2008-055 FDEP Grant Agreement for Earman River Water PipelineRESOLUTION 2008-55
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A RESOLUTION OF THE VILLAGE COUNCIL OF THE VILLAGE OF
NORTH PALM BEACH, FLORIDA, APPROVING A FINANCIAL
ASSISTANCE AGREEMENT WITH THE FLORIDA DEPARTMENT OF
ENVIRONMENTAL PROTECTION FOR GRANT FUNDS RELATING TO
THE REPLACEMENT OF THE EARMAN RIVER WATER PIPE LINE AND
AUTHORIZING THE MAYOR AND VILLAGE CLERK TO EXECUTE SAME;
AUTHORIZING THE EXPENDITURE OF MATCHING FUNDS; PROVIDING
FOR CONFLICTS; AND PROVIDING FOR AN EFFECTIVE DATE.
WHEREAS, the Village and the Florida Department of Environmental Protection ("DEP") are
seeking to enter into a Financial Assistance Agreement whereby DEP will provide the Village
with $85,000 in matching grant funds for replacement of the Earman River water pipe line; and
WHEREAS, the Village Council determines that the adoption of this Resolution is in the best
interests ofthe Village and its residents.
NOW, THEREFORE, BE IT RESOLVED BY THE VILLAGE COUNCIL OF THE VILLAGE
OF NORTH PALM BEACH, FLORIDA, as follows:
Section 1. The foregoing `whereas" clauses are hereby adopted and incorporated herein.
Section 2. The Village Council hereby approves the Financial Assistance Agreement between
the Village and DEP, a copy of which is attached hereto and incorporated herein, and authorizes
and directs the Mayor and Village Clerk to execute such Agreement on behalf of the Village.
Section 3. The Village Council hereby approves the expenditure ofnecessary matching funds in
the amount of$85,000.00 from Account No. A7321-66210 (Construction and Major Renovation).
Section 4. All resolutions or parts of resolutions in conflict with this Resolution aze hereby
repealed to the extent of such conflict.
Section 5. This Resolution shall be effective immediately upon adoption.
PASSED AND ADOPTED THIS 28th DAY OF AUGUST. 2008.
(Village Seal),
ATTEST;,.°"~~
~~ MAYOR
VILLAGE CLERK
STATE FINANCIAL ASSISTANCE AGREEMENT
VILLAGE OF NORTH PALM BEACH
DEP AGREEMENT NO. LP8954
STATE OF FLORIDA
GRANT ASSISTANCE
PURSUANT TO LINE ITEM 1772C OF THE 2008 - 2009 GENERAL APPROPRIATIONS ACT
THIS AGREEMENT is entered into between the STATE OF FLORIDA DEPARTMENT OF
ENVIRONMENTAL PROTECTION, whose address is 2600 Blair Stone Road, MS 3505, Tallahassee, Florida
32399-2400 (hereinafter referred to as the "Department") and the VILLAGE OF NORTH PALM BEACH, whose
address is 501 North Highway 1, North Palm Beach, Florida, 33408 (hereinafter referred to as "Grantee" or
"Recipient"), a local government under the laws of the State. of Florida, to provide funds for the North Palm Beach
Earman River Water Pipe Line Replacement project.
In consideration of the mutual benefits to be derived herefrom, the Department and the Grantee do hereby
agree as follows:
1. The Grantee does hereby agree to perform in accordance with the terms and conditions set forth in this
Agreement, Attachment A (Project Work Plan), and all attachments and exhibits named herein which are
attached hereto and incorporated by reference. For purposes of this Agreement, the terms "Contract" and
"Agreement" and the terms "Grantee", "Recipient" and "Contractor" are used interchangeably.
2. This Agreement shall begin upon execution by both parties and end no later than August 31, 2009,
inclusive. This Agreement may be amended to provide for additional services if additional funding is made
available by the Legislature.
3. A. As consideration for the services rendered by the Grantee under the terms of this Agreement, the
Department shall pay the Grantee on a cost reimbursement basis in an amount not to exceed
$85,000 toward the total project cost estimate of $170,000. The parties hereto agree that the
Grantee is responsible for providing a minimum match of $85,000 toward the project described in
Attachment A. Prior written approval from the Department's Grant Manager shall be required for
changes between budget categories of up to 10% of the total budget. The Department's Grant
Manager will transmit a copy of the written approval and revised budget to the Department's
Contracts Disbursements Office for inclusion in the Agreement file. Changes greater than ]0%
will require a formal amendment to the Agreement. If the Grantee finds, after receipt of
competitive bids, that the work described in Attachment A cannot be accomplished for the current
estimated project cost, the parties hereto agree to modify the Project Work Plan described in
Attachment A to provide for the work that can be accomplished for the funding identified above.
B. The Grantee shall be reimbursed on a cost reimbursement basis for all eligible project costs upon
receipt and acceptance of a properly completed Disbursement Request Package (provided as
Attachment B). In addition to the Disbursement Request Package, the Grantee must provide from
its accounting system, a listing of expenditures charged against this Agreement. The listing shall
include, at a minimum, a description of the goods or services purchased, date of the transaction,
voucher number, amount paid, and vendor name. All requests for reimbursement of travel
expenses shall be in accordance with the travel limits established in Section 112.061, Florida
Statutes. The Disbursement Request Package must include:
(1) A completed Disbursement Request Form signed by the Grantee's Grant Manager. Such
requests must be accompanied by sufficiently itemized summaries of the materials, labor, or
services to identify the nature of the work performed; the cost or charges for such work; and
the person providing the service or performing the work. If payment is based on an
authorized advance for incurred costs, invoices reflecting such costs must be included. After
receipt of advance funds the Grantee shall provide proof of payment to the Department
DEP Agreement No. LP8954, Page 1 of 6
within thirty (30) days of receipt of the advance funds. If payment is based on
reimbursement, proof of payment of the invoices is required.
