Backup Documents 04/14/2015 Item #16D2 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SL P
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO fi fl 2
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNA
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.
2.
3. County Attorney Office County Attorney Office CMG 4/14/15
4. BCC Office Board of County
Commissioners 4\k45
5. Minutes and Records Clerk of Court's Office 1" t I(565 C(;
PM
PRIMARY CONTACT INFORMATION l
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 Natali Betanc ,Beach and Water Phone Number 252-4059
Contact/ Department
Agenda Date Item was 4/14/15 Agenda Item Number 16-D-2
Approved by the BCC
Type of Document Agreement-Summer Food Service Number of Original iaam-
Attached Program Documents Attached - r.,-i .
PO number or account n/a
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? STAMP OK CMG
2. Does the document need to be sent to another agency for additional signatures? If yes, CMG Sc-P---\t .oc.-
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 CMG
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 CMG
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 CMG
document or the fmal negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's CMG
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip CMG
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 4/14/15 and all changes made during the CMG
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 .A-kC.,
BCC,all changes directed by the BCC have been made,and the document is ready fo the
Chairman's signature.
PLEASE CONTACT NATALI BETANCUR(4059) WHEN READY
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
1602
MEMORANDUM
Date: April 16, 2015
To: Natali Betancur, Operations Analyst
Park & Recreation Department
From: Ann Jennejohn, Deputy Clerk
Minutes & Records Department
Re: Agreement with the Collier County District School Board
to sponsor and operate the 2015 Summer Food Service Program
Attached for further processing are three (3) original copies of the agreement referenced
above, (Item #16D2) approved by the Board of County Commissioners April 14, 2015.
After you have obtained the necessary signature(s), please return one of the fully
executed original agreements to the Minutes & Record's Department for the Board's
Official Record. Until then our department will hold a copy of the agreement in the record.
If you have any questions, please call me at 252-8406.
Thank you.
Attachment (3)
1602
Contract 15-
Florida Department of Agriculture and Consumer Services
;� •' Division of Food, Nutrition and Wellness
AGREEMENT TO FURNISH FOOD SERVICE
ADAM H.PUTNAM FOR THE SUMMER FOOD SERVICE PROGRAM
COMMISSIONER
THIS AGREEMENT is made and entered into between Collier County Public Schools.
School
County and Collier County
Sponsor
WHEREAS the Collier County Public Schools agrees to supply unitized meals
School
(inclusive/exclusive) of milk and juice to Collier County
Sponsor
location sites listed on the attached form with and for the rates herein listed:
Breakfast $ 1.98 each Lunch $ 3.48 each
Snacks $ each Supper $ each
It is further agreed that the Collier County Public Schools pursuant to the provisions of
School
The Summer Food Service Program regulations, attached copy of which is part of this
agreement, will assure that said meals meet the minimum meal pattern requirements as to
components and portion sizes, and will maintain full and accurate records that the
Collier County will need to meet its responsibility including menu
Sponsor
records containing the amount of food prepared and daily number of meals delivered by type.
These records must be reported to the Collier County promptly
Sponsor
at the end of the month. Collier County Public Schools _agrees also to retain records
School
required under the preceding clause for a period of 3 years from the date of receipt of final
payment under this agreement (or longer, if an audit is in progress); and upon request, to make
all accounts and records pertaining to the Program available to representatives of the U.S.
Department of Agriculture and the General Accounting Office for audit or administrative review
at a reasonable time and place.
This agreement shall be effective as of June 8, 2015 . It may be terminated by notice in
Date
writing given by either party hereto to the other, at least 30 days prior to the date of termination.
IN WI r ESS WHE IF, the par ies hereto have executed this agreement as of the dates
ind .
et,
//
ool Official Sponsor COLLIER COUNTY by TIM NANCE
School Board Chair CHAIRMAN 4/14/15
Approved as toTorm a'• legality
Title Date Title S te-
Reviewed: b c. 'ViGi4T E. BR®CK Ctei 4,2e.,( 11 Igo
Assistant County A orney
DACS-01772 01/12 '`"
Attest irman's
signature only.