Backup Documents 06/09/2015 Item #16E2 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE t r
it
Print on pink paper. Attach to original document. 1 h completed routing slip and original documents are to be ions anted to the County Atlornr, Olde
at the time the item is placed on the agenda. All completed routing,slips and original documents most he received in the(mints Attorney Office no later
than Monday precediut!the Board meeting.
**NEW" ROUTING SLIP
Complete routing lines a I through 42 as appropriate tilt additional signatures.dates.ardor inhumation needed. If the document is already complete with the
exception of the Chairman's signature.draw a line through routing lines s I through 42.complete the checklist,and foresaril to the Counts Attorney Office,
Route to Addressee(s) (List in routing order! Office Initials Date
2.
3. County Attorney Office County Attorney Office 5X--1 6 >v
4. BCC Office Board of County _
Commissioners e— \t 1V 4VZ.V
5. Minutes and Records Clerk of Court's Office
{3.A245 10:SU*,
PRIMARY CONTACT INFORMATION
Normally the primary contact is the person who createdrprepared the Executive Sunmrars. Primary contact inlnmaation is needed in the event one of the
addressees above.may need to contact staff for additional or missing information.
Name of Primary Staff Linda Swisher or Alan McLaughlin Phone Number 239 695-4114
Contact ' Department Ochopee F' Control District
Agenda Date Item was 6-9-15 Agenda item Number 16E21
Approved by the BCC _
Type of Document Amended Exhibit B Number of Original 3
Attached Documents Attached
PO number or account FedEx to: FedEx Account:
number if document is Erik R.Fenniman.
to be recorded Deputy General Counsel
Florida Dept of Transportation
605 Suwannee St. M.S.58
Tallahassee, FI 32399-0458
(850)414-5264
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A" in the Not Applicable column,whichever is Yes NIA(Not
appropriate. (Initial) Applicable)
Does the document require the chairman's original signature?
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 /� "
by the Office of the County Attorney. �C•
4. All handwritten`strike-through and revisions have been initialed by the County Attorney's
Office and all other patties 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 61/y}'
document or the final negotiated contract date whichever is applicable. jj�rCC It
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's
signature and initials are required.
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 onand all changes matte during the
meeting have been incorporated in the attached t ocument. The County Attorney's
Office has reviewed the changes, if applicable. 1 t
is Forms,County Forms/BCC Fouts-Original Documents Routing Slip \\•\FS Original 9.03.04.Revised 1.26.05.Revised 2.24,05:Revised 11/30/12
141.
9. Initials of attorney veritvine that the attached document is the version approved by the �r
BCC.all changes directed by the BCC have been made.and the document is ready for th \ t;"
Chairman's signature. .
6
2
I:Fomes/County Forms/BCC Forms/Original Documents Routing Slip \\'\\'S Original 9.03.04.Revised 1.26.05.Revised 2.24.05:Revised 11/30/12
1
1 6 17: c. I
Coarrty9f Cd lier
CLERK OF THE C)RC IT COURT
COLLIER COUNTY� OUR OUSE
3315 TAMIAMI TRL E STE 102 Dwight E.Brock- ('! •rk of circuit Court P.O.BOX 413044
NAPLES,FL 34112-5324 )" NAPLES,FL 34101-3044
Clerk of Courts • Comptroller • Auditor-7.� ust1ian of County Funds
June 12, 2015
Attn: Erik R. Fenniman
Deputy General Counsel
Florida Dept. of Transportation
605 Suwannee St., M.S.58
Tallahassee, FL 32399
Re: Amended Exhibit B to Schedule of Annual Funding Schedule for SFY 2015/16
Mr. Fenniman,
Enclosed are three (3) original documents, approved on June 9, 2015 by the Board of County
Commissioners of Collier County. Please sign and return two originals back to my office and
keep one original for your records. I have included a return fedex slip. If you have any questions
please contact me. 239-252-8411.
