HomeMy WebLinkAboutCOM 0066.015 2004-2006 r a„
Harry Kim e.`~' Alan R. Parker
t9grw' Fxecunve on Agrng
County o~ Hawaii
OFFICE OF AGING
Hdn lagoon Centre, IOl Aupuni Street Suite 342. Hilo, Hawaii 96720.4262
Phone (808)961-8600 • Pax (8081961-8603
Hanama Plnce. 7>-5706 Auakinf Highway, Surte 106- Kailoa-Kona. Ilnwai'i 96740-1751
Phone (808)327-3597 Fax I808)327d599
DATE: October 4, 2005
TO: Stacy K. i a, ouncil Chair and Council Members
FROM: Alan Parker, xecutive on Aging
RE: FINAL REPORT
Name of Grant Program: Senior Employment Program
Federal or State Grantor: State of HI, Dept. of Lab & Ind. Rel., Workforce Dev. Div.
County Grantee Department or Agency: Office of Aging
Grant No. (IF KNOWN): PY04-SCSEP-H-HCOA
Amount of Grant: $275,873.33
Amount of County Match: $ 89,082.40
Grant Period (Comm. & Completion): July 1, 2004 to June 30, 2005
Goals: To provide subsidized part-time employment & training
opportunities for individuals 55+ and to achieve
economic self-sufficiency.
Objectives: See attached Final Report.
Outcomes or Results: See attached Final Report.
Comm. No. ~p'
Cc: Parks & Recreation
Ref. To:
RaI. Data f1~T_,,,,,,_ 7
7(1~5-
Hmrai i (~ounp~ ec do eyua( oppnrluniq~ provider and emplo7~e~'. .!n 9rea 9Rran~ nn 3gng
Mtv w N~ sg~
Harry Kim Alan R. Parker
Mcryor h~mculrve nn Aging
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h~•Of•N'rP
COUNTY OF HAWAII
OFFICE OF AGING
I hlo Lngoon Ccmre, 101 Aupnm Streel, Suite 342, Hllo, Hnwai'i 9 6 72 0-42 62
Phone (808)961-8600 fi Pax (ROR)961-8603
Hanama Place, 75-5706 Kuakini Highway, Suite 106- Kailua-Kona, liawan 9G740-1751
Phone (808) 3273597 Fax (R08) 327-3599
MEMORANDUM
TO: Mr. Patrick Fukuki, Business Management Officer
Department of Labor and Industrial Relations
,~-s~"cc
FROM: Alan R. Parker
Executive on Aging
DATE: September 6, 2005
RE: SCSEP Closeout Package - PY04-SCSEP-H-HCOA
Enclosed herewith is the PY04 Closeout Package for the Senior Community Service
Employment Program (SCSEP) for Hawaii County contract No. PY04-SCSEP-H-HCOA.
Please contact Lito Asuncion of our office if you have any questions regarding this report.
Thank you very much.
Ima
-3OH
Arz drrn Agency on i1 y+ng
An Equul h)npl<rvmen[ Oppnrninlty Provider & Employer
STATE OF HAWAII DEPT. OF LABOR Date Contract Number
Subgrantee's Submittal of Closeout Documents 09/02/05 PY04-SCSEP-H-HCOA
Contractor Name and Address
Hawaii County Office of Aging
Business Management Officer 1D1 Aupuni St., Rm. 342
Department of Labor 8 Industrial Relations Hilo, HI 96720
830 Punchbowl Street, Room 311
Honolulu, Hawaii 96813
Attn: WIA Unit
As you requested in the subgrant closeout notification letter dated OS-30-05 I have taken actions related to
the closeout of subject SCSEP grant PY04-SCSEP-H-HCOA and am enclosing required closeout documents as
follows: Check appropriate boxes. Each item must be covered, (if applicable). Explain fully any item not submitted.
Use se crate sheet, if necessa
Unable to
Enclosed Furnish Identification of Document
X 1. Final Subcontractor's Invoice and Final Expenditure Register.