(2) A certification signed by the Grantee's Grant Manager as to the current estimated cost of the
Project; that the materials, labor, or services represented by the invoice have been
satisfactorily purchased, performed, or received and applied to the project; that all funds
received to date have been applied toward completing the Project; and that under the terms
and provisions of the contracts, the Grantee is required to make such payments.
(3) A certification by the engineer responsible for overseeing constmction stating that
equipment, materials, labor and services represented by the construction invoices have been
satisfactorily invoiced, purchased, or received, and applied to the Project in accordance with
constmction contract documents; stating that payment is in accordance with constmction
contract provisions; stating that construction, up to the point of the requisition, is in
compliance with the contract documents; and identifying all additions or deletions to the
Project which have altered the Project's performance standards, scope, or purpose since the
issue of the Departrnent constmction permit.
(4) Such other certificates or documents by engineers, attorneys, accountants, contractors, or
suppliers as may reasonably be required by the Department.
C. In addition to the invoicing requirements contained in paragraph 3.B. above, the Department will
periodically request proof of a transaction (invoice, payroll register, etc.) to evaluate the
appropriateness of costs to the Agreement pursuant to State and Federal guidelines (including cost
allocation guidelines), as appropriate. This information when requested must be provided within
thirty (30) calendar days of such request. The Grantee may also be required to submit a cost
allocation plan to the Department in support of its multipliers (overhead, indirect, general
administrative costs, and fringe benefits). All bills for amounts due under this Agreement shall be
submitted in detail sufficient for a proper pre-audit and post-audit thereof.
D. State guidelines for allowable costs can be found in the Department of Financial Services'
Reference Guide for State Expendimres at htro //www fldfs com/aadir/reference%SFeuide.
4. The State of Florida's performance and obligation to pay under this Agreement is contingent upon an annual
appropriation by the Legislature. The parties hereto understand that this Agreement is not a commitment of
furore appropriations.
5. Progress Reports (Attachment C) shall be submitted describing the work performed, problems
encountered, problem resolution, schedule updates and proposed work for the next reporting period.
Progress reports shall be submitted along with the Disbursement Request Package, described th paragraph
3.B. [f advance payment is authorized, the Grantee shall report (and document as required under paragraph
3 above and on Attachment E) the amount of funds expended during the reporting period, the Agreement
expenditures to date, interest earned during the quarter and clearly indicate the method for repayment of the
interest to the Department (see paragraph 16). It is understood and agreed by the parties that the term
"reporting period" reflects the period of time for which the invoices submitted in the Disbursement Request
Package are covered. The Department's Grant Manager shall have ten (10) calendar days to review
deliverables submitted by the Grantee.
6. Each party hereto agrees that it shall be solely responsible for the negligent. or wrongful acts of its
employees and agents. However, nothing contained herein shall constitute a waiver by either party of its
sovereign immunity or the provisions of Section 768.28, Florida Statutes.
7. A. The Department may terminate this Agreement at any time in the event of the failure of the
Grantee to fulfill any of its obligations under [his Agreement. Prior to termination, the Department
DEP Agreement No. LP8954, Page 2 of 6
shall provide thirty (30) calendar days written notice of its intent to terminate and shall provide the
Grantee an opportunity to consult with the Department regarding the reason(s) for termination.
B. The Department may terminate this Agreement for convenience by providing the Grantee with
thirty (30) calendar days written notice.
8. This Agreement may be unilaterally canceled by the Department for refusal by the Grantee to allow public
access to all documents, papers, letters, or other material made or received by the Grantee in conjunction
with this Agreement, unless the records are exempt from Section 24(a) of Article I of the State Constitution
and Section 119.07(1), Florida Statutes.
9. A. The Grantee shall comply with the applicable provisions contained in Attachment D (Special Audit
Requirements), attached hereto and made a part hereof. Exhibit 1 to Attachment D summarizes the
funding sources supporting the Agreement for purposed of assisting the Grantee in complying with
the requirements of Attachment D. A revised copy of Exhibit 1 must be provided to the Grantee for
each amendment, which authorizes a funding increase or decrease. [f the Grantee fails to receive a
revised copy of Exhibit 1, the Grantee shall notify the Deparhnent's Grant Manager identified in this
Agreement to request a copy of the updated information.
B. The Grantee is hereby advised that the Federal and/or Florida Single Audit Act Requirements may
further apply to lower tier transactions that may be a result of this Agreement. The Grantee shall
consider the type of financial assistance (federal and/or state) identified in Attachment D, Exhibit 1
when making its determination. For federal financial assistance, the Grantee shall use the guidance
provided under OMB Circular A-133, Subpart B, Section _.210 for determining whether the
relationship represents that of a subrecipient or vendor. For state financial assistance, the Grantee
shall use the form entitled "Checklist for Nonstate Organizations RecipienUSubrecipient vs Vendor
Determination" (form number DPS-A2-NS) that can be found under the "Links/Forms" section
appearing at the following website:
htro://apps. fldfs. com/fsaa
The Grantee should confer with its chief fmancial officer, audit director, or contact the Department for
assistance with questions pertaining to the applicability of these requirements.
10. The Grantee may subcontract, assign, or transfer any work under this Agreement without the written
consent of the Department's Grant Manager. The Grantee shall submit a copy of the subcontract upon the
request of the Department's Grant Manager. The Grantee agrees to be responsible for the fulfillment of all
work elements included in any subcontract consented to by the Department and agrees to be responsible for
the payment of all monies due under any subcontract. It is understood and agreed by the Grantee that the
Department shall not be liable to any subcontractor for any expenses or liabilities incurred under the
subcontract and that the Grantee shall be solely liable to the subcontractor for all expenses and liabilities
incurred under the subcontract.
