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HomeMy WebLinkAboutResolution - 2010-R0595 - Contract 9870 SPAG Funds U.S. Dept. Of HHS To TX DADS Meals And Transportation - 12_02_2010Resolution No. 2010-RO595 December 2, 2010 Item No. 5.1.1 RESOLUTION BE IT RESOLVED BY THE CITY COUNCIL OF THE CITY OF LUBBOCK: THAT the Mayor of the City of Lubbock BE and is hereby authorized and directed to execute for and on behalf of the City of Lubbock, a Contract with the South Plains Association of Governments (SPAG) for funds passed through the U.S. Department of Health and Human Services to the Texas Department of Aging and Disability Services for an Area Agency on Aging Direct Purchase of Services Program grant and any associated documents, a copy of which Contract is attached hereto and which shall be spread upon the minutes of this Council and as spread upon the minutes of this Council shall constitute and be a part hereof as if fully copied herein in detail. Passed by the City Council this 2nd day of A'I" rEST: Re ca Garza, City Secretar -Ij APPROVED AS TO CONTENT: December TOM MARTIN, MAYOR 'o - Ran Tru sdell, Community Services Director APPROVED AS TO FORM: Chad Weaver, Assistant City Attorney Resolution SPAG 10-11 11 12 10 , 2010. Resolution No. 2010-RO595 //ea Contract. 9870 gency THE SOUTH PLAINS ASSOCIATION OF GOVERNMENTS WO/I Aging AREA AGENCY ON AGING VENDOR AGREEMENT City of Lubbock, hereinafter referred to as Vendor, and The South Plains Association of Governments Area Agency on Aging (AAA) do hereby agree to provide services effective beginning October 1, 2010, in accordance with the Older Americans Act of 1965 (OAA), as amended, regulations of the Department of Aging and Disability Services (DADS), the AAA Direct Purchase of Services program and the stated Scope of Services. The AAA Direct Purchase of Services program is designed to promote the development of a comprehensive and coordinated service delivery system to meet the needs of older individuals (60 years of age or older) and their caregivers. This agreement provides a mechanism for the creation of an individualized network of community resources accessible on a program participant -by -program participant basis in compliance with the Older Americans Act, as amended, and Texas DADS AAA Access and Assistance guidelines. The purpose of the system of Access and Assistance is to develop cooperative working relationships with service providers to build an integrated service delivery system that ensures broad access to and information about community services, maximizes the use of existing resources, avoids duplication of effort, identifies gaps in services, and facilitates the ability of people who need services to easily find the most appropriate Vendor. 1. SCOPE OF SERVICES A. The Vendor agrees to provide the following service(s) as identified below to program participants authorized by the AAA staff, in accordance with the vendor application, all required assurances, licenses, certifications and rate setting documents, as applicable. Service: CONGREGATE MEALS TRANSPORTATION Service Definition: CONGREGATE MEAL A hot or other appropriate meal served to an eligible older individual which meets 331/. percent of the dietary reference intakes established by the Food and Nutrition Board of the Institute of Medicine of the National Academy of Sciences and complies with the most recent Dietary Guidelines for Americans, published by the Secretary of Agriculture, and which is served in a congregate setting. The objective is to reduce food insecurity and promote socialization of older individuals. There are two types of congregate meals: • Standard meal - A regular meal from the standard menu that is served to the majority or all of the participants. • Therapeutic meal or liquid supplement - A special meal or liquid supplement that has been prescribed by a physician and is planned specifically for the participant by a dietician (e.g., diabetic diet, renal diet, pureed diet, tube feeding). TRANSPORTATION — Taking an older individual from one location to another but does not include any other activity. There are two types of transportation services: Forth #: AIAAA_VA1.2 Edition !Date: 6/22l10 • Demand/Response-transportation designed to carry older individuals from specific origin to specific destination upon request. Older individuals request the transportation service in advance of their need, usually twenty-four to forty-eight hours prior to the trip. Unit Definition: CONGREGATE MEALS: One Meal TRANSPORTATION — Demand/Response: One One-way Trip Service Area (to be filled in by Vendor): City of Lubbock All Texas Administrative Code standards are located at the Texas Secretary of State website: x\ \\ \\ .sos.state.