Backup Documents 01/27/2015 Item #16D4 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
6 I
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATUR t
Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office
at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later
than Monday preceding the Board meeting.
**NEW** ROUTING SLIP
Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already complete with the
exception of the Chairman's signature,draw a line through routing lines#1 through#2,complete the checklist,and forward to the County Attorney Office.
Route to Addressee(s) (List in routing order) Office Initials Date
1. Jennifer A. Belpedio, ACA County Attorney Office 9a12) 11210
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A /�m uz () `�(s.�, (00-Office
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2. BCC Office Board of County — C
Commissioners \ç�1 \\Zcl.VS
3. Minutes and Records Clerk of Court's Office
) 3 Da2Pin,
PRIMARY CONTACT INFORMATION
Normally the primary contact is the person who created/prepared the Exe utive Summary. Primary contact information is needed in the event one of the
addressees above,may need to contact staff for additional or missing informs on.
Name of Primary Staff Priscilla Doria, Grant Coordinator Phone Number 239-252-5312
Contact/ Department Community and Human Services ept
Agenda Date Item was Jan uarq or?, .3015 Agenda Item Number )Lo -,J LI
Approved by the BCC
Type of Document Gc,O,, d 1 e � ,� b. ,i Number of Original
Attached
I l i e r C /ti . Documents Attached'o '1"� l.:C
C0�(>1c<I () rinWO/tJ►'
PO number or account
number if document is
to be recorded
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A"in the • •p �able column,whichever is Yes N/A(Not
appropriate. (tial Applicable)
1. Does the document require the chairm 's original ':nature?
2. Does the document need to be sent to another agency for additional signatures? If yes, /�
provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet.
3. Original document has been signed/initialed for legal sufficiency. (All documents to be
signed by the Chairman,with the exception of most letters,must be reviewed and signed .D
by the Office of the County Attorney.
4. All handwritten strike-through and revisions have been initialed by the County Attorney's I i
Office and all other parties except the BCC Chairman and the Clerk to the Board
5. The Chairman's signature line date has been entered as the date of BCC approval of the n
document or the final negotiated contract date whichever is applicable. J
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's /�
signature and initials are required. J
7. In most cases(some contracts are an exception),the original document and this routing slip
should be provided to the County Attorney Office at the time the item is input into SIRE.
Some documents are time sensitive and require forwarding to Tallahassee within a certain
time frame or the BCC's actions are nullified. Be aware of your deadlines!
8.
The document was approved by the BCC on )llis- and all changes made
during the meeting have been incorporated in the attached document. The County 72
Attorney's Office has reviewed the changes,if applicable.
9. Initials of attorney verifying that the attached document is the version approved by the
BCC,all changes directed by the BCC have been made,and the document is ready for the '
Chairman's signature.
I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05;Revised 11/30/12
604
MEMORANDUM
Date: January 30, 2015
To: Priscilla Doria, Grants Coordinator
Housing, Human & Veteran Services
From: Teresa Cannon, Deputy Clerk
Minutes & Records Department
Re: Amendment #2 to Agreement between Collier County and Centro
Campesino-Farmworker Center, Inc.
Attached is an original copy of the document referenced above, (Item #16D4)
approved by the Board of County Commissioners on Tuesday, January 27, 2015.
The second original agreement amendment has been held in our department for the
Board's Official Record.
If you have questions, please feel free to call me at 252-8411.
Thank you
Attachment
1 6 4
Grant- SHIP FY 2011-2012
SHIP FY 2012-2013
SHIP FY 2013-2014
Activity: - Owner-Occupied
Rehabilitation Program
Subrecipient: - Centro Campesino-
Farmworker Center, Inc.
DUNS # - 173849191
CSFA# - 52.901
SECOND AMENDMENT TO AGREEMENT BETWEEN COLLIER COUNTY
AND
CENTRO CAMPESINO-FARMWORKER CENTER, INC.
