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Backup Documents 06/23/2015 Item #16D 3 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIPI 6 D 3 TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 1 THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Print on pink paper. Attach to original document. "Ilse 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 he received in the County Attorney Office no later than Monday preceding the Board meeting. �'"�,� f V/-2,7) **NEW** ROUTING SLIP .#1-D-/VI 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 routinIines#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 ) l 5.1 4. BCC Office Board of County Commissioners l VW-5/ - \ks 5. Minutes and Records Clerk of Court's Office 10(23115 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 Brandy Otero &Tessie Sillery Phone Number 252-5859&2$2-5840 Contact/ Department PublicTransit NBHD Enhmt(old atm) Agenda Date Item was 6-23-2015 Agenda Item Number 16(D)3 Approved by the BCC 15261 Type of Document Attached JPA Agreement Number of Original 6 )JPA Agreement Documents Attached PO number or account number if document is to be recorded SPECIAL INSTRUCTIONS: Federal Express Acct.four acct.#- )to: Please fed ex 2 copies with original signatures to: Debi Stephens,Transit Projects Coordinator,Florida Department of Transportation,District One Modal Development Office/Public Transit,Southwest Area Office 10041 Daniels Parkway,Fort Myers,FL 33913 Phone(239)225-1982 Fax(239)338-2353 INSTRUCTIONS&CHECKLIST Initial the Yes column or mark"N/A"in the Not Applicable column, Yes N/A(Not whichever is appropriate. (Initial) Applicable) 1. Does the document require the chairman's original signature? Bcerter.49 2. Does the document need to be sent to another agency for additional BO 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 BO 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. 4. All handwritten strike-through and revisions have been initialed by the �O County Attorney's Office and all other parties except the BCC 1 0 Chairman and the Clerk to the Board 5. The Chairman's signature line date has been entered as the date of BO BCC approval of the document or the final negotiated contract date / whichever is applicable. r 6. "Sign here"tabs are placed on the appropriate pages indicating where BO the Chairman's signature and initials are required. 7. In most cases(some contracts are an exception),the original document B 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 41' frame or the BCC's actions are nullified. Be aware of your deadlines! 8. The document was approved by the BCC on 6-23--2015 and all BO changes made 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 the 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 1603 Centennial ier 1915*2015 Florida Department of Transportation RICK SCOTT 801 North Broadway Avenue JIM BOXOLD GOVERNOR Bartow,FL 33830 SECRETARY MEMORANDUM Date: June 4, 2015 To: Billy L. Hattaway, P.E., District Secretary From: Chris Smith, Director of Transportation Development Copies: Carol Finn, Randy Prescott, Greg Bowne, Jennifer Stults, John Kubler, Bernie Masing, Jerri McCants Subject: Delegation of Authority I will be out of the office beginning Tuesday, June 23, 2015 through Friday, June 26, 2015 returning to the office on Monday, June 29, 2015. I delegate authority to John Kubler, Program Management Administrator to act on my behalf and to sign all documents within my authorization which may be delegated pursuant to Florida Statutes in my absence. In the event I return to the office prior to the expiration of this delegation of authority, said delegation automatically expires. CS/jm www.dot.state.fl.us 1603 Centennial FDO -;:'"":4.7947:5":201.5" „ 1915:201.5 . R L.t c ■ I v t r_a Florida Department of Ira, JUN 7 RICK SCOTr 801 North Broadway GOVERNOR Bartow,FL 33830 SOUTH WEST AREA U1"FiCh DATE: April 27, 2015 TO: Brandy Otero,Associate Project Manager 20y5 FROM: Paul A. Simmons,District Modal Development (JUN 2 9 SUBJECT: EXTENSION OF