(s.us. All Older Americans Act and other required rules and regulations are located at littp://h\-\\w.aoa.L)ok/AoARoot/Abotit/Authol•izins Statutes/index.aspx. Targeting: AAA Access and Assistance services are designed to identify eligible program participants, with an emphasis on high -risk program participants and to serve older individuals with greatest economic and social need, low-income minorities and those residing in rural areas, as required by the OAA. B. Services & Reimbursement Methodology: Service Fixed Rate (include rate) Variable Rate (identify range) Cost Reimbursement Congregate 6.84 N/A N/A Transportation 6.09 N/A N/A 2. TERMS OF AGREEMENT A. Vendor agrees to: Provide services in accordance with current or revised DADS policies and standards and the OAA. 2. Submit billings with appropriate documentation as required by the AAA by the close of business on the 2"d working day of each month following the last day of the month in which services were provided. a. If the 2"d working day falls on a SPAG holiday, the information shall be delivered by the close of business on the preceding business day. b. The AAA cannot guarantee payment of a reimbursement request received for more than 45 calendar days of service delivery. c. No reimbursement for services provided will be made if vendor payment invoices are not submitted to the AAA within 45 days of service delivery 3. Encourage program participant contributions (program income) on a voluntary and confidential basis. Such contributions will be properly safeguarded and accurately accounted Forth #: AIAAA_VA1.2 Edition bate: 6/22/10 for as receipts and expenditures on Vendor's financial reports if contributions are not required to be forwarded to the AAA. Client contributions (program income) will be reported fully, as required, to the AAA. Vendor agrees to expend all program income to expand or enhance the program/service under which it is earned. 4. Notify the AAA Access and Assistance division within immediately if, for any reason, the Vendor becomes unable to provide the service(s). 5. Maintain communication and correspondence concerning program participants' status. 6. Establish a method to guarantee the confidentiality of all information relating to the program participant in accordance with applicable federal and state laws, rules, and regulations. This provision shall not be construed as limiting AAA or any federal or state authorized representative's right of access to program participant case records or other information relating to program participants served under this agreement. 7. Keep financial and program supporting documents, statistical records, and any other records pertinent to the services for which a claim for reimbursement was submitted to the AAA. The records and documents will be kept for a minimum of five years after close of contract year. 8. Make available at reasonable times and for required periods all fiscal and program participant records, books, and supporting documents pertaining to services provided under this agreement, for purposes of inspection, monitoring, auditing, or evaluations by AAA staff, the Comptroller General of the United States and the State of Texas, through any authorized representative(s). B. The Vendor further agrees: 1. The agreement may be terminated for cause or without cause upon the giving of 30 days advance written notice. 2. The agreement does not guarantee a total level of reimbursement other than for individual units/services authorized; contingent upon receipt of funds. 3. Acknowledgement it is an independent provider, NOT an agent of the AAA. Thus, the Vendor indemnifies, saves and holds harmless the AAA of the South Plains Association of Governments against expense or liability of any kind arising out of service delivery performed by the Vendor. Vendor must immediately notify the AAA if the Vendor becomes involved in or is threatened with litigation related to Access and Assistance participants. 4. Employees of the Vendor will not solicit or accept gifts or favors of monetary value by or on behalf of program participants as a gift, reward or payment. C. Through the Direct Purchase of Services program, the South Plains Association of Governments AAA agrees to: 1. Review program participant intake and assessment forms completed by the Vendor, as applicable, to determine program participant eligibility. Service authorization is based on program participant need and the availability of funds. 2. Provide timely written notification to Vendor of program participant's eligibility and authorization to receive services. 3. Maintain communication and correspondence concerning the program participants' status. 4. Provide timely technical assistance to Vendor as requested and as available. 5. Conduct quality -assurance procedures, which may include on -site visits, to ensure quality services are being provided. Forth #: AIAAA_VA1.2 3 Edition Date: 6/22/10 6. Provide written policies, procedures, and standard documents concerning program participant authorization to release information (both a general and medical/health related release), client rights and responsibilities, contributions, and complaints/ grievances and appeals to all program participants. 