Thank you,
sa Cannon, Deputy Clerk
Phone- (239) 252-2646 Fax- (239) 252-2755
Website- www.CollierClerk.com Email- CollierClerk@collierclerk.com
1 6 E 2
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16E 2
AMENDED EXHIBIT B — Schedule of Annual Funding Schedule
For SFY 2015/16
Estimated Budgeted Amount
Item/Work for O&M
Action/Milestone Estimated Budget Estimated Budget
Current Proposed 2015/16
Annual 3.5 Paramedics Hired (includes $389,000 $405,000
uniforms and protective clothing)
Includes all benefits and all insurance
coverage for personnel including workers
compensation & malpractice insurance
Annual 9.5 Fire Fighters Hired — $833,000 $843,000
Uniforms/Gear noted below.
Includes all benefits and all insurance
Coverage for personnel including workers
Compensation.
Annual Admin/Indirect costs/800 MHZ $12,000 $27,000
maintenance/IT services/phone/
Internet/radio repair, maintenance, parts
and accessories
Annual Building maintenance $4,500 $9,000
Annual Bulk fuel on site- estimate includes $12,000 $25,000
Trucks, & station generator fill and estimated
Annual consumption. This also includes
Diesel Exhaust Fluid.
Amended Exhibit "B" as per Contract Number: ARF81 Financial Project ID: 435289-1-94-01
For SFY 2015/16 with CPI
State of Florida Department of Transportation
Department-Collier County Interlocal Agreement
1
16E 2
Action/Milestone Estimated Budget Estimated Budget
Current Proposed 2015/16
Annual Canal dive and water search & $16,000 $13,000
Rescue Equipment, Haz/Mat absorbent &
Response, foam minor medical,
minor operating equipment
Annual Haz/Mat-Mutual Aid $12,500 $12,500
contingency
Annual Insurance-All Coverage Estimates $208,000 $30,000
for Facilities, errors and Omissions,
portable equipment environmental
estimated, vehicles
Annual Minor office supplies $500 $3,500
Annual Minor station supplies $1,200 $4,069.60
Annual Electric estimated (water and $7,600 $10,000
Sewer included in site lease provided by
FDOT Rest Area systems)
Annual Vehicle and Apparatus, Small $1,800 $33,000
Equipment and Compressor maintenance
repair, SCBA, Hose, Apparatus,Protective
Clothing testing/certification and calibration
Annual Operational, Training& Licensing $0 $7,000
Annual Uniform clothing, accessories, $0 $15,000
personal protective gear and
safety equipment
Amended Exhibit "B" as per Contract Number: ARF81 Financial Project ID: 435289-1-94-01
For SFY 2015/16 with CPI
State of Florida Department of Transportation
Department-Collier County Interlocal Agreement
2
GP
1 E2
Action/Milestone Estimated Budget Estimated Budget
Current Proposed 2015/16
Annual Machinery and Fire Equipment, $0 $25,000
Radio and Station Appliance replacement
Annual EMS Medical Supplies and $0 $60,000
Equipment (includes the second LP15)
Note:The LP15 is a heart monitor
Defibulator a spare is required due
to the remote location of the station and
response area for the purpose of continuity
of service.
Annual O&M for SFY $1,498,100 $1,522,069.60
Amended Exhibit "B" as per Contract Number: ARF81 Financial Project ID: 435289-1-94-01
For SFY 2015/16 with CPI.
State of Florida Department of Transportation
Department-Collier County Interlocal Agreement
3
16E2
This Amendment to Exhibit B of Contract Number: ARF81 Financial Project ID:
435289-1-94-01 for SFY 2015/16 with CPI is approved by the Collier County Board of County
Commissioners after motion, second, and majority vote favoring approval on,May , 2015.
ATTEST BOARD OF COUNTY COMMISSIONERS
DWIGHT E. BROM,Clerk COLLIER COUNTY, FLORIDA
n
� Vis► .._---.-� /'� I
By: `"—
ttest as to Chain'004 Clerk Tim Nance, Chairman
sign ure
Approved as to.fdrtn'and legality:
St.**04.4l
Scott R. Teach, Deputy County Attorney
4
Centennial 1 E 2
FDOT
1915*2015
Florida Department of Transportation
RICK SCOTT 605 Suwannee Street JIM BOXOLD
GOVERNOR Tallahassee,FL 32399-0450 SECRETARY
June 26, 2015
Teresa Cannon
Deputy Clerk
Collier County Clerk of Courts
3299 Tamiami Trail East
Suite 401
Naples, FL 34112
Re: Amended Exhibit B to Schedule of Annual Funding Schedule for SFY 2015/16
Dear Ms. Cannon:
Enclosed, as requested, are two fully executed originals of the above document.