X 2. Subgrantee's Release
X 3. Subgrantee's Assignment of Refunds, Rebates and Credits
X 4. Inventory Certification and Inventory Lists
X 5. Special Bank/Financial Account and Bank Statement
NA a. List of possible claimants for unclaimed checks cancelled or payments stopped.
NA b. Refund check (with breakdown statement) to include:
o Unliquidated advance payments.
o Aggregate of unclaimed wages/other outstanding checks.
o Interest earned or owed on Government funds.
o Workers Compensation/other insurance.
o Other refunds.
6. subgrant Closeout Tax Certification.
X 7. Representation Letter.
X 8. Balance Sheet.
X 9. Other Documents (specify)
Contractor's Signature ~ L a ~ ~ Title Executive on Aging
-y
App A-13
SUBCONTRACTOR'S INVOICE FINAL Invoice Number: 13
1. Subcontractor's Name (Agency) Address (Number and Street)
Hawaii County Office of Aging 101 Aupuni Street, Room 342
2. Clty or Town Funds Requested For:
Hilo [ ]Initial [ ]Periodic [ X ] Reim- [ ]Final
6. Contract Number: Advance Advance bursement Invoice
PY04-SCSEP-H-HCOA
8. Funds Requested For: Senior Community Service Employment Program
9. Contract Period: 10. Report Period:
From: To: From: To:
July 1, 2004 June 30, 2005 July 1, 2004 June 30 , 2005
11. CASH TRANSACTION DATA
a. Total cash received to date . $266,585.02
b. Total disbursements to date from July 1, 2004 to June 30, 2005 $275,873.33
c. Cash on hand/deposit (9,288.31)
d. Cash requested but not received
e. Cash on hand/deposit & cash requested but not received . (9,288.31)
f. Estimated disbursements from to N/A
g. Amount of cash advance requested herewith. $9,288.31
12. EXPENDITURE DATA
Total Accrued expenditure to date. $275,873.33
(From Expenditure Register, page 2)
13. CONTRACTOR'S CERTIFICATION - I certify that the cost incurred are taken from the books
of account and that such costs are valid and consistent with the terms of agreement.
Authorized Subcontractor Signaf~e an Title Date Signed
CLCu ->c~ SEP 0 6 2005
Alan Parker, Executive on Aging n~i
kkkkkkkkkk:: 'ETA A;INISTF2ATIL}ht tJ.ONLY kkkkkkkekk
Recommendation Appropriation Number
Amount to be paid
Signature Date
CONTRACT NO:
PY04-SCSEP-H-HCOA SCSEP EXPENDITURE REPORT PAGE 1
COUNTY: HAWAII SUBCONTRACTOR'S NAME: Hawaii County Office of Aging
REPORT PERIOD: CONTRACT PERIOD:
FROM: TO: FROM: TO:
1-Jul-OS 15-Jul-O5 July 1, 2004 June 30, 2005
COST CATEGORY PROG.
FEDERAL FUNDS PLANNED ACCRUED % OF ACT.
BUDGET EXPEND. PLAN ADMIN WAGES/ SVCS, WORK
LINE ITEMS FRINGE EXP.
ADMINISTRATION
Personnel 19,989.00 18,281.06 91% 18,281.06 18,281.06
Fringe Benefits 4,797.00 4,310.67 90% 4,310.67 4,310.67
Travel 2,662.00 1,876.71 71% 1,876.71 1,876.71
Supplies 1,500.00 1,394.27 ss% 1,394.27 1,394.27
Contractual 300.00 638.21 213% 638.21 638.21
Equipment 1,266.00 547.95 43% 547.95 547.95
Other 1,601.00 1,693.06 106% 1,693.06 1,693.06
TOTALADMIN 32,115.00 28,741.93 89% 28,741.93 0.00 28,741.93
twzrrificatian: I G`EATIFY thattr~ the best of my knowledge snit beli«fthat this repor[ is correct a~43 complete ;anrf that ali
dislbcusements have beeei made far the and condition of tlrc Grant<
_
AUTHORIZED SIGNATURE TITLE DATE SUBMITTED
SFP C 6 2005
Alan Parker Executive on Aging
CONTRACT NO:
PY04-SCSEP-H-HCOA SCSEP EXPENDITURE REPORT PAGE 2
COUNTY: HAWAII SUBCONTRACTOR'S NAME: Hawaii County Office of Aging
REPORT PERIOD: CONTRACT PERIOD:
FROM: TO: FROM: TO:
1~lul-OS 15-Jul-O5 July 1, 2004 June 30, 2005
PROG.
