Backup Documents 03/11/2014 Item #16D1 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 61 1
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 Initials Date
1. '
2.
3. Colleen Greene County Attorney Office
C/146" 33i 1L
4. BCC Office Board of County .
Commissioners \1 / A\ \
5. Minutes and Records Clerk of Court's Office
uic (14 3.52Pm
PRIMARY CONTACT INFORMATION
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 addition or missing information.
Name of Primary Staff Natali Betancur °�c,� — C:s Phone Number 239-252-4059
Contact/ Department
Agenda Date Item wa( 3/l l/14 Agenda Item Number 16D1_--/
i
Approved by the BCC
Type of Document Agreement Number of Original 3
Attached \--vie-L._ _ Documents Attached
PO number or account
number if document is
to be recorded
fir, - �1 <a =��s� - \t,;—_,,c'
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? NB
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 NB {`_ t �
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 NB
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 NB
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip -NB-- {
should be provided to the County Attorney Office at the time the item is input into SIRE. N IA,
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 and all changes made during NB
the meeting have been incorporated in the attached doe ent. The County
Attorney's Office has reviewed the changes,if applicable. .3 ///
9. Initials of attorney verifying that the attached document is the version approved by the NB
BCC,all changes directed by the BCC have been made,and the document is ready for
Chairman's signature. 4
I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised L26.05,Revised 2.24.05;Revised 11/30/12
1613 1
MEMORANDUM
Date: April 2, 2014
To: Natali Betancur, Operations Analyst
Park & Rec's Beach
From: Teresa Cannon, Deputy Clerk
Minutes & Records Department
Re: Agreement to Furnish Food Service for the Summer Food Service
Program
Attached are three (3) originals of the document referenced above, (Item #16D1)
approved by the Board of County Commissioners on March 11, 2014.
Please forward for additional signatures and return a fully executed original back
to the Minutes and Records Department to he kept in the Board's Official Records.
If you have any questions, please contact me at 252-8411.
Thank you.
Attachments (3)
1 6D 1
Contract 14-
- 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 the District School Board of Collier
School
County and Collier County
Sponsor
WHEREAS the the District School Board Collier County 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 $ 1.95 each Lunch $ 3.38 each
Snacks $ each Supper $ each
It is further agreed that the District School Board Collier County 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. The District School Board Collier County 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 9, 2014 . 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 WITN SS WHEREOF, the parties hereto have execute this _reement as of the dates
indicated ,elow: T 762
School Official Sponsor TOM Ii v,, ING
School Board Chair CHAIRMAN, BOARD OF COUNTY COMMISSIONERS
Title D pproved as to form apiltinality Date 3/11/14
Reviewed:A VuLimstATTEST:
AssistantCounty Attorney DWI T-E. SRO s Clerk
DACS-01772 01/12
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