Sincerely,
Harper Bearss
Assistant to the Deputy General Counsel
www.dot.state.fl.us
16E2
AMENDED EXHIBIT B—Schedule of Annual Funding Schedule
For SFY 2015/16
Estimated Budgeted Amount
Item/Work for O&M
Action/Milestone Estimated Budget Estimated Budget
Current Proposed 2015/16
Annual 3.5 Paramedics Hired (includes $389,000 $405,000
uniforms and protective clothing)
Includes all benefits and all insurance
coverage for personnel including workers
compensation &malpractice insurance
Annual 9.5 Fire Fighters Hired— $833,000 $843,000
Uniforms/Gear noted below.
Includes all benefits and all insurance
Coverage for personnel including workers
Compensation.
Annual Admin/Indirect costs/800 MHZ $12,000 $27,000
maintenance/IT services/phone/
Internet/radio repair,maintenance,parts
and accessories
Annual Building maintenance $4,500 $9,000
Annual Bulk fuel on site-estimate includes $12,000 $25,000
Trucks, &station generator fill and estimated
Annual consumption. This also includes
Diesel Exhaust Fluid.
Amended Exhibit"B"as per Contract Number:ARF81 Financial Project ID:435289-1-94-01
For SFY 2015/16 with CPI
e/a Oil
State Florida Department of Transportation
Department-Collier County Interlocal Agreement
1
16E2
Action/Milestone Estimated Budget Estimated Budget
Current Proposed 2015/16
Annual Canal dive and water search& $16,000 $13,000
Rescue Equipment, Haz/Mat absorbent&
Response,foam minor medical,
minor operating equipment
Annual Haz/Mat-Mutual Aid $12,500 $12,500
contingency
Annual Insurance-All Coverage Estimates $208,000 $30,000
for Facilities, errors and Omissions,
portable equipment environmental
estimated,vehicles
Annual Minor office supplies $500 $3,500
Annual Minor station supplies $1,200 $4,069.60
Annual Electric estimated (water and $7,600 $10,000
Sewer included in site lease provided by
FDOT Rest Area systems)
Annual Vehicle and Apparatus,Small $1,800 $33,000
Equipment and Compressor maintenance
repair,SCBA, Hose,Apparatus,Protective
Clothing testing/certification and calibration
Annual Operational,Training& Licensing $0 $7,000
Annual Uniform clothing, accessories, $0 $15,000
personal protective gear and
safety equipment
Amended Exhibit"B"as per Contract Number:ARF81 Financial Project ID:435289-1-94-01
For SFY 2015/16 with CPI
19 4/
State of Fl da 4,AD rtment of Transportation
Department-Collier County Interlocal Agreement
2
16E2
Action/Milestone Estimated Budget Estimated Budget
Current Proposed 2015/16
Annual Machinery and Fire Equipment, $0 $25,000
Radio and Station Appliance replacement
Annual EMS Medical Supplies and $0 $60,000
Equipment (includes the second LP15)
Note:The LP15 is a heart monitor
Defibulator a spare is required due
to the remote location of the station and
response area for the purpose of continuity
of service.
Annual O&M for SFY $1,498,100 $1,522,069.60
Amended Exhibit"B"as per Contract Number:ARF81 Financial Project ID:435289-1-94-01
For SFY 2015/16 with CPI.
,stiO
State of Florida Department of Transportation
Department-Collier County Interlocal Agreement
"
3
GQ`
1 6 E 2
This Amendment to Exhibit B of Contract Number: ARF81 Financial Project ID:
435289-1-94-01 for SFY 2015/16 with CPI is approved by the Collier County Board of County
Commissioners after motion, second,and majority vote favoring approval onMay q , 2015.
