Backup Documents 03/10/2015 Item #16D 1 6 a I
ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
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 Init �1s Date
1. Peggy Hager Community & Humane
Services (CHS) Division SA/
2. County Attorney Office County Attorney Office
-(;(P
3 f r 15
3. BCC Office Board of County VDL\
Commissioners /S/ -S\17-VC
4. Minutes and Records Clerk of Court's Office a:` Cc
PRIMARY CONTACT INFORMATION JJ
Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the
addressees above,may need to contact staff for additional or missing information.
Name of Primary Staff Rosa Munoz, CHS Phone Number 252-5713
Contact/ Department
Agenda Date Item was March 10,2015 • Agenda Item Number 16D1
Approved by the BCC
Type of Document Amendment#2 to CCHA Subrecipient Number of Original ,rl` <,
Attached Agreement-Electrical Replacement Documents Attached
PO number or account
number if document is
to be recorded
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A" in the Not Applicable column,whichever is Yes N/A(Not
appropriate. (Initial) Applicable)
1. Does the document require the chairman's original signature? RM
2. Does the document need to be sent to another agency for additional signatures? If yes, N/A
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 RM
signed by the Chairman, with the exception of most letters,must be reviewed and signed
by the Office of the County Attorney.
4. All handwritten strike-through and revisions have been initialed by the County Attorney's N/A
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 RM
document or the final negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's RM
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip RM
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 03/10/15 and all changes made RM
during the meeting have been incorporated in the attached document. The County
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 t -
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
MEMORANDUM
1 6131
Date: March 10, 2015
To: Rosa Munoz, Grant Coordinator
Housing, Human & Veteran Services
From: Teresa Cannon, Deputy Clerk
Minutes & Records Department
Re: Amendment #2 to CCHA Subrecipient Agreement for Electrical
Replacement
Attached are two (2) original amendment to the agreement referenced above, (Item
#16D1) approved by the Board of County Commissioners on Tuesday, March 10,
2015.
An original has been kept by the Minutes and Records Department for the
Official Records of the Board.
If you have any questions, please feel free to contact me at 252-8411.
Thank you.
Attachment
16131
Grant# - B-13-UC-12-0016
CFDA/CSFA# - 14.218
Subrecipient—Collier County Housing
Authority, Inc.
Agreement# CD13-06
DUNS # - 040977514
IDIS# - 460
FEID # - 59-1490555
FY End 09/30
Monitoring Deadline 02/2020 05/2020
SECOND AMENDMENT TO AGREEMENT BETWEEN COLLIER COUNTY
AND
COLLIER COUNTY HOUSING AUTHORITY, INC.
lh
This Amendment is made and entered into this IQ day of YY1 tux LA , 2015,
by and between "Collier County Housing Authority, Inc.", a special independent district of the State
of Florida created a public body corporate and politic in accordance with Florida Statute §421.27 et
seq-:, hereinafter referred to as SUBRECIPIENT and Collier County, Florida, hereinafter referred to as
"COUNTY," collectively stated as the "Parties."
RECITALS
WHEREAS, on January 14, 2014, the COUNTY entered into an Agreement with Collier
County Housing Authority, Inc. for Community Development Block Grant Program funds to be used
for the CDBG Electrical Replacement Project (hereinafter referred to as the "Agreement"); and
WHEREAS, the Parties desire to amend the Agreement to extend the project completion date,
and include language to clarify federal compliance requirements of meeting a National Objective, revise
project schedule and reduce agreement amount.
NOW, THEREFORE, in consideration of foregoing Recitals, and other good and valuable
consideration, the receipt and sufficiency of which is hereby mutually acknowledged, the Parties agree
to amend the Agreement as follows:
Words 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).
I. SCOPE OF SERVICES
All activities funded with CDBG funds must meet one of the CDBG program's National
Objectives: benefit low- and moderate-income persons; aid in the prevention or elimination of slums or
Collier County Housing Authority,Inc.