11. The Department of Environmental Protection supports diversity in its procurement program and requests
that all subcontracting opportunities afforded by this Agreement embrace diversity enthusiastically. The
award of subcontracts should reflect the full diversity of the citizens of the State of Florida. A list of
minority owned firms that could be offered subcontracting opportunities may be obtained by contacting the
Florida Department of Management Services, Office of Supplier Diversity, at 850/487-0915.
12. In accordance with Section 216.347, Florida Statutes, the Grantee is hereby prohibited from using funds
provided by this Agreement for the purpose of lobbying the Legislature, the judicial branch or a state
agency.
DEP Agreement No. LP8954, Page 3 of 6
13. The Grantee shall comply with all applicable federal, state and local rules and regulations in providing
services to the Department under this Agreement. The Grantee acknowledges that this requirement includes
compliance with all applicable federal, state and local health and safety rules and regulations. The Grantee
further agrees to include this provision in all subcontracts issued as a result of this Agreement.
14. The Department's Grant Manager for this Agreement is identified below.
Tommy Williams
Bureau of Water Facilities Funding
Florida Department of Environmental Protection
2600 Blair Stone Road, MS 3505
Tallahassee, Florida 32399-2400
Phone: 850-245-8358
Fax: 850-245-8411
Email: thomas.e.williams@depstate.B.us
15. The Grantee's Grant Manager for this Agreement is identified below.
Charles Huf[
Village of North Palm Beach
501 North Highway 1
North Palm Beach, Florida 33408
Phone: 561-348-0697
Fax: 561-848-3344
Email: chuff@village-npb.org
16. In accordance with Section 216.181(16)(b), Florida Statutes, the Department, upon written request from
the Grantee and written approval from the State's Chief Financial Officer, if applicable, may provide an
advance to the Grantee. The Grantee must temporarily invest the advanced funds, and return any interest
income [o the Department, within thirty (30) days of each calendar quarter, or apply said interest income
against the Deparhnent's obligation to pay, if applicable, under this Agreement. Interest earned must be
resumed to the Department within the timeframe identified above or invoices must be received within the
same timeframe that shows the offset of the interest earned.
Unused funds, and interest accrued on any unused portion of advanced funds that have not been remitted to
the Department, shall be returned to the Department within sixty (60) days of Agreement completion.
The parties hereto acknowledge that the State's Chief Financial Officer may identify additional
requirements, which must be met in order for advance payment to be authorized. If the State's Chief
Financial Officer imposes additional requirements, the Grantee shall be notified, in writing, by the
Department's Grant Manager regarding the additional requirements. Priot to releasing any advanced funds,
the Grantee shall be required to provide a written acknowledgement to the Department's Grant Manager of
the Grantee's acceptance of the terms imposed by the State's Chief Financial Officer for release of the
funds.
If advance payment is authorized, the Grantee shall be responsible for submitting the information requested
in the Interest Earned Memorandum (Attachment E) and the Advance Payment Justification Form
(Attachment F) to the Department's Grant Manager quarterly. This information shall be requested by the
Grant Manager and submitted by the Grantee on a quarterly basis in conjunction with the invoice/reporting
requirements established in paragraphs 3 and 5.
17. To the extent required by law, the Grantee will be self-insured against, or will secure and maintain during
[he life of this Agreement, Workers' Compensation Insurance for all of his employees connected with the
work of this project and, in case any work is subcontracted, the Grantee shall require the subcontractor
similarly to provide Workers' Compensation Insurance for all of the tatter's employees unless such
DEP Agreement No. LP8954, Page 4 of 6
employees are covered by the protection afforded by the Grantee. Such self-insurance program or insurance
coverage shall comply fully with the Florida Workers' Compensation law. In case any class of employees
engaged in hazardous work under this Agreement is not protected under Workers' Compensation statutes,
the Grantee shall provide, and cause each subcontractor to provide, adequate insurance satisfactory to the
Department, for the protection of those employees not otherwise protected.
18. The Grantee, as an independent contractor and not an agent, representative, or employee of the Department,
agrees to carry adequate liability and other appropriate forms of insurance. The Department shall have no
liability except as specifically provided in this Agreement.
19. The Grantee covenants that it presently has no interest and shall not acquire any interest that would conflict
in any manner or degree with the performance of services required.
20. The purchase of non expendable personal property or equipment costing $1,000 or more is not authorized
under [he terms of this Agreement.
21. The Department may at any time, by wtitten order designated to be a change order, make any change in the
Project Work Plan within the general scope of this Agreement (e.g., specifications, task timeline within
current authorized agreement period, method or manner of performance, requirements, etc.). All change
orders are subject to the mutual agreement of both parties as evidenced in writing. Any change order that
causes an increase or decrease in the Grantee's cost or time shall require formal amendment to this
Agreement.
22. A. No person, on the grounds of race, creed, color, national origin, age, sex, or disability, shall be
excluded from participation in; be denied the proceeds or benefits of; or be otherwise subjected to
discrimination in performance of this Agreement.
B. An entity or affiliate who has been placed on the discriminatory vendor list may not submit a bid
on a contract to provide goods or services to a public entity, may not submit a bid on a contract
with a public entity for the construction or repair of a public building or public work, may not
submit bids on leases of real property to a public entity, may not award or perform work as a
contractor, supplier, subcontractor, or consultant under contract with any public entity, and may
not transact business with any public entity. The Florida Department of Management Services is
responsible for maintaining the discriminatory vendor list and intends to post the list on its website.
Questions regarding the discriminatory vendor list may be directed to the Florida Department of
Management Services, Office of Supplier Diversity, at 850/487-0915.
23. Land acquisition is not authorized under the terms of this Agreement.
24. This Agreement represents the entire agreement of the parties. Any alterations, variations, changes,
modifications or waivers of provisions of this Agreement shall only be valid when they have been reduced
to writing, duly signed by each of the parties hereto, and attached to the original of this Agreement, unless
otherwise provided herein.