THIS AGREEMENT is made and entered into this pr] day of iCt,n t t(i r q ,
2015, by and between Collier County, a political subdivision of the State of Florida,
("COUNTY" or "Grantee") having its principal address as 3339 E. Tamiami Trail, Suite 211,
Naples FL 34112, and "Centro Campesino-Farmworker Center, Inc." a private not-for-profit
corporation existing under the laws of the State of Florida, having its principal office at 35801
SW 186th Avenue, Florida City, Florida 33034-5508
WHEREAS, on June 24, 2014, Item 16D1, the COUNTY entered into an Agreement
with Subrecipient to administer the State Housing Initiatives Partnership Program (SHIP)
Owner-Occupied Rehabilitation Program ("Agreement").
WHEREAS, on September 9, 2014, Item 16F1, the COUNTY approved the first
amendment to the Agreement.
WHEREAS, the Parties desire to amend the Agreement to modify Exhibit B, the Budget
Narrative, to add inspection fee to Project Component Two of Line Item Description, allow for
inspection payment, and make related modifications to Exhibits C, D, and E.
WHEREAS, the Parties further desire to amend the Agreement to extend expenditure
deadline granted by the Florida Housing Finance Corporation for Fiscal Year 2011/2012 funds to
April 30, 2015.
NOW, THEREFORE, in consideration of the mutual promises and covenants herein
contained, it is agreed by the Parties as follows:
Words Struck Throe`h are deleted; Words Underlined are added
* All references to Housing, Human and Veteran Services (HHVS) throughout agreement shall
now read Community and Human Services (CHS).
Amendment#2 SHIP- Owner Occupied Rehabilitation
Centro Campesino Farmworker Center, Inc,
Page 1 of 6
V. AGREEMENT AMOUNT 1 6 0 4
The budget identified for the Project shall be as follows:
Line Item Description Total SHIP Funds
Project Component One: Rehabilitation to owner- $ 770/100.00
occupied units.
Project Component Two: Project $85,600*not to exceed
Delivery/Inspection Fee for entire grant
$856,000.00
TOTAL $-856,000.00
* *
EXHIBIT B
BUDGET NARRATIVE
OWNER OCCUPIED REHABILITATION PROGRAM
The total SHIP allocation to SUBRECIPIENT for the Owner-Occupied Rehabilitation Program
shall be $856,000.00.
Sources for these funds are as follows:
Fiscal Year Project Rehab Fund Total Rehab and Expenditure
Delivery Project Deadline
Delivery/Inspection
2011-2012 $25,000* $225,000 $250,00W 12/31/2014
4/30/2015
2012-2013 $12,600* $113,100 $126,000 4/30/2015
2013-2014 $98,000* $432,000 $480,000 7/31/2015
Total Funds $85,600 $770460 $856,000
*maximum project deliver
If SUBRECIPIENT determines during the initial inspection of a home that the property is not
eligible for rehabilitation or if the homeowner post inspection and prior to bid
construction/award withdraws from rehab program a fee of$250.00 per home shall be paid to the
SUBRECIPIENT. If SUBRECIPIENT determines that rehabilitation is required a project
delivery fee of 10% of the total rehabilitation award but no less than $1,000 shall be paid for
each completed unit for total compensation to the SUBRECIPIENT. not to exceed $15,000 for
FY11 12; $22,600 for FY 12 13; $48,000 for FY 13 14. Associated work to perform technical
and administrative work involving the construction and renovation of residential properties is
included in the inspection fee or the project delivery and shall not also be reimbursed.
* *
Amendment#2 SHIP- Owner Occupied Rehabilitation
Centro Campesino Farmworker Center, Inc,
Page 2 of 6
1 6 0 4
EXHIBIT C
DISBURSEMENT SCHEDULE
1. Upon satisfactory expenditure and with satisfactory completion of each unit rehabilitated,
funds will be released in accordance with 2.A. below.
2. Submission of Exhibit"E"-Request for Payment to include all supporting documentation;
A. Rehabilitation
Proof of completion of the repairs identified in the work write-up, as evidenced
by the following:
• Certificate of occupancy or hard cards showing County building official
approval of work requiring County permit (if applicable);
• A copy of the release of liens;
• A copy of the invoice submitted to the Subrecipient SUBRECIPIENT
by the contractor;
• A copy of the check paid to the contractor (or copies of checks paid to
subcontractors) by the SUBRECIPIENT;
• Project Pictures (before and after);
• Schedule of Values.