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blight; or meet community development needs having a particular urgency, as defined in 24 CFR
570.208
National Objectives
• CDBG recipients are responsible for assuring that each eligible activity meets one of three
national objectives (§ 570.208):
1. Low Mod Income benefit
2. Elimination of Slum and Blight
3. Urgent Need
Activities in LMI neighborhoods may qualify under the criterion for the LMI area benefit National
Objective if they provide a service to that neighborhood; or
Activities benefiting severely deteriorated areas may qualify under the Slums/Blight Area National
Objective if the area meets the CDBG requirements.
Provide final beneficiary information of low to moderate income households of 51% of rehabilitated
units including final inspection permits, must be completed no later than September 30, 2016. Failure
to serve the required percentage of low to moderate income beneficiaries and receive the required final
inspection permits will require the SUBRECIPIENT to repay the COUNTY the CDBG investment in
full.
II. TIME OF PERFORMANCE
Services of the SUBRECIPIENT shall start on the 11th day of February, 2014 and end on the
31_ day of May, 20 5 , February 1, 2016. The term of this Agreement and the provisions herein may
be extended by amendment to cover any additional time period during which the SUBRECIPIENT
remains in control of CDBG funds or other CDBG assets, including program income.
* * *
III. AGREEMENT AMOUNT
The COUNTY agrees to make available THREE HUNDRED AND TEN
THOUSAND DOLLARS ($38500-5310,000) for the use by the SUBRECIPIENT during the Term
of the Agreement (hereinafter, the aforestated amount including, without limitation, any additional
amounts included thereto as a result of a subsequent amendment(s) to the Agreement, shall be referred
to as the "Funds").
* * *
The County shall reimburse the SUBRECIPIENT for the performance of this Agreement upon
completion or partial completion of the work tasks as accepted and approved by HHVS.
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SUBRECIPIENT may not request disbursement of CDBG funds until funds are needed for eligible
costs, and all disbursement requests must be limited to the amount needed at the time of request.
Invoices for work performed are required every month. SUBRECIPIENT may expend funds only for
allowable costs resulting from obligations incurred during the term of this agreement. If no work has
been performed during that month, or if the SUBRECIPIENT is not yet prepared to send the required
backup, a $0 invoice will be required. Explanations will be required if two consecutive months of$0
invoices are submitted. Payments shall be made to the SUBRECIPIENT when requested as work
progresses but, not more frequently than once per month. Reimbursement will not occur if
SUBRECIPIENT fails to perform the minimum level of service required by this Agreement. Final
invoices for work performed during the grant period are due no later than 90 days after the end of the
agreement, and may not be reimbursed. Work performed during the term of the program but not
invoiced within 90 days without written exception from the Grant Coordinator will not be reimbursed.
No payment will be made until approved by HHVS for grant compliance and adherence to any and all
applicable local, state or Federal requirements. Payment will be made upon receipt of a properly
completed invoice and in compliance with §218.70, Florida Statutes, otherwise known as the "Local
Government Prompt Payment Act."
The following table details the project deliverables and payment schedule:
PAYMENT DELIVERABLES
Deliverable Payment—Supporting Documents Submission Schedule
Project Component One: FundingUpon invoicing will reimburse Submission of monthly
costs will include but not limitedallowable expenses on AIA G702- invoices: Exhibit B
to the following expenses: Design, 1992 form or equivalent document
installation, inspection, permits for per contractor's schedule of values.
electrical rewiring, removal and Supporting documents must be
replacement in up to 74-a units in provided as back up.