FEDERAL FUNDS PLANNED ACCRUED % OF ACT.
BUDGET EXPEND. PLAN ADMIN WAGES/ SVCS, WORK
LINE ITEMS FRINGE EXP.
ENROLLEE WAGES/FB
Personnel 218,400.00 216,450.45 99% 216,450.45 216,450.45
Fringe Benefits 26,820.00 24,979.48 93% 24,979.48 24,979.48
Total EW/FB 245,220.00 241,429.93 98% 241,429.93 241,429.93
OTHER ENROLLEE COSTS
Supplies/Enrollee Services 1,744.00 2,311.93 133% 2,311.93 2,311.93
Equipment 4,157.00 2,947.76 71% 2,947.76 2,947.76
Other 1,000.00 441.78 44% 441.78 441.78
TotaIOEC 6,901.00 5,701.47 83% 5,701.47 5,701.47
TOTAL 284,236.00 275,873.33 97% 28,741.93 241,429.93 5,701.47 275,873.33
Certifieation: I G~tTtfi'I'tl#at to the best of my knpwicdge and belie that :this xepart is correct anal comptcte arni that all i
dishuxsertiepts have heart ttf~a~de fnr the nae aryl cnxtditinat of tip cirsiit<
AUTHORIZED SIGNATURE TITLE DATE SUBMITTED
C~~,, L i~~~.-' SEP 0 6 2005
Alan Parker Executive on Aging
CONTRACT NO:
PY04-SCSEP-H-HCOA SCSEP EXPENDITURE REPORT PAGE 3
COUNTY: HAWAII SUBCONTRACTOR'S NAME: Hawaii County Office of Aging
REPORT PERIOD: CONTRACT PERIOD:
FROM: TO: FROM: TO:
1-Jul-OS 15-Jul-OS July 1, 2004 June 30, 2005
COST CATEGORY PROG.
NON-FEDERAL FUNDS PLANNED ACCRUED % OF ACT.
BUDGET EXPEND. PLAN ADMIN WAGES/ SVCS. WORK
LINE ITEMS FRINGE EXP.
ADMINISTRATION
Personnel (Coord.) 33,744.00 32,409.46 96% 32,409.46 32,409.46
(Counselor) 9,122.40 12,794.95 140% 12,794.95 12,794.95
OEC
Personnel (Coord.) 8,436.00 10,861.82 129% 10,861.82 10,861.82
(Counselor) 36,489.60 33,016.17 90°~ 33,016.17 33,016.17
TOTAL 87,792.00 89,082.40 101% 45,204.41 0.00 43,877.99 89,082.40
Cet1i&cataom; X C)~RTT~"a'tGattothe hest,of aay knowledge and Uelief
that this repatt is crazre~t and umpletta ~n~ thaE all
diebw~ssexneirts hnue Veen anacle far the purpose sail canditian of tfie t~irran>n
AUTHORIZED SIGNATURE TITLE DATE SUBMITTED
C~.~.~~~-~-~~~ sF~ o s 2005
Alan Parker Executive on Aging
State of Hawaii
Department of Labor & Industrial Relations
Workforce Development Division
SUBGRANTEE'SRELEASE
Pursuant to the terms of Grant Number No. PY04-SCSEP-H-HCOA and in consideration of the sum of:
Two Hundred Seventy-Five Thousand Eight Hundred Sevent}_-Three and 00/100 Dollars $ 275,873
Total of amounts paid and payable
which has been or is to be paid under the said subgrant to:
Hawaii County Office of Aging
] O1 Aupuni St. Rm. 342
Hilo, HI 96720
hereinafter called the subgrantee, the subgrantee, upon payment of the said sum by the State of Hawaii,
Department of Labor and Industrial Relations, hereinafter called the Government, does remise, release,
and discharge the Government, its officers, agents, and employees, of and from all liabilities,
obligations, claims, and demands whatsoever under or arising from the said subgrant except:
1. Specified claims in stated amounts or in estimated amounts where the amounts are not
susceptible of exact statement by subgrantee as follows:
NONE
(If none, so state)
1. Claims, together with reasonable expenses incidental thereto, based upon the liabilities of the
subgrantee to third parties arising out of the performance of said subgrant which are not known
to the subgrantee on the date of the execution of this release and of which the subgrantee files a
valid claim,
IN WITNESS WHEREOF, this release has been executed this 2nd day of September, 2005.