7. Reimburse the Vendor based on the agreed reimbursement methodology, approved rate(s), service(s) authorized, and in accordance with subsection (A) (2) of this document, within 45 days of the AAA's receipt of Vendor's invoice. 8. Reimburse the Vendor upon receipt of a properly prepared vendor payment invoice, identified in (7) of this subsection, contingent upon the AAA's receipt of funds authorized for this purpose from DADS. 3. ASSURANCES The Vendor shall comply with: A. Title VI of the Civil Rights Act of 1964 (42 U.S.C. §2000d et.seq.) B. Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. §794) C. Americans with Disabilities Act of 1990 (42 U.S.C. § 12101 et seq. ) D. Age Discrimination in Employment Act of 1975 (42 U.S.C. §§6101-6107) E. Title IX of the Education Amendments of 1972 (20 U.S.C. §§1681-1688) F. Food Stamp Act of 1977 (7 U.S.C. §200 et seq.) G. Drug Free Workplace Act of 1988 H. Texas Senate Bill 1 - 1991, as applicable I. DADS administrative rules, as set forth in the Texas Administrative Code, to the extent applicable to this Agreement J. Certification Regarding Debarment - 45CFR §92.35 Sub awards to debarred and suspended parties; this document is required annually as long as this agreement is in affect 4. ATTACHMENTS A. Description of Assurances listed in section 3 of this document. B. List of Focal Points in the South Plains Association of Governments AAA Region Form #: AIAAA VA1.2 4 Edition :Date: 6/22/10 5. SIGNATURES For the faithful performance of the terms of this agreement, the parties affix their signatures and bind themselves effective October 1, 2010. Authorized Vendor Signature Tom Martin Print Name Mayor Title Authorized Signature South Plains Association of Governments (Area Agency on Aging) P.O. Box 3730 - Freedom Station (Address) Lubbock, Texas 79452 (City, State, Zip) Attest: Approve as to C nt: Appr v s to Form: CIR _*_� `6 Reb cca Garza RaAdy Truesdell Nid Weaver City Secretary Community Services Director Assistant City Attorney Form #: AIAAA_VA1.2 Edition (Date: 6/22110 Resolution No. 2010—RO595 Attachment A ASSURANCES ATTACHMENT A. Title VI of the Civil Rights Act of 1964 (42 U.S.C. §2000d et.seq.), which prohibits discrimination because of race, color religion sex or nations origin in all employment practices including hiring, firing, promotion, compensation and other terms, privileges and conditions of employment. B. Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. §794), which states that employers may not refuse to hire or promote handicapped persons solely because of their disability. C. Americans with Disabilities Act of 1990 (42 U.S.C. §12101 et sea.), which prohibits a covered entity from discriminating against a qualified individual on the basis of disability in regard to job application procedures, the hiring, advancement, or discharge of employees, employee compensation, job training, and other terms, conditions, and privileges of employment. D. Age Discrimination in Employment Act of 1975 (42 U.S.C. 0101-6107), prohibits discrimination on the basis of age in programs and activities receiving federal financial assistance. E. Title IX of the Education Amendments of 1972 (20 U.S.C. 4§1681-1688), which prohibits the use of federal money to support sexually discriminatory practices in education programs such as sexual harassment and employment discrimination, and to provide individual citizens effective protection against those practices. F. Food Stamp Act of 1977 (7 U.S.C. §200 et seg.), whose purpose is to strengthen the agricultural economy; to help to achieve a fuller and more effective use of food abundances; to provide for improved levels of nutrition among low-income households through a cooperative Federal -State program of food assistance to be operated through normal channels of trade; and for other purposes. G. Drug Free Workplace Act of 1988, which requires that all organizations receiving federal grants, regardless of amount granted, maintain a drug -free workplace. H. Texas Senate Bill 1 - 1991, as applicable, which refers to proper reporting of contributions as addressed in OAA §315 and TAC, Title 40, §85.201. DADS administrative rules, as set forth in the Texas Administrative Code, to the extent applicable to this Agreement J. Certification Regarding Debarment - 45CFR §92.35 Sub -awards to debarred and suspended parties; this document is required annually as long as this agreement is in effect. Resolution No. 2010-RO595 Attachment B FOCAL POINTS FOR THE SOUTH PLAINS ASSOCIATION OF GOVERNMENTS REGION FY 2010-2011 CENTER: DIRECTOR: BOOKKEEPER: ADDRESS: CITY: PHONE: DAYS & HRS. OPEN: SERVICES: COUNTY: CENTER: DIRECTOR: BOOKKEEPER: ADDRESS: CITY: PHONE: DAYS & HRS. OPEN: SERVICES: COUNTY: CENTER: DIRECTOR: BOOKKEEPER: ADDRESS: CITY: PHONE: DAYS & HRS. OPEN: SERVICES: COUNTY: Abernathy Sr. Citizens Association, Inc. (A-005) Louise Thomason H — 298-4055/ C — 789-5165 Louise Thomason 717 Avenue C Abernathy, Texas 79311 (806) 298-2842 E-mail: abernathysrcenter(d�erf%vireless.net Tues. & Thurs. 