Section A at Farm Workers
Village in Immokalee, FL Final 5% 10% ($38,500 $15,500) Released upon documentation of
. . ., _ completion of rehabilitation
completion of activities and will activities and income
occur with each invoice documentation for occupants of
18 units
Released upon documentation of
Final 5% ($ 15,500 ) completion of rehabilitation
activities and income
qualification of 18 units
Project Component Two: Funding ERR document(s), invoice, canceled Upon completion and approval
costs will include but not limited check and any additional documents submission of invoice
to the following expenses: as needed utilizing Exhibit B
Environmental
Review/Assessment
PROGRAM DELIVERABLES
Deliverable Program—Deliverable Supporting Submission Schedule
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Documents
Quarterly Reports Exhibit D Quarterly through 9/2016 and
annually thereafter until 2020
Proof of Insurance Insurance Certificate Annually within 30 days of
renewal until 2020
Affirmative Action Plan Plan Documents Within 60 days of executed
agreement and updates
submitted annually 9/30 until
2020
Annual Audit Audit Report with Management 3/30 annually for 5 years
Letter and Exhibit E annually within 180 days after
year end through a 1 2020
Fair Housing Plan Plan Documents Within 60 days of executed
agreement and updates
submitted annually on 9/30 until
2020
Program Income Reuse Plan Annually on 9/30 for 5 years
until 2020
Inventory Inventory Listing Annually for 5 years on 9/30
until 2020
The COUNTY will monitor the performance of the SUBRECIPIENT based on goals and performance
standards as stated with all other applicable federal, state and local laws, regulations, and policies
governing the funds provided under this contract. Substandard performance as determined by the
COUNTY will constitute noncompliance with this Agreement. If corrective action is not taken by the
SUBRECIPIENT within a reasonable period of time after being notified by the COUNTY, contract
suspension or termination procedures will be initiated. SUBRECIPIENT agrees to provide HUD, the
HUD Office of Inspector General, the General Accounting Office, the COUNTY, or the COUNTY's
internal auditor(s) access to all records related to performance of activities in this agreement, unless
prohibited by any Federal Privacy Act.
Collier County Housing Authority,Inc.
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IN WITNESS WHEREOF, the Subrecipient and the County, have each, respectively, by an
authorized person or agent, hereunder set their hands and seals on the date first written above.
ATTEST: BOARD OF COUNTY COMMISSIONERS OF
DWIGHT E. BROCK, CLERK COLLIERNTY, FLORIDA
trAcN%-kkAVAOSICAA-MrIA.Cd / y_4�By: `r, Ge .
, Deputy Clerk TIM NANCE, CHAIRMAN
44..•• Dated; ? 'ka-'l ----
n, °L Y�tte,'`,",1PJjC(s�'s
4 `° : st*t 01ly.
�F�_ � Collier unty Housing Authority, nc.
By: 40x/t,Gt 462.k 1, .4_.
Signature
Approved as to form and legality: Esmeralda Serrata, Executive Director
Type/print Subrecipient name and title
�W\-)'
Jennifer A. Belpedio
Assistant County Attorney ��OP
`���G'
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EXHIBIT `B"
COLLIER COUNTY HOUSING, HUMAN AND VETERAN SERVICES
REQUEST FOR PAYMENT
SECTION I: REQUEST FOR PAYMENT
Sub recipient Name: Collier County Housing Authority, Inc.
Sub recipient Address: 1800 Farm Worker Way, Immokalee, FL 34142
Project Name: Electrical Replacement
Agreement No: CD-13-06 Payment Request#
Dollar Amount Requested: $ Date
Period of Availability through
Period for which Agency has incurred indebtedness: through
SECTION II: STATUS OF FUNDS
1. Grant Amount Awarded $
2. Sum of Past Claims Paid on this Account $
3. Total Grant Amount Awarded Less Sum
Of Past Claims Paid on this Account $
4. Amount of Previous Unpaid Requests $
5. Amount of Today's Request $
6. 10%of Retainage Amount Withheld
7. Current Grant Balance (Initial Grant Amount Awarded
Less Sum of all requests) (Includes Retainage) $
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 as the SUBRECIPIENT. To the best of my
knowledge and belief, all grant requirements have been followed.
Signature Date
Title
Grant Coordinator Grant Accountant
Supervisor (approval required $15,000 and above)
Dept Director (approval required $15,000 and above)
Collier County Housing Authority, Inc.
Electrical Replacement
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0
1 6 01
EXHIBIT "D"
QUARTERLY PROGRESS REPORT
Sub-recipients: Please fill in the following shaded areas of the report
t "'"'''Irt,.- Contract
Agency Name: Collier County Housing Authority,Inc.- Date: `.
1.; ,'" ,7$ gyp_ ?1y
Project Title: Electrical Replacement,.