DEP Agreement No. LP8954, Page 5 of 6
IN WITNESS WHEREOF, the parties have caused this Agreement to be duly executed, the day and yeaz
last written below.
VILLAGE OF NORTH PALM BEACH
By~tF~ 11Manue1, M or
STATE OF FLORIDA DEPARTMENT OF
ENVIRONMENTAL PROTECTION
By;
Deputy Director
Division of Water Resource Management
Date:~~t/ O
Attest: ~k~'~~~Q.
Village Clerk
FEID No.: 59-6017984
SEP 0 2 2008
/~ ~
Tommy Willi s, DEP Grant Manager
*For Agreements with governmental boazds/commissions: If someone other than the Chairman signs this
Agreement, a resolution, statement or other document authorizing that person to sign the Agreement on behalf of the
governmental boazd/commission must accompany the Agreement.
List ofattachments/exhibits included as part of this Agreement
Specify Letter/ Description (include number of pages)
Type Number
Attachment A Project Work Plan (4 Pages)
Attachment B Disbursement Request Package (3 Pages)
Attachment C Progress Report Fomt (2 Pages)
Attachment D Special Audit Requirements (5 Pages)
Attachment E Advance Payment- Interest Earned Memorandum (I Page)
Attachment F Advance Payment Justification Form (3 Pages)
DEP Agreement No. LP8954, Page 6 of 6
ATTACHMENT A
GRANT WORK PLAN
Village of North Palm Beach
LP8954
Project Title: North Palm Beach Earman River Water Pi a Line Replacement
Project Location: The project is located in the Village of North Palm Beach, in Palm Beach
County. The pipe line to be replaced crosses the North Palm Beach Waterway (a tributary of the
Earman River), neaz Shore Drive across the waterway to the retention pond on the North Palm
Beach Country Club pro erty.
Project Background:
The current water supply pipe line from the Earman River to the Village's retention pond has
numerous leaks from the failure of its joints. The Village's engineering consultants have
determined that the complete failure of this water supply line is imminent. As a result of the
consultants' review, the Village will abandon the existing pipe line and replace it by the process
of directional boring. The project will also include the installation of a one-piece pipe line.
Project Objectives: Provide a list of objectives, in bullet format, expected to be achieved as a
result offunding/completing this proposed project.
• Objective 1: Continue the water supply to North Palm Beach Village properties by
replacing the current pipeline.
• Objective 2: Avoid complete failure of current line which will result in damage to
Village properties including costly damage to the Village's newly renovated golf course.
• Objective 3: Dramatically reduce the disturbance to natural habitats in and around the
Earman and its tributaries by installing the new pipeline by directional bore.
• Objective 4: Use materials that will maximize the pipe line's life (200 years).
Project Description:
The replacement of the water pipe line will will begin with boring from the eastern end of
Pelican Way, underneath the North Palm Beach Waterway/Intracoastal Waterway, to the basin
where the existing supply pipe is encased. A 12-inch High Density Pipe will then be inserted
following the bore path. The pipe will be hot fused every 20 feet as to create one solid,
continuous pipe. The effectiveness of this project will be monitored. The new pipe is expected
to last at least 200 years.
DEP Agreement #####, Attachment A, Page I of 4
This project will provide a substantial benefit as it will replace a pipe line that is failing and
expected to completely fail in the near future. Using the process of directional boring will allow
the pipe to be place in and around the Intracoastal Waterway without excessive damage to
natural habitats. The use of the hot fusing process to create one continuous pipe will ensure the
ability to carry water to Village properties for the 200 years. This pipeline also helps to keep the
water levels of two basins balanced with varying rainfall.
The use of directional boring in this project will allow the Village to maintain a water supply to
its properties without adverse effects to submerged natura] resources in the Intracoastal
Waterway. Since the boring will create a narrow path underneath the earth bottom of the North
Palm Beach Waterway, submerged and waterside habitats will be preserved.
The Village of North Palm Beach is committed to providing a 50% match of $85,000 for this
project. The project is planned to begin early August 2008 and will not take more than one
month to complete which well within the grant period. The Village's Public Works staff has
long been responsible for monitoring the Village's water supply lines. This monitoring
responsibility will continue indefinitely after the project's completion.
Project Milestones/Deliverables/Outputs: Identify by task/activiry (as listed under Project
Description), start date, and completion date. Clear cells in table below header row before
beginning to add data. Identify outputs/deliverables to result from this project. (Examples
include: reports (progress, draft project report, final project report), manuals, videos, maps,
BMPs installed, meetings, field days, issued permits, progress reports, quality assurance plans,
etc.) Identify dates for providing/completing the outputs/deliverables on a schedule based on the
date of agreement execution. Format should appear as follows:
No.
Task/Activity
Descri lion
e Start
Complete
Deliverables/Outputs Deliverable/Output
Due Dates
] Directional bore 08-10-08 08-20-08 None
2 Installation and
hot fusing of
new pipeline 08-20-08 08-30-08 None
3 Testing of new
i eline o8-30-08 09-07-08 Results of testing 09-I 5-08
~/,~1(oq
iw b
DEP Agreement #####, Attachment A, Page 2 of 4
Project Budget: Detailed budgets must be submitted to support the budget information
summarized in this section. Detailed budgets should be developed on a task-by-task basis.
u,,.d„or ;,,! .-,,,.,r;.,., ~,,,,,,.,.r;,,n nll mntrh ovnortall fnr this nrnicrt must al.cn he nravided.
Project Funding Matchin Funds and Source
Activity DEP Grant Funding Fundin Source of Funds
Professional Services:
Construction &
Demolition: $85,000 $85,000 Village Funds
Land:
E ui ment:
Other (list):
Other (list):
Total:
Total Project Cost: $85,000 $85,000
Match Required: $85,000 Amount of Match: 50%
Project Budget Narrative: Provide budget detail for each Project Fundingilctivity stated
above for both DEP Funding and Match. Construction costs include directional boring,
installation of new pipe line and its testing. ~,
Professional Services: What services will be subcontracted? All services will be contracted
with a single firm who specializes in the installation of pipe line through directional boring.