8:00-12:00, 1:00-4:00, Wed. 8:00-4:00 SCO. Lubbock Anton Sr. Citizens Association, Inc. (A-015) Carol Rendon Carol Rendon Box 378 (201 Main Street) Anton, Texas 79313 (806) 997-2781 E-mail: antonsr(r�yvindstream.net Mon. — Fri. 8-2 CONG., H.D., SCO. Hockley Bailey County Commissioners Court (A-020) Debbie Floyd Debbie Floyd 300 South First Street Room 110 Muleshoe, Texas 79347 (806) 272-3647 E-mail: bmjn2rd)fivearea.eom Mon. - Fri. 8:30-12:00, 1:00-5:00 Fax: (806) 272-4656 H.D., TRANS., B.C. Cell: (806) 729-0680 Bailey CENTER: Bailey County Senior Citizens Assoc., Inc. (A-007) DIRECTOR: Laverne Winn H — (806)272-4491 C — (806) 946-8809 BOOKKEEPER: Helen Cook ADDRESS: 319 S. Main St / PO Box 292 CITY: Muleshoe, Texas 79347 PHONE: (806) 272-4969 E-mail: seniors(aifivearea.com DAYS & HRS. OPEN: Mon. — Fri.. 8:00 — 4:00 Fax: (806) 272-4460 SERVICES: CONG., SCO. COUNTY: Bailey FOCAL PO►NTS 1 UPDATED 10/11/2010 CENTER: Brownfield Senior Citizens, Inc. (A-025) DIRECTOR: Betty Charlebois BOOKKEEPER: Betty Charlebois ADDRESS: P.O. Box 1021 (500 W. Bridges) CITY: Brownfield, Texas 79316 PHONE: (806) 637-6933 E-mail: bfldsrcitnyahoo.com DAYS & HRS. OPEN: Mon. - Fri. 8:30-2:00 SERVICES: CONG., H.D., SCO., TRANS. COUNTY: Terry CENTER: Cochran Co. Senior Citizens Assoc., Inc. (A-045) DIRECTOR: Nancy Luper C - (806) 523-3362 BOOKKEEPER: Nancy Luper ADDRESS: 120 W. Wilson CITY: Morton, Texas 79346 PHONE: (806) 266-5121 E-mail: ccsci(a—)valornet.com DAYS & HRS. OPEN: Mon. — Fri. 8-4 Fax #: 266-9027 SERVICES: CONG., SCO., TRANS. COUNTY: Cochran CENTER: Crosby Co. Senior Citizens Assoc., Inc. (A-050) DIRECTOR: Angie Reyna BOOKKEEPER: Donna Arnold ADDRESS: 119 North Berkshire CITY: Crosbyton, Texas 79322 PHONE: (806) 675-2107 E-mail: CrosbyCountySeniors tr�windstreant.net DAYS & HRS. OPEN: Mon. —Fri. 8-3 SERVICES: CONG., H.D., SCO. COUNTY: Crosby CENTER: DIRECTOR: BOOKKEEPER: ADDRESS: CITY: PHONE: DAYS & HRS. OPEN: SERVICES: COUNTY: Floydada Senior Citizens, Inc. (A-055) Sylvia Bueno Sylvia Bueno P.O. Box 573 (301 E. Georgia St.) Floydada, Texas 79235 (806) 983-2032 E-mail: senior.citizens(q_�att.net Mon. — Fri. 8-2 CONG., H.D., SCO. Floyd FOCAL POINTS 2 UPDATED 10/11/2010 CENTER: Garza County Trailblazers, Inc. (A-070) DIRECTOR: Ila Workman BOOKKEEPER: Ila Workman ADDRESS: 205 E. 10th CITY: Post, Texas 79356 PHONE: (806) 495-2998 E-mail:garzatrailblazei-s &yahoo.com DAYS & HRS. OPEN: Mon. — Fri. 8-2 SERVICES: CONG., H.D., SCO. COUNTY: Garza CENTER: Hale Center Senior Citizens Assoc., Inc. (A-075) DIRECTOR: Vickie Rosales BOOKKEEPER: Vickie Rosales ADDRESS: P.O. Box 205 (416 West 2nd St.) CITY: Hale Center, Texas 79041 PHONE: (806) 839-2428 E-mail: hcsrcenter a sbcglobal.net DAYS & HRS. OPEN: Mon. — Fri. 8-3 SERVICES: CONG., H.D., SCO., TRANS. COUNTY: Hale CENTER: Hockley County Senior Citizens Assoc., Inc. (A-085) DIRECTOR: Susan Sprowls BOOKKEEPER: Diane Buzbee ADDRESS: 1202 Houston CITY: Levelland, Texas 79336 PHONE: (806) 894-2228 E-mail: dibuzbee a.,aol.com sksprowlsnhol.com DAYS & HRS. OPEN: Mon. — Fri. 8-4:30 (Smyer): Tues & Fri, 8-3) SERVICES: CONG., H.D., SCO., TRANS. COUNTY: Hockley CENTER: Lorenzo Senior Citizens Assoc., Inc. (A-095) DIRECTOR: Christina Edwards BOOKKEEPER: Christina Edwards ADDRESS: P.O. Box 571 (606 6d' St.) CITY: Lorenzo, Texas 79343 PHONE: (806) 634-5957 E-mail: lorenzoscaawindstream.net DAYS & HRS. OPEN: Mon. —Fri. 8-3 SERVICES: CONG., H.D., SCO. COUNTY: Crosby FOCAL POINTS 3 UPDATED 10/11/2010 CENTER: Lubbock - City of Lubbock (A-100) DIRECTOR: Johnny McLellan, Supervisor: 775-2678 Nancy Neill, 775-2685 ADDRESS: P.O. Box 2000 (1010 9t' St.) CITY: Lubbock, Texas 79457 PHONE: (806) 775-2678 E-mail: _imelellan(a—)rgiail.ci.lubbock.tx.us nneillnnnylubbock.us & P_ibrownna mylubbock.us DAYS & HRS. OPEN: Mon. —Fri. 8-5 Fax: 775-2686 SERVICES: CONG., TRANS. COUNTY: Lubbock Mae Simmons — 767-2708, Traci Crawford (2004 Oak Avenue 79404), Copper Rawlings — 767-2704, Herminia Martinez (213 40'' Street 79404), (40" & Ave. B), Maggie Tre'o — 767-2705, Ida Aguilar (3200 Amherst 79415), Homestead - 687-7898, Ida Aguilar (5401 56 th Street 79414); Lubbock Senior Center — 767-2710, Paula Brown (2001 19`h Street 79401) FAX 765-0820 CENTER: Lynn County Pioneers (A-110) DIRECTOR: Bianca Baker BOOKKEEPER: Bianca Baker ADDRESS: P.O. Box 223 (1600 S. 3`d St.) CITY: Tahoka, Texas 79373 PHONE: (806) 561-5264 E-mail: Icp a� cloor.net DAYS & HRS. OPEN: Mon. —Fri. 9-3 Fax: 561-5571 SERVICES: CONG., H.D., SCO. (No Cong. in O'Donnell) COUNTY: Lynn CENTER: Motley County Sr. Citizens Association, Inc. (A-112) DIRECTOR: Tommye Keith