SUBGRANTEE' S NAME SIGNATURE
Hawaii County Office of Aging BY
101 Aupuni St. Rm. 342
Hilo, HI 96720 Alan Parker
TITLE
Executive on Aging
App A-1
State of Hawaii
Department of Labor & Industrial Relations
Workforce Development Division
SUBGRANTEE'S ASSIGNMENT OF REFUNDS, RI'sBA"TES AND CREDITS
Subgrantee's Name & Address (No., Street, City, State, Zip Code) Grant No.
Hawaii County Office of Aging PY04-SCSEP-H-HCOA
101 Aupuni St. Rm. 342
Hilo, HI 96720
Pursuant to the terms of SCSEP Grant No. PY04-SCSEP-H-HCOA and in consideration of the
reimbursement of costs provided in said subgrant, the subgrantee (Name & Address)
Hawaii County Office of Aging 101 Aupuni St. Rm. 342 Hilo, HI 96720
Does hereby:
1. Assign, transfer, set over and release to the State of 13awaii, Department of Labor and
Industrial Relations (hereinafter called the Government), all rights, titles, and interest to
all refunds, rebates, credits or other amounts (including any interest thereon) arising out
of the performance of the said grant, together with all the rights of action accrued or
which may hereafter accrue thereunder,
2. Agree to take whatever action may be necessary to effect prompt collection of all such
refunds, rebates, credits or other amounts (including any interest thereon) due or which
may become due, and to forward promptly to the State of Hawaii, Department of Labor
and Industrial Relations, Fiscal Office checks for Amy proceeds so collected. The
reasonable costs of any such action to effect collection shall constitute allowable costs
when approved by the Business Management Officer as stated in the said grant and may
be applied to reduce any amounts otherwise payable to the Government under the terms
hereof.
3. Agree to cooperate fully with the Government as to any claim or suit in connection with
such refunds, rebates, credits of other amounts due (including any interest thereon): to
execute any protest, pleading, application, power of attorney or other papers in connection
therewith; and to permit the Government to represent it at any hearing, trial or other
proceeding arising out of such claim or suit.
This assignment has been executed this 2"`~ day of September, 2005.
SUBGRANTEE'S NAME SIG~NjAT~U_RE
Hawaii County Oftce of Aging BY
101 Aupuni St. Rm. 342 Alan Parker
Hilo, HI 96720 T1TEE
App A- 20
FINAL (CLOSEOUT) INVENTORY CERTIFICATION
A. For Grants with Government Property.
I do hereby certify as the responsible officer of (grantee's name)
Hawaii County Office of Aging
that the attached inventory listings for nonexpendab[e property which was I) transferred
from another Federal grant and 2) acquired with this grants funds is to be considered as
the "final" inventory and lists all Government property for which I am accountable and is
correct in every respect. I further certify that the Govemment property identified above
has been approved for use in the new grants number PY04-SCSEP-H-HCOA .
