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Backup Documents 06/23/2015 Item #16A20 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SL TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO § 20 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 D1W24VT- 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 SRT 6/23/15 4. BCC Office Board of County Commissioners 5. Minutes and Records Clerk of Court's Office1'1'^n \ (0(23(15 lk'.4%tn 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 additional or missing information. Name of Primary Staff John Miller, ransportation Engineering Phone Number 252-8260 Contact/ Department Agenda Date Item was 6/23/15 Agenda Item Number 16-A-20 Approved by the BCC Type of Document Exhibit"A"Work Order—FDOT Lighting Number of Original Three I Attached Maintenance Documents Attached 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 SRT 2. Does the document need to be sent to another agency for additional signatures? If yes, SRT 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 SRT 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 SRT 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 SRT 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 SRT signature and initials are required. 7. In most cases(some contracts are an exception),the original document and this routing slip SRT 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 6/23/15 and all changes made during the SRT 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 e BCC,all changes directed by the BCC have been made,and the document is read for the Chairman's signature. PLEASE CONTACT JOHN MILLER WHEN READY—HE WILL T'+• SMIT TO ;OT 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 16A20 Martha S. Vergara From: Khawaja, Anthony Sent: Tuesday, June 23, 2015 5:43 PM To: Minutes and Records Cc: Miller, John; Bathon, Dale; Wilson, Pamela; Lehmann, June Subject: Re: Reminder - Highway Lighting Maintenance and Compensation Agreements - MUST BE FULLY EXECUTED NO LATER THAN 6/30/15 Hi Martha, There are no additional documents. The FDOT contact is: Pam Grissette District One Maintenance Contract Specialist 801 North Broadway Avenue Bartow, Florida 33830 ((863) 519-2761 7(863) 534-7045 * pamela.grissette@dot.state.fl.us<mailto:pamela.grissette@dot.state.fl.us> Our FedEx account is: Number is: Collier County Traffic Ops 2885 Horseshoe Dr S Naples FL 34104-6130 Our phone number on the account is 239-252-8260 Thanks for your help. Anthony N. Khawaja P.E. Chief Engineer of Traffic Operations Growth Management Division 2885 South Horseshoe Drive<x-apple-data-detectors://0/0> Naples, FL 34104<x-apple-data-detectors://0/0> AnthonyKhawaja@CollierGov.Net<mailto:AnthonyKhawaja@CollierGov.Net> Tel: (239) 252-8260<tel:(239)%20252-8260> On Jun 23, 2015, at 12:36 PM, Minutes and Records <MinutesandRecords@collierclerk.com<mailto:MinutesandRecords@collierclerk.com>>wrote: Hi Anthony, Please forward any and all documents that are to be attached to the packet, a contact name and address, and a FedEx Account number so that we can forward the document to FDOT. As soon as it's received for attestation, our office will e-mail you a complete scanned copy of what is being sent to FDOT 1 16 A 20 Cohntyof Collier CLERK OF THE ORC6kIT COURT COLLIER COUNTIOUR'IDOUSE 3315 TAMIAM1 TRL E STE 102 Dwight E. Brock-d.4erk of Circuit Court P.O. BOX 413044 NAPLES, FL 34112-5324 NAPLES, FL 34101-3044 Clerk of Courts • Comptroller • Audita '• Cstodian of County Funds June 24, 2015 FDOT Attn: Pam Grissette District One Maint. Contract Specialist 801 North Broadway Avenue Bartow, Florida 33830 Re: FDOT Work Order— State Highway Lighting Maintenance & Compensation Agreement Transmitted herewith are the originals of the above referenced document for your records per request, as adopted by the Collier County Board of County Commissioners of Collier County, Florida on Tuesday, June 23, 2015, during Regular Session. Please forward/e-mail an original, once the Work Order is fully executed to (martha.vergara@a collierclerk.com) for the Boards Official Records. Very truly yours, DWIGHT E. BROCK, CLERK Martha Vergara, I - huty Clerk Enclosure Phone- (239) 252-2646 Fax- (239) 252-2755 Website- www.CollierClerk.com Email- CollierClerk@collierclerk.com 16 A 20 EXHIBIT"A" FY 15/16 FDOT WORK ORDER STATE HIGHWAY LIGHTING MAINTENANCE, AND COMPENSATION AGREEMENT Contract Number ANDO3 Maintaining Agency: Collier County Financial Project No.: 412574-1-78-01 Effective Date: July 1, 2015 to June 30,2016 1.0 PURPOSE This exhibit defines the method and limits of compensation to be made to the Maintaining Agency for the services described in the original agreement executed on 9/30/03. 2.0 COMPENSATION The Department will compensate each Maintaining Agency for maintenance of lights being maintained on state highways for FY 15/16 is 90%of the total number of lights at $258.86 per light. , The current inventory of lights to be maintained by your agency for FY 15/16 is one-thousand-two-hundred-eighty(1,280) at a cost of$258.86 per light, which brings the amount of compensation to$298,206.72. 3.0 PAYMENT PROCESSING The Maintaining Agency shall invoice the Department yearly for services rendered in a format acceptable to the Department. For Satisfactory completion of all services as detailed in the original agreement for this FY 15/16,the Department will pay the Maintaining Agency a Total Lump Sum of $298,206.72. By: By. 7-r- /(Ze_v Sharon L. Harris City/County TIM DANCE, FDOT District Maintenance Administrator CHAIRMAN Date: Date: �,`-A\S pprove as o and legality ATTEST ,L,.v L.-- DWIGHT E. BRCK, CLERK Scott R.T ach,Deputy County Attorney -1, � BY: i '� 41),