BOOKKEEPER: Tommye Keith ADDRESS: P. O. Box 184 (621 Stewart Street) CITY: Matador, Texas 79244 PHONE: (806) 347-2496 E-mail: meseniorn,caprock-spur.corn DAYS & HRS. OPEN: Monday - Friday 8-3 SERVICES: CONG., H.D., SCO. COUNTY: Motley CENTER: N. Dickens Co. Senior Citizens Assoc., Inc. (A-115) DIRECTOR: Vonda Brendle BOOKKEEPER: Vonda Brendle ADDRESS: P.O. Box 163 (511 Montgomery) CITY: Dickens, Texas 79229 PHONE: (806) 623-5520 E-mail: ndcsccO)caprock-spur.com DAYS & HRS. OPEN: Mon. —Fri. 8-2 SERVICES: CONG., H.D., SCO. COUNTY: Dickens FOCAL POINTS 4 UPDATED 10/11/2010 CENTER: Senior Citizens Assoc. of S. Dickens County (A-130) DIRECTOR: Beverly Watson BOOKKEEPER: Jean Hoover ADDRESS: 210 Burlington CITY: Spur, Texas 79370 PHONE: (806) 271-4472 E-mail: sscaosdc(a)caprock-spur.com DAYS & HRS. OPEN: Mon. —Fri. 8-3 SERVICES: CONG., H.D., SCO. COUNTY: Dickens CENTER: Slaton Senior Citizens Assoc., Inc. (A-135) DIRECTOR: Charlotte O'Connell BOOKKEEPER: Charlotte O'Connell ADDRESS: 230 West Lynn CITY: Slaton, Texas 79364 PHONE: (806) 828-3784 E-mail: coconnell(a�door.net DAYS & HRS. OPEN: Mon. —Fri. 8-4 slatonseniors(a),door.net SERVICES: CONG., H.D., SCO. COUNTY: Lubbock CENTER: Yoakum County Senior Citizens Assoc., Inc. (A-150) DIRECTOR: Elsie White BOOKKEEPER: Pat Castillo ADDRESS: 412 West 5th St., #8 CITY: Denver City, Texas 79323 PHONE: (806) 592-8000 E-mail: Elsie - ycsc60nwindstreain.net DAYS & HRS. OPEN: Mon. —Fri. 9-2 ion i6ran(i6aymail.com SERVICES: CONG., H.D., SCO., TRANS. COUNTY: Yoakum Fax: (806) 592-2835 LEGEND CONG. - Congregate (on -site) Meals H.D. - Home Delivered Meals SCO. - Senior Center Operations B.C. - Benefits Counseling TRAN. - Transportation Services FOCAL POINTS 5 UPDATED 10/11/2010 Schedule of Providers' Board Meetings Abernathy The board meets quarterly, but not on specific dates — Except for the annual meeting on the last Wednesday of Sept. Anton The board meets quarterly, but not on specific dates — Except for meetings in Nov. and Dec. to elect officers Bailey Co. The Commissioners' Court meets 2"d Monday of each month The Board of Directors for home delivered meals meets 2 times a year, but not on specific dates Bailey Co. Sr. The board meets on 2"d Wednesday of each month Brownfield The board meets on 2"d Thursday of each month Cochran Co. The board meets on 1" Tuesday of every other month — With a meeting in December to elect officers Crosby Co. The board meets the 2"d Friday of each month. Annual meeting held the last week in October Floydada The board meets on 2"d Tuesday of each month Garza Co. The board meets on 3rd Tuesday of each month Hale Center The board meets on 2"d Monday of Jan., April, July & Oct. Hockley Co. The board meets on 41h Wednesday of each month Lorenzo The board meets on 2"d Monday of every other month Lynn Co. The board meets quarterly but not on specific dates Motley Co. The board meets quarterly but not on specific dates N. Dickens Co. The board meets 2"d Wednesday of each month S. Dickens Co. The board holds 6 meetings per year (one every 2 months) But not on specific dates, and called meetings as needed. FOCAL POINTS 6 UPDATED 10/11/2010 Slaton The board meets 2°d Thursday of each month. Called meetings as needed. Yoakum The board meets on 41h Wednesday of each month FOCAL POINTS 7 UPDATED 10/11/2010 Certification Regarding Debarment CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION FOR COVERED CONTRACTS AND GRANTS Federal Executive Order 12549 requires the Texas Department of Aging and Disability Services (TDADS)) to screen each covered potential vendor/grantee to determine whether each has a right to obtain a contract/grant in accordance with federal regulations on debarment, suspension, ineligibility, and voluntary exclusion. Each covered vendor/grantee must also screen each of its covered sub vendors/providers. In this certification "vendor/grantee" refers to both vendor/grantee and sub vendor/sub- grantee: "contract/grant" refers to both contract/grant and subcontract/sub-grant. By signing and submitting this certification the potential vendor/grantee accepts the following terms: 1. The certification herein below is a material representation of fact upon which reliance was placed when this contract/grant was entered into. It is later determined that the potential vendor/grantee knowingly rendered an erroneous certification, in addition to other remedies available to the federal government, the Department of Health and Human Services. United States Department of Agriculture or other federal department or agency, or the Texas Department of Aging and Disability Services may pursue available remedies, including suspension and/or debarment. 2. The potential vendor/grantee shall provide immediate written notice to the person to whom this certification is submitted if at any time the potential vendor/grantee learns that the certification was erroneous when submitted or has become erroneous by reason of changed circumstances. 