SIGNATURE NAMF. AND TITLE
CLIP ~ - Alan Parker, Executive on Aging
L
A. For Grants with No Government Property.
I do hereby certify as the responsible officer of (grantee's name}
Hawaii County Office of A~InQ
that no Government property was furnished or acquired under the terms of and conditions
of this grant.
SIGNATURE NAME AND TITLE
~'?l~, '~~C7ri~Q~ Alan Parker, Executive on Aging
A. For All State and/Local Government Grantees.
I do hereby certify as the responsible officer of (grantee's name)
Hawaii County Office of Aging
that any property acquired with funds made available under this agreement which is from
the Employment and 'T'raining Administration, pursuant to United States Department of
Labor regulations and OMB Circulars is included in a listing of property acquired with
grant funds, containing a description with manufacturers serial number (if any) and said
listing is hereby submitted.
SIGNATURE NAME AND TITLE
~ y~,'~~ -L~~-~- Alan Parker, Executive on Aging
App A- 22
Corrected Coov (9/21/051
INVENTORY LISTING
A. Subgrantee Name C. Grant/Agreement Number
Hawaii County Office of Aging PY04-SCSEP-H-HCOA
D. Grant/Agreement Period
B. Program From: 07/01/04
Senior Community Service Employment Program To: 06/30/05
ITEM SERIAL OR DATE ACQUIRED UNIT LD.
DESCRIPTION FACTORY LD. NO. (DATE OF APPROVAL) COST TAG NO.
P-Computer 79H4L61 02/05 1473.88 SEP12
P-Computer 99H4L61 02/05 1473.88 SEP13
P-Computer 5127341 12/23/04 1282.31 SEP10
P-Computer BQKBW41 05/06/04 1507.54 SEP11
Computer 9800059453 10/16/98 2061.72 SEP9
Laser Jet Printer USFC125273 12/2]/94 1495.83 SEP6
Computer SYS8DTK1010 08/24/93 1727.81 SEP8
Computer MEXHA705402384 09/22/97 1359.74 SEP7
Air Conditioner 4995B31844954 07/24/97 1060.45 SEP3
Air Conditioner 0896B24119 07/24/97 936.45 SEP4
Air Conditioner 029B1854] 07/24/97 614.54 SEPS
Air Conditioner 43X921260 01/]9/93 1016.00 SEPl
Air Conditioner 4991B00541 01/19/93 1379.00 SEP2
Total 17,389.15
CERTIFICATION: I hereby certify that, to the best of my knowledge, all property listed has been
purchased or disposed of in accordance to applicable property management guidelines as provided by the
State of Hawaii, DLIR/WDD.
`~?f ~ Executive on Aging 9/21/05
SIGNATURE TITLE DATE
App A-1
SPECIAL BANK/FINANCIAL ACCOUNT
Contractor Hawaii County Office of Aqinq Contract No. Pv-oa-SCSeP-n-HCOn
A. Zero Balance Bank Statement: N/A
B. Fidelity Bonds: N/A
C. Unclaimed or Outstanding Checks: N/A
D. Refunds Due Goverment: N/A
1) Unliquidated advance payments
2) Unclaimed wages/outstanding checks.
3) Interest owed on Government funds
4) Fidelity Bond
5) Workmen's Compensation
6) Other Refunds
Total Check
~~li ~ ~ 9LL`~ v 09/02/05
Signature - Date
App A-21
SUBGRANT CLOSEOUT TAX CERTIFICA'T'ION
In the performance of SCSEP Grant No. PY04-SCSEP-H-HCOA, I certify that 1 have complied
with requirements of the law and the Department of Labor & Industrial Relations, Workforce
Development Division, regarding the obtaining of employer identification account number,
collection, payment, deposit, and reporting of Federal, State, and local taxes; and the provision of
W-2 forms to employee/enrollees who are not now my employees. For present
employees/enrollees, (formally employed under the subgrant), W-2 forms will be furnished as
specified in Circular E, Employer's Tax Guide.