Construction & Demolition: What is being constructed, rehabilitated, expanded, etc? A water
pipe line will be installed.
Land: What size is the property? What is its use? The project site is the North Palm Beach
Waterway and a North Palm Beach Country Club water retention area.
Equipment: What equipment will be purchased? Eguipment is $1,000 or more per unit cost.
This project does not include the purchase of any equipment.
Other: List the service or category of expenditure. What are the funds for?
NOTE: IF THERE IS MATCH, THE SAME DETAIL MUST BE PROVIDED FOR THE
MATCH.
Total Budget by Task: This should correspond with the tasks/activities identified and described
above.
DEP Grant Matchin Funds and Source
Task Funding Matchin Funds Source of Funds
1 Boring & installation $85,000 $85,000 Village Funds
2
3
4
5
6
DEP Agreement #####, Attachment A, Page 3 of 4
Total: $85,000 $85,000
Project Total: $170,000
Measures of Success: Identify factors that can be used to evaluate project performance/
outcomes to support project success. Include appropriate timelines for conducting such reviews.
The contractor will test new pipe once installed. The Village's Public Works Department will
run periodic tests on the pipe line as it does its other water pipe lines.
Note that any changes to the Grant Work Plan Project Budget (of more than 10% in any line
item), scope of work, or timelines shall require Department approval and amendment to the grant
agreement.
DEP Agreement #####, Attachment A, Page 4 of 4
ATTACHMENT B
Disbursement Request Package
Legislative Projects (LP) Grants
1. Grantee/Recipient VILLAGE OF NORTH PALM BEACH
2. Project Number LP8954 Date of Request
3. Disbursement Request Number Required Match
4. Type of Request: Partial ^ Final ^
5. Federal Employer Identification Number
6. Mail ^ EFT ^ Send Remittance to:
Disbursement Details
(cumulative amounts rounded to the nearest dollar)
1. Professional Services (attach invoices)
2. Construction and Demolition (attach invoices)
3. Equipment (attach invoices)
4. Land (attach invoices)
5. Other (list -must be specified in agreement)
6. Total cumulative to date
7. Disbursements previously requested
8. Amount requested for disbursement (line 6 minus line 7) $
Requests for Invoices already Paid: Requests for Invoices not yet Paid:
1) Copy of Invoice 1) Copy of Invoice
2) Proof of Payment 2) Advance Payment Justification (one per quarter)
3) Advance Payment -interest Earned (after initial advance)
*If prior Disbursement Request was requested by invoices without proof of payment documentation, proof of the
prior payment will be required before this request can be disbursed.
** SUBMIT ONE ORIGINAL COPY OF THIS FORM AND SUPPORTING DOCUMENTATION TO: **
Florida Department of Environmental Protection
Bureau of Water Facilities Funding MS 3505
2600 Blair Stone Road
Tallahassee, Florida 32399-2400
DEP Agreement No. LP8954, Attachment B, Page 1 of 3
Grant Manager's Certification
of Disbursement Request
(name of Grantee's Grant Manager designated in [he Agreement)
on behalf of , do hereby certify that:
(name of Grantee/Recipient)
1. The disbursement amount requested on Page 1 of this form is for allowable costs for [he project described in the
Agreement;
2. Materials, labor, equipment, and/or services representing costs included in the amount requested have been
satisfactorily purchased, performed or received, and applied toward completing [he project; such costs are
documented by invoices or other appropriate documentation which are filed in the Grantee's permanent records;
3. The Grantee is required to pay such costs under the terms and provisions of contracts relating directly to the project;
and the Grantee is not in default of any terms or provisions of the contracts;
4. All funds received to date have been applied toward completing the project; and
5. All permits and approvals required for the construction which is underway have been obtained.
( Signature of Grant Manager)
(Date)
DEP Agreement No. LP8954, Attachment B, Page 2 of 3
Engineer's Certification
of Disbursement Request
I ,being [he Professional Engineer retained by
(name of Professional Engineer)
am responsible for overseeing construction of the
(name of Grantee/Recipient)
project described in the Agreement and do hereby certify [hat:
]. Equipment, materials, labor, and services represented by the construction invoices have been satisfactorily purchased
or received and applied [o the project in accordance with construction contract documents filed with and previously
approved by the Department of Environmental Protection;
2. Payment is in accordance with construction contract provisions;
3. Adequate construction supervision is being provided to assure compliance with construction requirements and
Florida Administrative Code Chapter 62-600 or Chapter 62-604, as appropriate;
4. Construction up to [he point of this disbursement is in compliance with the contract documents;
5. All changes, additions, or deletions to [he construction contract(s) have been documented by change order and all
change orders have been submitted to the Department; and
6. All additions or deletions to the Project which have altered the Project's performance standards, scope, or purpose
(since issue of [he pertinent Department permit) have been identified in writing to the Department or are identified
and attached hereto.
Signature of Professional Engineer
Firm or Affiliation
(Dale) (P.E. Number)
DEP Agreement No. LP8954, Attachment B, Page 3 of 3
ATTACHMENT C
PROGRESS REPORT FORM
DEP A reement No.: LP8954
Grantee Name: VILLAGE OF NORTH PALM BEACH
Grantee Address:
Grantee's Grant Mana er: Tele hone No.:
Quarterl Re ortin Period:
Pro'ect Number and Title:
Provide a summary of project accomplishments to date. (Include a comparison of actual
accomplishments to the objectives established for the period. If goals were not met,
provide reasons why.)
Provide an update on the estimated time for completion of the project and an explanation for
any anticipated delays.