3. The words "covered contract," " debarred," "suspended," "ineligible," "participant," "person," "principal," "proposal," and "voluntarily excluded," as used in this certification have meanings based upon materials in the Definitions and Coverage sections of federal rules implementing Executive Order 12549. Usage is as defined in the attachment. 4. The potential vendor/grantee agrees by submitting this certification that, should the proposed covered contract/grant be entered into, it shall knowingly into any subcontract with a person who is debarred, suspended, declared ineligible, or voluntarily excluded from participation in this covered transaction, unless authorized by the Department of Health and Human Services, United States Department of CERTIFICATION REGARDING DEBARMENT Page 2 Agriculture or other federal department or agency, and/or the Texas Department of Aging and Disability Services, as applicable. Do you have or do you anticipate having sub vendors/sub-grantees under this proposed contract? Yes X No S. The potential vendor/grantee further agrees by submitting this certification that it will include this certification titled "Certification Regarding Debarment, Suspension, Ineligibility, and Voluntary Exclusion for Covered Contracts and Grants" without modification, in all covered subcontracts and in solicitations for all covered subcontracts. S. A vendor/grantee may rely upon a certification of a potential sub vendor/sub-grantee that is not debarred, suspended, ineligible, or voluntarily excluded from the covered contract/grant, unless the vendor/grantee knows that the certification is erroneous. A vendor/grantee must, at a minimum obtain certifications from its covered sub vendors/sub-grantees upon each subcontract's/sub-grant's initiation and upon each renewal. 7. Nothing contained in all the foregoing shall be construed to require establishment of a system of records in order to render in good faith the certification by this certification document. The knowledge and information of a vendor/grantee is not required to exceed that which is normally possessed by a prudent person in the ordinary course of business dealings. S. Except for contracts/grants authorized under paragraph 4 of these terms, if a vendor/grantee in a covered contract/grant knowingly enters into a covered subcontract/subgrant with a person who is suspended, debarred, ineligible, or voluntarily excluded from participation in the transaction, in addition to other remedies available to the federal government, Department of Health and Human Services, United States Department of Agriculture, or other federal department or agency, as applicable, and/or the Texas Department of Aging and Disability Services may pursue available remedies, including suspension and/or debarment. CERTIFICATION REGARDING DEBARMENT Page 3 Indicate which statement applies to the covered potential vendor/grantee: X The potential vendor/grantee certifies by submission of this certification that neither it nor its principals are presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this contract/grant by any federal department or agency or by the State of Texas. The potential vendor/grantee is unable to certify one or more of the terms in this certification. In this instance, the potential vendor/grantee must attach an explanation for each of the above terms to which it is unable to make certification. Attach the explanation(s) to this certification. NAME OF POTENTIAL VENDOR/GRANTEE City of Lubbock VENDOR ID NO. /FEDERAL EMPLOYER'S ID NO. 1-75-6000590-6 ti Signature of Authorized Representative Chad Weaver Printed/Typed Name of Authorized Representative Assistant City Attorney 10/1/10 Title of Authorized Representative Date THIS CERTIFICATION IS FOR FY 2011, PERIOD BEGINNING 10/1/2010 and ENDING 9/30/2011. CERTIFICATION REGARDING DEBARMENT Page 4 DEFINITIONS Covered Contract/Grant and Subcontracts/Sub-grants. (1) Any non -procurement transaction which involves federal funds (regardless of amount and including such arrangements as sub -grants) and is between the Texas Department of Aging and Disability Services or its agents/grantees and another entity. (2) Any procurement contract for goods or services between a participant and a person, regardless of type, expected to equal or exceed the federal procurement small purchase threshold fixed at 10 U.S.C. 2304(g) and 41 U.S.C. 253(g) (currently $25,000) under a grant or sub -grant. (3) Any procurement contract for goods or services between a participant and a person under a covered grant, sub -grant, contract or subcontract, regardless of amount, under which that person will have a critical influence on or substantive control over that covered transaction including: a. Principal investigators. b. Providers of audit services required by the Texas Department of Aging and