B. Property determined not eligible for rehabilitation
• Inspection report prepared by SUBRECIPIENT determining unit ineligible
for rehabilitation.
• Documentation of withdrawal from homeowner
**Remainder of page intentionally left blank**
Amendment#2 SHIP- Owner Occupied Rehabilitation
Centro Campesino Farmworker Center, Inc,
Page 3 of 6
c,1(,
1604
EXHIBIT D
REPORTING REQUIREMENTS
OWNER-OCCUPIED REHABILITATION PROGRAM
Contract Period State Date: June 24, 2014
Contract Period End Date: September 30, 2015
Type of Report Period Covered/Supporting Documents Date Due
1. Monthly Period covered by the previous month. By the 15th of the
Progress Report following month.
• Exhibit "F"- Monthly Progress Report
Other:
• Listing of any special issues or items of concern
to SUBRECIPIENT relating to the Rehabilitation.
2. Financial & • Copy of Annual Audit 180 days after end of
Compliance • Exhibit"G"-Annual Audit Monitoring Report fiscal year
Audit
3. Invoice Upon final completion of
• Exhibit "E"-Request for Payment
rehabilitation to a unit or
upon determination of
unit not eligible for
rehabilitation or
homeowner withdrawal
**Remainder of page intentionally left blank.
Amendment#2 SHIP- Owner Occupied Rehabilitation
Centro Campesino Farmworker Center, Inc,
Page 4 of 6 C�, 1.
EXHIBIT E
REQUEST FOR PAYMENT
Sub recipient Name: Centro Campesino-Farmworker Center, Inc.
Sub recipient Address: PO Box 343449, Florida City, FL 33034
Project Name: Owner- Occupied Rehabilitation Program
SHIP FILE# Homeowners Property Address:
Total Inspection Fee: $
Total Rehab Cost Requested: $
Total Project Delivery Requested $ (10% of total rehab cost
but no less than$1,000)
Total Invoice Cost Requested: $
Check documents provided with request for payment;
Invoice from Contractor
Cleared Check and/or Bank Statement
Waiver of lien Release
Schedule of Values
Certification of Completion signed by Subrecipient and Homeowner
Subrecipient Agreements with Contractor and Homeowner
Permits issued, if applicable
Certificate of Occupancy, if applicable
Pictures: Initial and Final
OR
Inspection report determining unit not eligible for rehabilitation
Homeowner withdrawal notice
I certify that this request for payment has been drawn in accordance with the terms and conditions of
the Agreement between the COUNTY and us. To the best of my knowledge and belief, all grant
requirements have been followed.
Signature Date
Title
Authorizing HHVS Grant Coordinator:
Authorizing Accountant:
HHVS Supervisor: (approval authority under over $15,000)
HHVS Dept Director: (approval required $15,000 and above)
Amendment#2 SHIP- Owner Occupied Rehabilitation
Centro Campesino Farmworker Center, Inc,
Page 5 of 6 (T
1613 4
ATTEST: BOARD OF COUNTY COMMISSIONERS OF
DWIGHT E. BROCK, CLERK COLLIER COUNTY, FLORIDA
'P By:
‘11,14-e-
gifea,as C : its' Clerk
��: Tim N ate« Choi rmun I'a7 dao 15
signatdeonta
Dated: 1 1.'49 1
(SEAL)
Centro Campesino-Farmworker Center, Inc.,
By:
�
Subrecipient Signature
1 14k
Subrecipient Name
likte
Title
Approved as to form and legality:
Jenni er A. Belpe�.
Assistant County rney
This Amendment has been approved on oZ ? day of Jav►)a( , 2015. Agenda Item
# Rn fl I-- `J
Amendment#2 SHIP- Owner Occupied Rehabilitation
Centro Campesino Farmworker Center, Inc,
Page6of6