AUTHORIZED SIGNATURE;: r( .
~~I lL~. L L "~~t L~
NAME OF SUBGRANTEE: Hawaii County Office of Aging
ADDRESS: 101 Aupuni St. Rm. 342
Hilo, HI 96720
App A- 25
REPRESENTATION LETTER
Nelson Befitel, Director
Department of Labor & Industrial Relations
830 Punchbowl Street, Room 31 I
Honolulu, Hawaii 96813
To Director Nelson Befitel
In connection with this closeout on Grant No. PY04-SCSEP-H-HCOA, and I hereby certify the
following representations based upon my best knowledge and belief:
1) This closeout was prepared utilizing the financial and program records which are
available for your inspection.
2) All material transactions have been recorded in accounting records in accordance with the
applicable OMB Circulars in conformity with Senior Community Services Employment
Program (SCSEP) regulations.
3) All related material events subsequent to submittal of this closeout will be made known
to you by the most expeditious route.
4) All reported costs were incurred in the performance of the gcant. There was never any
intention to frustrate the provisions of SCSEP, the regulations, or the grant.
Sincerely,
C
Alan Parker
Executive on Aging
September 2, 2005
Date
App A- 26
State of Hawaii
Department of Labor & Industrial Relations
Workforce Development Division
SUBGRANTEE'S ASSIGNMENT OF REFUNDS, RF,BATES AND CREDITS
Subgrantee's Name & Address (No., Street, City, State, Zip Code) Grant No.
Hawaii County Office of Aging PY04-SCSEP-H-HCOA
101 Aupuni St. Rm. 342
Hilo, HI 96720
Pursuant to the terms of SCSEP Grant No. PY04-SCSEP-H-HCOA and in consideration of the
reimbursement of costs provided in said subgrant, the subgrantee (Name & Address)
Hawaii County Office of Aging 101 Aupuni St. Rm. 342 Hilo, HI 96720
Does hereby:
1. Assign, transfer, set over and release to the State of Hawaii, Department of Labor and
Industrial Relations (hereinafter called the Government), all rights, titles, and interest to
all refunds, rebates, credits or other amounts (including any interest thereon) arising out
of the performance of the said grant, together with all the rights of action accrued or
which may hereafter accrue thereunder.
2. Agree to take whatever action may be necessary to effect prompt collection of all such
refunds, rebates, credits or other amounts (including any interest thereon) due or which
may become due, and to forward promptly to the State of Hawaii, Department of Labor
and Industrial Relations, Fiscal Oflce checks for any proceeds so collected. The
reasonable costs of any such action to effect collection shall constitute allowable costs
when approved by the Business Management Officer as stated in the said grant and may
be applied to reduce any amounts otherwise payable to the Government under the terms
hereof.
3. Agree to cooperate fully with the Government as to any claim or suit in connection with
such refunds, rebates, credits of other amounts due (including any interest thereon): to
execute any protest, pleading, application, power of attorney or other papers in connection
therewith; and to permit the Government to represent it at any heazing, trial or other
proceeding arising out of such claim or suit.
This assignment has been executed this 2nd day of September, 2005.
SUBGRANTEE'S NAME SIGNATURE
i
1_>~c i.
Hawaii County Office of Aging BY
101 Aupuni St. Rm. 342 Alan Parker
Hilo, HI 96720 TITLE
App A- 20
BALANCE SHEET
Date: 09/02/05
ASSETS
Petty Cash 0.00
Cash in Bank 0.00
Accounts Receivable 0.00
Property and Equipment
Other Assets 17,389.15
Total Assets 17,389.15
LIABILITIES AND FUND BALANCE
Vouchers Payable
Accrued Liabilities
Other Liabilities
Total Liabilities
Fund Balance
Investment in Property and Equipment 17,898.15
Reserved for Encumbrances
Reserved Fund Balance
Total Liabilities and Fund Balance 17,389.15
App A-1