Disability Services or federal funding source. C. Researchers. DEBARMENT An action taken by a debarring official in accordance with 45 CFR Part 76 (or comparable federal regulations) to exclude a person from participating in covered contracts/grants. A person so excluded is "debarred." GRANT An award of financial assistance, including cooperative agreements, in the form of money, or property in lieu of money, by the federal government to an eligible grantee. INELIGIBLE Excluded from participation in federal non -procurement programs pursuant to a determination of ineligibility under statutory, executive order, or regulatory authority, other an Executive Order 12549 and its agency implementing regulations: for example, excluded pursuant to the Davis -Bacon Act and its implementing regulations, the equal employment opportunity acts and executive orders, or the enviromnental protection acts and executive orders. A person is ineligible where the determination of ineligibility affects such person's eligibility to participate in more than one covered transaction. CERTIFICATION REGARDING DEBARMENT Page 5 PARTICIPANT Any person who submits a proposal for, enters into, or reasonably may be expected to enter into a covered contract. This term also includes any person who acts on behalf of or is authorized to commit a participant in a covered contract/grant as an agent or representative of another participant. PERSON Any individual, corporation, partnership, association, unit of government, or legal entity, however organized, except: foreign governments or foreign governmental entities, public international organizations, foreign government owned (in whole or part) or controlled entities, and entities consisting wholly or partially of foreign governments or foreign governmental entities. PRINCIPAL Officer, director, owner, partner, key employee, or other person within a participant with primary management or supervisory responsibilities: or a person who has a critical influence on or substantive control over a covered contract/grant whether or not the person is employed by the participant. Persons who have a critical influence on or substantive control over a covered transaction are: (1) Principal investigators. (2) Providers of audit services required by the Texas Department of Aging and Disability Services or federal funding source. (3) Researchers. PROPOSAL A solicited or unsolicited bid, application, request, invitation to consider or similar communication by or on behalf of a person seeking to receive a covered contract/grant. SUSPENSION An action taken by a suspending official in accordance with 45 CFR part 76 (or comparable federal regulations) that immediately excludes a person from participating in covered contracts/grants for a temporary period, pending completion of an investigation and such legal, debarment, or Program Fraud Civil Remedies Act proceedings as may ensue. A person so excluded is "suspended." VOLUNTARY EXCLUSION OR VOLUNTARILY EXCLUDED A status of nonparticipation or limited participation in covered transactions assumed by a person pursuant to the terms of a settlement. Congregate Meals BUDGET WORKSHEET CALCULATION OF THE PER MEAL UNIT RATE 1. Total Budgeted Expenses for Contract Year 2_ Total Number of Anticipated Meals to be Provided by Funding Source Local Funds DADS A&I AAA 23,853 Eligible Meals 6,144 Other Sources 5 0 Other Funds - Non -Eligible Program Income 6,700 Meals 0 3. Cost per meal (Line 1 divided by Line 2) Reimbursement Calculation DADS A81 AAA 4. Projected NSIP per Meal Value 0.64 5, Rate Less NSIP per Meal Value $ 6.89 6. Mandatory Local Match of 10% $ 0.69 '• If Applicable, Match Reduction From the In -kind Match Certification form $ (0.00) Required Match $ 0.69 7. Proposed Meal Rate (Line 3 minus Line 6) $ 684 Other Sources 6 0 •' If any portion of the required match is in -kind, you must complete an In -Kind Match Certification form. By signing below, the provider acknowledges that all related records are subject to audit in accordance with contract requirements and all applicable federal and state laws. City of Lubbock Legal Name of Contracted Provider Signature South Plains Association of Governments Name of Area Agency on Aging T C. P'efe ri d/Typ N me of Signer e 1A . , Signatu October 1, 2010 Date Attest: �R__ ecca Garaa City Secretary Tom Martin, Mayor Printed/Typed Name of Signer Approv s to Co nt: RanAy Truesdell Community Services Director October 1, 2010 Date 1. $ 276,204.09 2. 