Provide any additional pertinent information including, when appropriate, analysis and
explanation of cost overruns or high unit costs.
DEP Agreement No. LP8954, Attachment C, Page I of 2
(continued from page 1)
Identify below, and attach copies of, any relevant work products being submitted for the
project for this reporting period (e.g., report data sets, links to on-line photographs, etc.)
Provide a project budget update, com
Total Project
Bud et Cate o Bud et aring the project budget to actual costs to date.
Expenditures
Prior to this Expenditures
Reporting this Reporting Project Funding
Period Period Balance
This report is submitted in accordance with the reporting requirements of DEP Agreement No.
LP8954 and accurately reflects the activities and costs associated with the subject project.
Signature of Grantee's Grant Manager
Date
DEP Agreement No. LP8954, Attachment C, Page 2 of 2
ATTACHMENT D
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
(whrch 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-] 33, 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 instmctions 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 anon-profit organization as defined in OMB
Circular A-133, as revised.
In the event that the recipient expends $500,000 or more in Federal awazds 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 [o this Agreement indicates Federal funds awarded through the Department
of Environmental Protection by this Agreement. In determining the Federal awards expended in its fiscal
year, the recipient shall consider all sources of Federal awards, including Federal resources received from
the Department of Environmental Protection. The determination of amounts of Federal awards expended
should be in accordance with the guidelines established by OMB Circular A-133, as revised. An audit of the
recipient conducted by the Auditor General in accordance with the provisions of OMB Circular A-133, as
revised, will meet the requirements of this part.
2. In connection with the audit requirements addressed in Part 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.
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 awazds 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 intemet at htto://12.46.245.173/cfda/cfda.html.
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.
In the event that the recipient expends a total amount of State Enancial assistance equal to or in excess of
$500,000 in any fiscal year of such recipient, the recipient must have a State single or project-specific audit
for such fiscal year in accordance with Section 215.97, Florida Statutes; applicable rules of the Department
of Financial Services; and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and for-profit
DEP Agreement No. LP8954, Attachment D, Page 1 of 5
organizations), Rules of the Auditor General. EXHIBIT 1 to this Agreement indicates State Financial
assistance awarded through the Department of Environmental Protection by this Agreement. In determining
the State financial assistance expended in its fiscal year, the recipient shall consider all sources of State
financial assistance, including State financial assistance received from the Department of Environmental
Protection, other state agencies, and other nonstate entities. State financial assistance does not include
Federal direct or pass-through awards and resources received by a nonstate entity for Federal program
matching requirements.
2. In connection with the audit requirements addressed in Part II, paragraph 1; the recipient shall ensure that
the audit complies with the requirements of Section 215.97(7), Florida Statutes. This includes submission of
a financial reporting package as defined by Section 215.97(2), Florida Statutes, and Chapters 10.550 (local
governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General.
3. If the recipient expends less than $500,000 in State financial assistance in its fiscal year, an audit conducted
in accordance with the provisions of Section 215.97, Florida Statutes, is not required. In the event that the
recipient expends less than $500,000 in State financial assistance in its fiscal year, and elects to have an
audit conducted in accordance with the provisions of Section 215.97, Florida Statutes, the cost of the audit
must be paid from the non-State entity's resources (i.e., the cost of such an audit must be paid from [he
recipient's resources obtained from other than S[a[e entities).
4. For information regarding the Florida Catalog of State Financial Assistance (CSFA), a recipient should
access the Florida Single Audi[ Act website located at httos://apps.fldfs.com/fsaa for assistance. In
addition to the above websites, the following websites may be accessed for information: Legislature's
Website at http://www.le¢state.fl.us/Welcome/index.cfm, State of Florida's website at
http://www.myflorida.com/, Department of Financial Services' Website at http://www.fldfs.com/ and the
Auditor General's Website at http://www.state.fl.us/audeen.
PART III: OTHER AUDIT REQUIREMENTS
(NOTE: This part would be used to sped any additional audit requirements imposed by the State awarding entity
that are solely a matter of that State awarding entity's policy (i. e., the audit is not required by Federal or State laws
and is not in conflict with other Federal or State audit requirements). Pursuant to Section 2!5.97(8), Florida
Statutes, State agencies may conduct or arrange for audits of State financial assistance [hat are in addition to audits
conducted in accordance with Section 215.97, Florida Statutes. /n such an event, the State awarding agency must
arrange for funding the full cost of such additional audits.)
PART IV: REPORT SUBMISSION
Copies of reporting packages for audits conducted in accordance with OMB Circular A-133, as revised, and
required by PART I of this Attachment shall be submitted, when required by Section .320 (d), OMB
Circular A-133, as revised, by or on behalf of the recipient directly to each of the following:
A. The Department of Environmental Protection at the following address:
Audit Director
Florida Department of Environmental Protection
Office of the Inspector General, MS 40
3900 Commonwealth Boulevard
Tallahassee, Florida 32399-3000
B. The Federal Audit Clearinghouse designated in OMB Circular A-133, as revised (the number of
copies required by Sections .320 (d)(I) and (2), OMB Circular A-133, as revised, should be
submitted to the Federal Audit Clearinghouse), at the following address:
Federal Audit Clearinghouse
Bureau of the Census
1201 East 10th Street
Jeffersonville, IN 47132
DEP Agreement No. LP8954, Attachment D, Page 2 of 5
C. Other Federal agencies and pass-through entities in accordance with Sections .320 (e) and (f),
OMB Circular A-133, as revised.
