this Contract and that any subcontracts include an express requirement that subcontractors performing work or providing services pursuant to this Contract utilize the E-Verify system to verify the employment eligibility of all new employees hired by the subcontractor during the contract term.

Signature Date

Title

ATTACHMENT AE

CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND

VOLUNTARY EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS

(1) The Provider certifies, by signing this certification, neither it nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any federal department agency.

(2) Where the Provider is unable to certify to any of the statements in this certification, such prospective participants shall attach an explanation to this certification.

Signature Date

(Certification signature should be same as Contract signature)

Title Agency/Organization

INSTRUCTIONS FOR CERTIFICATION

1. The terms "covered transaction," "debarred," "suspended," "ineligible," "lower tier covered transaction," "person," "primary covered transaction," and "voluntarily excluded," as used herein, have the meanings set out in the sections of rules implementing Executive Order 12549. (2 CFR 180.5-180.1020, as supplemented by 2 CFR 376.10-376.995). You may contact the Consumer Services Consultant for assistance in obtaining a copy of those regulations.

2. This certification is a material representation of facts upon which reliance was placed when the Parties entered into this transaction. If it is later determined that the Provider knowingly rendered an erroneous certification, in addition to other remedies available to the federal government, the Agency may pursue available remedies, including suspension and/or debarment.

3. The Provider will provide immediate written notice to the Consumer Services Consultant if at any time the

Provider learns that its certification was erroneous when submitted or has become erroneous by reason of changed circumstances. The Provider may decide the method and frequency by which it determines the eligibility of its principals. Each participant to a lower tier covered transaction may, but is not required to, check the Excluded Parties List System (EPLS).

4. The Provider will include a "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary

Exclusion - lower tier covered transaction" in all its lower tier covered transactions and in all solicitations for lower tier covered transactions.

5. The Provider agrees that it shall not knowingly enter into any lower tier covered transaction with a person who is debarred, suspended, determined ineligible or voluntarily excluded from participation, unless otherwise authorized by the federal government.

6. If the Provider knowingly enters into a lower tier covered transaction with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal government, the Agency may pursue available remedies, including suspension, and/or debarment.

7. The Provider may rely upon a certification of a prospective participant in a lower tier covered transaction that it is not debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is erroneous.

(Revised June 2008)