TIME—JOINT PARTICIPI FINANCIAL PROJECT NO.: 432836-1-94-01 CONTRACT NO.: AQQ85 COUNTY: COLLIER PROJECT DESCRIPTION: Collier County Service Development for ADA Bus Stop improvements. The time allotted for the completion of services on subject agreement dated January 11, 2013 and any supplementals thereto will expire on. 12-31-2015. In accordance with Section 18.00 of the Joint Participation Agreement, you may request a time extension. Please complete, sign, date and return this fonn to me. ' It is requested that the Joint Participation Agreement for the subject project be extended until 12-31-2016. The reason for the Time Extension request must be included in a letter to the Department from the Director/ Manager/CEO of the organization. A detailed summary of the reason for the Time Extension and a schedule for completing the project must be included. Time Extensions will not be granted for billing purposes if the project is complete. COLLIER COUNTY RECOMMEND FOR APPROVAL: AGENCY TIM NANCE L./assts SIGNATORY(PRINTED OR T PED) DISTRICT MODAL DEVELOPMENT ADM INIS�T�(�gTAjf� k SIGNATURE APPROVED: CHAIRMAN U TITLE D . S CRET RY ODESIGNEE Date: _ ki '�. Date: 6/01 512 0/S- , /S- f. ATTEST v Appro ` t•4 as to fo► n' legality DWIGHT E: BROCK,CLERK EicAitti.„6t www.dot.state.fl a. R.Teach, i eputy County Attorney Attest site Chairman's (05) eiwsni..«w r.a.. - 60 3 Coanty of CO' 'tier CLERK OF THE CIRC IT COURT COLLIER COUNTY OUR OUSE 3315 TAMIAMI TRL E STE 102 Dwight E. Brock-i ikerk of circuit Court P.O. BOX 413044 NAPLES, FL 34112-5324 NAPLES, FL 34101-3044 Clerk of Courts • Comptroller • Audito ': C istodian of County Funds June 23, 2015 FDOT Attn: Debi Stephens 10041 Daniels Parkway Fort Myers, Florida 33913 Re: Extention of Time - Joint Participation Agreement Financial Project No.: 432836-1-94-01 Contract No.; AQQ85 County: Collier Project Description: Collier County Service Development for ADA Bus Stop Improvements Transmitted herewith is the original 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 a copy once the Notice is fully executed to (martha.vergara@collierclerk.com) for the Boards Official Records. Very truly yours, DWIGHT E. BROCK, CLERK Martha Vergara, Dep t C1 • - Enclosure Phone- (239) 252-2646 Fax- (239) 252-2755 Website- www.CollierClerk.com Email- CollierClerk@collierclerk.com 1603 Centennial --,,00,°!:#01-9;;.5*201.5 Florida Department of Transportation RICK SCOTT 801 North Broadway JIM BOXOLD GOVERNOR Bartow,FL 33830 SECRETARY DATE: April 27, 2015 TO: Brandy Otero,Associate Project Manager FROM: Paul A. Simmons,District Modal Development Administrator SUBJECT: EXTENSION OF TIME—JOINT PARTICIPATION AGREEMENT FINANCIAL PROJECT NO.: 432836-1-94-01 CONTRACT NO.: AQQ85 COUNTY: COLLIER PROJECT DESCRIPTION: Collier County Service Development for ADA Bus Stop improvements. The time allotted for the completion of services on subject agreement dated January 11, 2013 and any supplementals thereto will expire on 12-31-2015. In accordance with Section 18.00 of the Joint Participation Agreement, you may request a time extension. Please complete, sign, date and return this form to me. It is requested that the Joint Participation Agreement for the subject project be extended until 12-31-2016. The reason for the Time Extension request must be included in a letter to the Department from the Director/ Manager/CEO of the organization. A detailed summary of the reason for the Time Extension and a schedule for completing the project must be included. Time Extensions will not be granted for billing purposes if the project is complete. COLLIER COUNTY RECOMMEND FOR APPROVAL: AGENCY TIM NANCE SIGNATORY(PRINTED OR TYPED) DISTRICT MODAL DEVELOPMENT ADMINISTRATOR SIGNATURE APPROVED: CIIATRMAN± TITLE DISTRICT SECRETARY OR DESIGNEE Date: L\2-3,0�- _ Date: „ Ir tr r,,,, ATTES-7`+ . .''•, Ap.roved as to .rm d legality Dm Grft.t%fiR C;.C.ERK BY 1 , . ~ AM* �. www.dot.state.f7.us Scot R. Teach, �cputy County Attorney Attest as to Chairman' .¢ �� (..1) cianature only. , 160 3 cc: Accounting,MS 1-68