2. Pursuant to Section .320(f), OMB Circular A-133, as revised, the recipient shall submit a copy of the
reporting package described in Section .320(c), OMB Circular A-133, as revised, and any management
letters issued by the auditor, to the Department of Environmental Protection the following address:
Audit Director
Florida Departtnent of Environmental Protection
Office of the Inspector General, MS 40
3900 Commonwealth Boulevard
Tallahassee, Florida 32399-3000
Copies of financial reporting packages required by PART II of this Attachment shall be submitted by or on
behalf of the recipient direct) to each of the following:
A. The Department of Environmental Protection at the following address:
Audit Director
Florida Department of Environmental Protection
Office of the Inspector General, MS 40
3900 Commonwealth Boulevard
Tallahassee, Florida 32399-3000
B. The Auditor General's Office at the following address:
State of Florida Auditor General
Room 401, Claude Pepper Building
111 West Madison Street
Tallahassee, Florida 32399-1450
4. Copies of reports or management letters required by PART III of this Attachment shall be submitted by or
on behalf of the recipient directly to the Department of Endvonmental Protection at the following address:
Audit Director
Florida Department of Environmental Protection
Office of the Inspector General, MS 40
3900 Commonwealth Boulevard
Tallahassee, Florida 32399-3000
5. Any reports, management letters, or other information required to be submitted to the Department of
Environmental Protection pursuant to this Agreement shall be submitted timely in accordance with OMB
Circular A-133, Florida Statutes, or Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and
for-profit organizations), Rules of the Auditor General, as applicable.
6. Recipients, when submitting financial reporting packages to the Department of Environmental Protection
for audits done in accordance with OMB Circular A-133, or Chapters 10.550 (local governmental entities)
or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General, should indicate the date
that the reporting package was delivered to the recipient in correspondence accompanying the reporting
package.
DEP Agreement No. LP8954, Attachment D, Page 3 of 5
PART V: RECORD RETENTION
The recipient shall retain sufficient records demonstrating its compliance with the terms of this Agreement for a
period of 5 years from the date the audit report is issued, and shall allow the Department of Environmental
Protection, or its designee, Chief Financial Officer, or Auditor General access to such records upon request. The
recipient shall ensure that audit working papers are made available to the Department of Environmental Protection,
or its designee, Chief Financial Officer, or Auditor General upon request for a period of 3 yeazs from the date the
audit report is issued, unless extended in writing by the Department of Environmental Protection.
REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
DEP Agreement No. LP8954, Attachment D, Page 4 of 5
EXHIBIT - t
FUNDS A WARDED TO THE RECIPIENT PURSUANT TO THIS AGREEMENT CONSIST OF THE FOLLOWING:
Federal Funds Awarded to the Reci lent Pursuant to [his A reement Consist of the Followin
Federal
Program
Number
Federal A enc
CFDA
Number
CFDA Title
Fundin Amount State
Appropriation
Cate o
State Funds Awarded to the Reci lent Pursuant to this A reement Consist of the Followin Matchin Funds for Federal Pro rams:
Federal
Program
Number
Federal A enc
CFDA
CFDA Title
Fundin Amount State
Appropriation
Cate o
State Funds Awarded to the Reci lent Pursuant to this A reement Consist of the Followin Funds Sub'ect of Section 215.97, F.S.:
State
Program
Number
undin Source
tale
Fiscal Year Catalog of
State
Financial
Assistance
Number
CSFA Title
or
Fundin Source Descri tion
undin Amount
State
Appropriation
Cate o
Original
A reement LI 1772C -Ecosystem
Mana ement & Restoration TF 2008-2009 37.039 Statewide Surface Water Restoration
and Wastewater Pro~ects $85,000 140047-09
Total Award $85,000
For each program identified above, the recipient shall comply with the program requirements described in the Catalog of Federal Domestic Assistance (CFDA)
[http://12.46.245.173/cfda/cfda.html] and/or the Florida Catalog of State Financial Assistance (CSFA) [https://apps.fldfs.com/fsaa/searchCa[alog.aspx ]. The
services/purposes for which the funds are to be used are included in the Contract scope of services/work. Any match required by the recipient is clearly indicated in the
Contract.
DEP Agreement No. LP8954, Attachment D, Page 5 of 5
ATTACHMENT E
ADVANCE PAYMENT - INTEREST(' EARNED MEMORANDUM
WHEN REPORTING OR REMITTING, PLEASE RETURN A COPY OF THIS REQUEST
TO:
FROM: Darinda McLaughlin, Finance and Accounting Director
Bureau of Finance and Accounting, MS 78
DATE:
SUBJECT: Advance Payment -Contract No.
Interest Due to DEP:
Pursuant to Section 216.181(16), Florida Statutes, advance payments may be required to be deposited into an interest bearing account
until all funds have been depleted. In order to update the status on the unused portion of the advanced funds and/or interest due,
advance approval of the Chief Financial Officer, and the terms of the above referenced contract, the following information is needed
for our records no later than
Initial advance funding disbursed
1. Advanced funds principle expended or returned by contractor covering period of
to
2. Balance advance funding principle available
3. Interest earned on advanced funds covering period of to
4. Amount of interest paid to DEP as of
5. Interest balance due to DEP as of
(Project Manager's Signature) (Date)
Special Instructions: If the granUcontract speci5es that any accrued interest, which is based upon agrant/contract advance payment(s),
will not be paid to DEP until after termination of the grantlcontract, the advance fund recipient shall complete report items 1 and 2
only for the firs[ three quarters of the state's fiscal year. The report for [he state's fourth fiscal year quarter shall include items 1, 2, 3,
4, and 5. Items 3, 4, and 5 will be the life to date interest
If the contract states that no interest is due, quarterly reports of unexpended advances are required, lines I and 2.
In all cases the line 1 and 2 reported amounts are on a cash basis for the advance payment principle. Do not include receivables,
payables, or interest previously paid to DEP.
If the grandcontract requires quarterly accrued interest payments to DEP, the fund recipient must complete items 1 through 5 for each
quarterly report.
Payments of interest due to DEP shall be paid within the specifications of the contracUgrant.
Thank you for your cooperation in providing the above information. If you have questions, please contact Lydia Louis (850) 245-2452
in the Contracts Disbursement Section.