Alternate ' ,
Program Contact: Este Serrata ''''::'''''' ' i'"''' ' '''M'!3''''' l'-' ''' ''''''''' Contact: ,
>f
Telephone Number: ,`12.39)•657,'3649 • ,
•
*REPORT FOR QUARTER ENDING:(check one that applies to the
corresponding grant period):
Activity Reporting Period Report Due Date
October 15`-December 315' January 10`h
January ,69
31St-March 315' April 10" ,,
April 15 -June 30'h July 10th
July 15r-September 30'" October 10th 0 A4130/44 007/31/14 ❑1A134/14 ❑ ❑,
Please take note: •- -`_- e - ' -- - ' = e •• Each quarterly report needs to include cumulative
data beginning from the start of the agreement date of February, 2014
Please list the outcome goa(s)from your approved application&sub-recipient agreement and indicate your progress in meeting those
1. goals since October 1,2013.
A.Outcome Goals: list the outcome goals)from your approved application&sub recipient agreement.
a
i
Prosect Schedule included by Reference
B.Goal Progress: Indicate the progress to date in meeting each outcome goal
Outco 1:progress:
of Environmental Review Red?"',
Outcome 1 Completion of.rehabilrtation activities in 7'0 units
r
Outcome 3.Proof.of occupancy and Inco a de c€�mentation for'18 units
Ilp.,',,':i,,,,,,,,,zi,:s1
NG:(c 4.Proof of occupancy and inCorne documantcttron for 18 units �� -:, ,� „x � � '��z� 4
a �
3 -1,, ,,
9
7 f
k
yf
Is this project still in compliance with the original project schedule?If mare than 2 months behind schedule,must submit a new timeline
2. far approval,
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Yes
If no,explain:
3. Since October 1, 2013,of the persons assisted, how many....
a. ...now have new access(continuing)to this service or benefit?
b. ...now has improved access to this service or benefit?
c. ...now receive a service or benefit that is no longer substandard?
TOTAL: 0
4. What funding sources are applied for this period/(program year?
$ $
Section 108 Loan Guarantee - HOPWA
$ ' $ ' •
Other Consolidated Plan Funds CDBG -
$ ' $ '
Other Federal Funds ESG -
$ $
State/Local Funds HOME -
Total
$ Entitlement $
Total Other Funds - Funds -
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EXHIBIT "D"
UARTERLY PROGRESS REPORT
5. What is the total number of UNDUPLICATED clients served this •uarter,if ap•licable?
a. Total No.of adult females served: 0 Total No.of females served under 18: 0
b. Total No.of adult males served: Total No.of males served under 18: 0
s„
TOTAL: 0 TOTAL: 0
c. Total No.of families served: 0 Total No.of female head of household: 0
6. What is the total number of UNDUPLICATED clients served since October,if applicable?
a. Total number of adult females served: ' 0' " Total number of females served under 18: £}
b. Total number of adult males served: Total number of males served under 18: '0
TOTAL: 0 TOTAL: 0
c. Total No.of families served: ti „Total No.of female head of household:
Complete EITHER question#7 OR#8.Complete question#7 if your program only serves clients in one or more of the listed HUD Presumed
Benefit categories. Complete question#8 if any client in your program does not fall into a Presumed Benefit category.
DO NOT COMPLETE BOTH QUESTION 7 AND 8.
7. (PRESUMED BENEFICIARY DATA: r 8. 10THER BENEFICIARY DATA INCOME RANGE
Indicate the total number of UNDUPLICATED Indicate the total number of UNDUPLICATED persons
persons served since October 1 who fall into served since October 1 who fall into each income
each presumed benefit category (the total
should equal the total in question#6): category(the total should equal the total in question#6):
Report as: Report as:
0 Abused Children A40".,,, Extremely low Income(0-30%)
Homeless Person (*Low Income(31-50%)
0 1 Battered Spouses OM Moderate Income(51-80%)
0 -. '.Persons w/HIV/AIDS 4,30 Above Moderate Income(>80%)
Elderly Persons
0 Veterans
0 ,,Chronically/Mentally ill
0 Physically Disabled Adults
0 Other-Youth
TOTAL: 0 TOTAL: 0
9. Racial&Ethnic Data: (ifapplicable)
Please indicate how many UNDUPLICATED clients served since October fall into each race category. In addition
to each race category, please indicate how many persons in each race category consider themselves Hispanic
(Total Race column should equal the total cell).
RACE ETHNICITY
White ' I;of whom,how many are Hispanic?