36,697 3. $ 753 Appr <e s to Fo Ch d Weaver Assistant City Attorney Resolution No. 2010—RO595 Congregate Nleals BUDGET WORKSHEET CERTIFICATION 1L11-V OI LUDDOCK AS SIGNER OF THIS BUDGET WORKSHEET, I HEREBY CERTIFY THAT: • I have read the note below and the instructions applicable to this budget worksheet. • I have reviewed this budget worksheet after its preparation. To the best of my knowledge and belief, this budget worksheet is true, correct and complete, and was prepared in accordance with the instructions applicable to this budget worksheet. • This budget worksheet was prepared from the books and records of the contracted provider. • I acknowledge that all books and records related to this rate setting process are subject to audit in accordance with contract requirements and all applicable federal and state laws. Note: The person legally responsible for the conduct of the contracted provider must sign this Budget Worksheet Certification. If a sole proprietor, the owner must sign the Budget Worksheet Certification. If a partnership, a partner must sign the Budget Worksheet Certification. If a corporation, the person authorized by the Board of Directors Resolution must sign the Budget Worksheet Certification. Misrepresentation of information contained in the budget worksheet may result in adverse action, up to and including contract termination. Furthermore, falsification of information in the budget worksheet may result in a referral for prosecution. City of Lubbock Tom Martin, Mayor Name of Contracted Provider October 1, 2010 Date Signer Authority: ❑ Sole Proprietor Printedlryped Name of Signer ❑ Association Officer Signature (check one) ❑ Partner ❑ Board Member ❑ Corporate Officer � Governmental Official Attest: Approv as to Conte App e to Fo Re ecca Garza Ra y Truesdell Wad Weaver City Secretary Community Services Director Assistant City Attorney Transportation BUDGET WORKSHEET CALCULATION OF THE UNIT RATE 1.Total Budgeted Expenses for Contract Year 2.Total Number of Anticipated Units to be Provided DADS A&I AAA - 10 % Program Match Required 2,723 Income DADS A&I AAA - 25 % Local Funds - Match Required 0 Eligible Trips Other Funds - DADS A&I AAA - Full Unit Non -Eligible Rate 0 Trips 3. Cost per unit (Line 1 divided by Line 2) - Full Unit Rate 265 Other Sources 6 0 1.201 Other Sources 7 Other Sources 8 Reimbursement Calculation for Contracts Requiring Unit Rate Match Reduction 1, $ 28,351.35 2. 4,189 3. $ 677 4. Mandatory Local Match of 10% $ 0.68 " if Applicable, Match Reduction From the In -kind Match Certification form $ - Required Match 4. $ 0.68 5.Full Unit Rate Less Required Match (Line 3 minus Line 4, 5, $ 6.09 4. Mandatory Local Match of 25% $ 1.69 If Applicable, Match Reduction From the In -kind Match Certification form $ - Required Match 4. $ 1.69 5.Full Unit Rate Less Required Match (Line 3 minus Line 4; 5. $ 5.08 "If any portion of the required match is in -kind, you must complete an In -Kind Match Certification form. Contract Reimbursed at Full Cost Per Unit Rate. Match Requirements Will Be Met Through Provision of Additional Units $ 6.77 Contractor Initial AAA Initial Citv of Lubbock Legal Name of Contracted Provider Signature Tom Martin, Mayor Pdnted/Typed Name of Signer South Plains _Associa ion., overnments e of Ar A envy on Bing yy\(P� Signat Tim C. Pierce Printedlryped Name of Signer 10/01 /10 10/01 /10 Date Date Attest: Approve as to Con App e s to Fo " . +Rebecca Garza Ra y Truesd 11 Chad Weaver City Secretary Community Services Director Assistant City Attorney I'ra[Is plIrtalion ORK.shVI' h C I'R'I IF I(' \ HO\ AS SIGNER OF THIS BUDGET WORKSHEET, 1 HEREBY CERTIFY THAT: • I have read the note below and the instructions applicable to this budget worksheet. • I have reviewed this budget worksheet after its preparation. • To the best of my knowledge and belief, this budget worksheet is true, correct and complete, and was prepared in accordance with the instructions applicable to this budget worksheet. • This budget worksheet was prepared from the books and records of the contracted provider. • I acknowledge that all books and records related to this rate setting process are subject to audit in accordance with contract requirements and all applicable federal and state laws. Note: The person legally responsible for the conduct of the contracted provider must sign this Budget Worksheet Certification. If a sole proprietor, the owner must sign the Budget Worksheet Certification. If a partnership, a partner must sign the Budget Worksheet Certification. If a corporation, the person authorized by the Board of Directors Resolution must sign the Budget Worksheet Certification. Misrepresentation of information contained in the budget worksheet may result in adverse action, up to and including contract termination. Furthermore, falsification of information in the budget worksheet may result in a referral for prosecution. City of Lubbock Tom Martin, Mayor Name of Contracted Provider Printedrryped Name ofSigner October 1, 2010 Date Signature Signer Authority: ❑ Sole Proprietor ❑ Association Officer (check one) 0Partner i] Board Member 1] Corporate Officer d Governmental Official Attest: Approv as to Con A ve44s to F Re cca Garza Ra dy Trues ll Chad Weaver City Secretary Community ervices Director Assistant City Attorney