DEP Agreement No. LP8954, Attachment E, Page 1 of 1
ATTACHMENT F
ADVANCE PAYMENT JUSTIFICATON FORM
Use of this form is not required unless the advance requested requires the prior approval of [he State Chief Financial
Officer. For advance requests that are equal to or less than the purchasing threshold of category two as defined in
Section 287.017, Florida Statutes, and meet one of the advance payment requirements identified in Section 215.422(14),
Florida Statutes, use of [his form is waived. However, the purchase requisition or contract review form must clearly
identify the criteria being met under 215.422(14), Florida Statutes that allows the advance to be made without prior Chief
Financial Officer's approval.
Name/Address of the Vendor/Recipient:
.~ Contact Person/Phone No.:
Agreement No./Purchase Order No. (if known): LP8954
Commodities/Services/Project Description:
Organizational Structure
i.e. local ov't non- rofit cor oration etc.
Value of Purchase or Grant:
Advance Payment Amount Requested:
Period Advance Payment to Cover: ^ 90 days startup ^ Full Contract Period
^ uarterl ^ Other s ecif
indicate Statutory Authority: ^ 215.422, F.S ^ 216.181, F.S.
GAA Year and line Item Info: SFY: Line Item:
1. Reason advance payment is required:
2. The following information required for advances requested pursuant to 215.422, Florida Statues
(and the Reference Guide for State Expenditures) which exceed the purchasing threshold of category
two as defined in 257.017 Florida Statues.
A. Document, if applicable, the cost savings to be incurred as a result of an advance payment that are equal or
greater than the amount the State would earn by investing the funds and paying in arrears. Include the percent
(%) savings to be realized. In calculating the percent savings as compared [o the percent that can be earned by
the State, information may be obtained from the Department of Financial Services, Division of Treasury at
850/413-3165 regarding the current Treasury earnings rate.
8. Document, if applicable, how the goods or services are essential to the operation of the Department and why
they are available only if advance payment is made:
DEP Agreement No. LP8954, Attachment F, Page 1 of 3
Identify the procurement method used to select [he
3. The following information required for advances to Governmental Entities and Non-Profits pursuant
to 216.181, Florida Statutes. (Limited to GAA Authorized, Statutorily Authorized, and Grant & Aid
Appropriation Categories OSXXXX or 14XXXX)
A. The entity acknowledges the requirement to invest advance funds in an interest bearing account and to remit
interest earned to the Department on a quarterly basis.
Provide a description of how the entity intends to invest the advanced funds and track the interest earned on the
advanced funds:
Remittances must: 1) be identified as interest earnings on advances, 2) must identify the applicable DEP
Agreement (or Contract) No., and 3) be forwarded to the following address:
Florida Department of Environmental Protection
Bureau of Finance and Accounting
Receipts Section
P.O. Box 3070
Tallahassee, Florida 32315-3070
B. A letter requesting advance payment from the recipient, on, its letterhead, must be attached.
DEP 55-222 (03-02)
DEP Agreement No. LP8954, Attac}unent F, Page 2 of 3
3. The recipient must provide an estimated budget for each quarter coverea oy cne agreement. ,ne
summary information should include salaries, fringe benefits, overhead, contracts (specify services to
be contracted out), equipment, if authorized (specify items to be purchased), supplies, travel, and
other costs.
A sample summary format is provided below. The summary should include the breakdown for each quarter of the
agreement period.
Description First Quarter Second Third Quarter Fourth Quarter
uarter
Salaries
identif ersonnel titles
Frin a Benefits
Contractual Services
(list services and estimated
costs
Equipment
(identify each item and cost)
Su lies
Travel
Other s ecif
Overhead Indirect
Total:
Certification Statement
The forgoing. information is presented to the Florida Department of Environmental Protection in support of our
request for advance payment. I certify that the information provided accurately reflects the financial
issues facing the entity at this time.
By:
Type Name of Signatory: Date
Title: Chief Financial Officer or desi nee
DEP Pro ram Area Review A royal
Recommendation: ^ Approve Request ^ Deny Request
By:
Type Name of Signatory: Date
Title: Bureau: Division: '~
The DEP Program Area should forward this information to the Contracts Disbursements Section at M578. The
Contracts Disbursements Section will forward requests for advance payment to the State Comptroller for review
and le islature consultation as a ro ria[e.
Bureau of Finance & Accounting Use Only
DEP 55-222 (03-02)
DEP Agreement No. LP8954, Attachment F, Page 3 of 3
Florida Department of
Environmental Protection
Bob Martinez Center
2600 Blair Stone Road
Tallahassee, Florida 32399-2400
DHL DELIVERY -SIGNATURE REQUIRED
SEP 0 4 2008
Mc Chazles Huff
Director of Community Development
Village of North Palm Beach
501 North Highway 1
North Palm Beach, Florida 33408
Re: LP8954 -Village of North Palm Beach
North Palm Beach Earman River Water Pipe Line Replacement
Deaz Mr. Huff:
Charlie Crist
Governor
Icff Kottkamp
Lt. Governor
Michael W. Sole
Secretary
We are pleased to provide financial assistance for your drinking water improvement
project. One fully executed grant agreement is enclosed. To draw money under the
agreement, please call Tommy Williams at 850/245-8358 for assistance in completing a
disbursement request. For your convenience, electronic copies of the attachments are
located on our web page: httn://www.den.state.fl.us/water/wff/index.htm under
2008-2009 Legislative Project Information, LP Grant Attachments.
We congratulate you and your staff on your efforts and aze pleased that we can work with
you on this project.
Sincerely,
~~
Phil Coram, P.E.
Deputy Director
Division of Water Resource Management
PC/st
Enclosure
cc: Honorable William Manuel -Village of North Palm Beach
'Vlore Protection. Lcss Process"
wtnudepstate.0.us