4 '
Black/African American 0 (Ir ;of whom,how many are Hispanic?
Asian ;'. 0 0%N ;of whom,how many are Hispanic?
American Indian/Alaska Native 0 y',40 •of whom,how many are Hispanic?
Native Hawaiian/Other Pacific Islander 0 0. ',;of whom, how many are Hispanic?
American Indian/Alaskan Native&White 0 0T;of whom,how many are Hispanic?
Black/African American&White 0. 0 I;of whom,how many are Hispanic?
Am. Indian/Alaska Native&Black/African Am. 0 0 ;of whom,how many are Hispanic?
Other Multi-racial Q O'F,-;of whom,how many are Hispanic?
Other 4,13 0-: of whom,how many are Hispanic?
TOTAL: 0 0 TOTAL HISPANIC
Name: Signature:
Your typed name here represents your electronic
Title: signature
Collier County Housing Authority,Inc.
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EXHIBIT "E"
ANNUAL AUDIT MONITORING REPORT
OMB Circular A-133 Audits of States, Local Governments, and Non-Profit Organizations requires the Collier
County Housing, Human and Veterans Services Department to monitor our sub recipients of federal awards
and determine whether they have met the audit requirements of the circular and whether they are in
compliance with federal laws and regulations. Accordingly, we are requiring that you check one of the,
following, provide all appropriate documentation regarding your organization's compliance with the audit
requirements, sign and date this form.
Fiscal Year
Subrecipient Name Period
Total State Financial Assistance Expended during $
most recently completed Fiscal Year
Total Federal Financial Assistance Expended during most
recently completed Fiscal Year
Check Appropriate Boxes
We have exceeded the $500,000 federal/state expenditure threshold for our fiscal year ending
❑ as indicated above and have completed our Circular A-133 audit. A copy of the audit report
and management letter is attached.
We exceeded the $500,000 federal/state expenditure threshold for our fiscal year ending as
❑ indicated above and expect to complete our Circular A-133 audit by . Within
30 days of completion of the A-133 audit, we will provide a copy of the audit report and
management letter.
❑ We are not subject to the requirements of OMB Circular A-133-because we:
❑ Did not exceed the $500,000 federal/state expenditure threshold for the fiscal year
indicated above
❑ Are exempt for other reasons —explain
An audited financial statement is attached and if applicable, the independent auditor's
management letter.
(If findings were noted, please enclose a copy of the responses and corrective action plan.)
Certification Statement
I hereby certify that the above information is true and accurate.
Signature Date
Print Name and Title
This form may be used to monitor Florida Single Audit Act (Statute 215.97) requirements.
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EXHIBIT "F" 16 1:1 1
LOCAL AND FEDERAL RULES, REGULATIONS AND LAWS
25. Dispute Resolution - Prior to the initiation of any action or proceeding permitted by this
Agreement to resolve disputes between the parties, the parties shall make a good faith effort to
resolve any such disputes by negotiation. Any situations when negotiations, litigation and/or
mediation shall be attended by representatives of SUBRECIPIENT with full decision-making
authority and by COUNTY'S staff person who would make the presentation of any settlement
reached during negotiations to COUNTY for approval. Failing resolution, and prior to the
commencement of depositions in any litigation between the parties arising out of this
Agreement, the parties shall attempt to resolve the dispute through Mediation before an agreed-
upon Circuit Court Mediator certified by the State of Florida. Should either party fail to submit
to mediation as required hereunder, the other party may obtain a court order requiring mediation
under § 44.102, Florida Statutes and under .§164.101, the Florida Governmental Conflict of
Interest Resolution Act. The litigation arising out of this Agreement shall be Collier County,
Florida, if in state court and the US District Court, 20th Judicial Court of Florida, Middle District
of Florida, if in federal court. BY ENTERING INTO THIS AGREEMENT, COLLIER
COUNTY AND THE SUBRECIPIENT EXPRESSLY WAIVE ANY RIGHTS EITHER
PARTY MAY HAVE TO A TRIAL BY JURY OF ANY CIVIL LITIGATION RELATED TO,
OR ARISING OUT OF, THIS AGREEMENT.
Collier County Housing Authority,Inc.
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