ATTEST BOARD OF COUNTY COMMISSIONERS
DWIGHTE. BRCS Clerk COLLIER COUNTY,FLORIDA
est as o illptimty Clerk Tim Nance,Chairman
s nature �
Approved as to form and legality:
Scott R. Teach,Deputy County . ey
4
rQ'
1 6 E 2
AMENDED EXHIBIT B—Schedule of Annual Funding Schedule
For SFY 2015/16
Estimated Budgeted Amount
Item/Work for O&M
Action/Milestone Estimated Budget Estimated Budget
Current Proposed 2015/16
Annual 3.5 Paramedics Hired (includes $389,000 $405,000
uniforms and protective clothing)
Includes all benefits and all insurance
coverage for personnel including workers
compensation & malpractice insurance
Annual 9.5 Fire Fighters Hired— $833,000 $843,000
Uniforms/Gear noted below.
Includes all benefits and all insurance
Coverage for personnel including workers
Compensation.
Annual Admin/Indirect costs/800 MHZ $12,000 $27,000
maintenance/IT services/phone/
Internet/radio repair, maintenance, parts
and accessories
Annual Building maintenance $4,500 $9,000
Annual Bulk fuel on site- estimate includes $12,000 $25,000
Trucks, &station generator fill and estimated
Annual consumption. This also includes
Diesel Exhaust Fluid.
Amended Exhibit "B"as per Contract Number:ARF81 Financial Project ID: 435289-1-94-01
For SFY 2015/16 with CPI
State f Florida(pa ment of ransportation
Department-Collier County Interlocal Agreement
1
16E 2
Action/Milestone Estimated Budget Estimated Budget
Current Proposed 2015/16
Annual Canal dive and water search & $16,000 $13,000
Rescue Equipment, Haz/Mat absorbent&
Response, foam minor medical,
minor operating equipment
Annual Haz/Mat-Mutual Aid $12,500 $12,500
contingency
Annual Insurance-All Coverage Estimates $208,000 $30,000
for Facilities, errors and Omissions,
portable equipment environmental
estimated, vehicles
Annual Minor office supplies $500 $3,500
Annual Minor station supplies $1,200 $4,069.60
Annual Electric estimated (water and $7,600 $10,000
Sewer included in site lease provided by
FDOT Rest Area systems)
Annual Vehicle and Apparatus,Small $1,800 $33,000
Equipment and Compressor maintenance
repair, SCBA, Hose, Apparatus,Protective
Clothing testing/certification and calibration
Annual Operational,Training& Licensing $0 $7,000
Annual Uniform clothing, accessories, $0 $15,000
personal protective gear and
safety equipment
Amended Exhibit"B"as per Contract Number:ARF81 Financial Project ID:435289-1-94-01
For SFY 2015/16 with CPI
State o F orida Department of ansportation
Department-Collier County Interlocal Agreement
2
1 6 E 2
Action/Milestone Estimated Budget Estimated Budget
Current Proposed 2015/16
Annual Machinery and Fire Equipment, $0 $25,000
Radio and Station Appliance replacement
Annual EMS Medical Supplies and $0 $60,000
Equipment (includes the second LP15)
Note:The LP15 is a heart monitor
Defibulator a spare is required due
to the remote location of the station and
response area for the purpose of continuity
of service.
Annual O&M for SFY $1,498,100 $1,522,069.60
Amended Exhibit"B"as per Contract Number:ARF81 Financial Project ID:435289-1-94-01
For SFY 2015/16 with CPI.
(iY
State o Florida epartmen of Transportation
Department-Collier County Interlocal Agreement
3
16E2
This Amendment to Exhibit B of Contract Number: ARF81 Financial Project ID:
435289-1-94-01 for SFY 2015/16 with CPI is approved by the Collier County Board of County
Commissioners after motion, second,and majority vote favoring approval on.M&y \ , 2015.
ATTEST BOARD OF COUNTY COMMISSIONERS
DWIGHT E. BROC(.,,Clerk COLLIER COUNTY, FLORIDA
Z, .. A.A., Sck.' , ---
CS:4,1/4A,vom
B A�
y.
(6_,—__
tteSt as to Chair #13uty Clerk Tim Nance,Chairman
,;(.:p,i!trta -.,!\,-
Approved as to.fomn and legality:
+i2Li
Scott R. Teach, Deputy County Attorney
4
0