Backup Documents 06/09/2015 Item #16D17 (David Lawrence Center) 6017 •
ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
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. Peggy Hager Community and Human
Services AC/7,5-
2. County Attorney Office County Attorney Office _ [� 11511 �••
3. BCC Office Board of County 0-A
Commissioners � � ' k)
4. Minutes and Records Clerk of Court's Office
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 Geoffrey Ma on/Wendy Klopf/CHS Phone Number 252-2901
Contact/ Department
Agenda Date Item was 06/09/15 Agenda Item Number 16.D.17
Approved by the BCC
Type of Document Amendment to an Agreement Number of Original 3
Attached v Documents Attached
PO number or account NA
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 riginal si ature? ,,� Ket,i WK
2. Does the document need to be sent to another a cy for additional signatures? If yep, NA
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 WK
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 NA
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 WK
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 WK
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip NA
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_6/9115 and all changes made WK
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 `s
BCC,all changes directed by the BCC have been made,and the document is ready for the `R
Chairman's signature. ''
16 0 17
MEMORANDUM
Date: June 26, 2015
To: Geoffrey Magon, Grant Coordinator
Housing, Human & Veteran Services
From: Martha Vergara, Deputy Clerk
Minutes & Records Department
Re: 1st Amendment to Agreement between Collier County and David
Lawrence Mental Health Center, Inc.
Grant #B-14-UC-12-0016
Attached are two (2) originals of the document referenced above, (Item #16D17)
approved by the Board of County Commissioners on June 9, 2015.
An original amendment has been kept in the Minutes & Records Department as part of the
Board's Official Records.
If you have any questions, please feel free to contact me at 239-252-7240.
Thank you.
Attachments (2)
16017
Grant#- B-14-UC-12-0016
CFDA/CSFA# - 14.218
Subrecipient — David Lawrence Mental
Health Center, Inc.
DUNS # - 096580782
Agreement# CD14-07PS
IDIS# - 486
FEID #- 59-2206025
Fiscal Year End: 06/30
Monitor End: 09/2015
FIRST AMENDMENT TO AGREEMENT BETWEEN COLLIER COUNTY
AND
DAVID LAWRENCE MENTAL HEALTH CENTER, INC.
THIS AMENDMENT is entered into this i day of 2015, by and between the "David
Lawrence Mental Health Center, Inc." a private not-for-profit corporation existing under the laws of the State
of Florida, herein after referred to as "SUBRECIPIENT", having its principal office at 6075 Bathey Lane,
Naples, FL 34116; and Collier County, Florida, having its principal address as 3339 E. Tamiami Trail,
Naples FL 34112, hereinafter to be referred to as "COUNTY", collectively stated as the "PARTIES."
RECITALS
WHEREAS, on September 23, 2014, the COUNTY entered into an Agreement with the Community
Development Block Grant Program funds to be used for the Community Access Administrative Services
Program (hereinafter referred to as the "Agreement"); and
WHEREAS, the Parties desire to amend the Agreement to conform to the Department of Housing and
Urban Development's CDBG requirement regarding the records retention period.
NOW, THEREFORE, in consideration of foregoing Recitals, and other good and valuable
consideration, the receipt and sufficiency of which is hereby mutually acknowledged, the Parties agree to
amend the Agreement as follows:
Words Strueli-Through are deleted; Words Underlined are added
* *
Part II "Grant Control Requirements", Section 2.2D "Records and Documentation", is hereby amended as
follows:
* * *
D. Upon completion of all work contemplated under this Agreement copies of all documents
and records relating to this Agreement shall be surrendered to CHS if requested. In any event the
SUBRECIPIENT shall keep all documents and records in an orderly fashion in a readily
David Lawrence Mental Health Center,Inc.
CDBG(CD14-07PS)
Community Access Administrative Services Program Page 1 of 3
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16017
accessible, permanent and secured location for three (3) five (51 years after the date of
submission of the annual performance and evaluation report, as prescribed in 24 CFR 91.520
with the following exception: if any litigation, claim or audit is started before the expiration date
of the three (3) five (5) year period, the records will be maintained until all litigation, claim or
audit findings involving these records are resolved. The COUNTY shall be informed in writing if
an agency ceases to exist after closeout of this Agreement of the address where the records are to
be kept as outlined in 24 CFR 85.42. Meet all requirements for retaining public records and
transfer, at no cost, to COUNTY all public records in possession of the SUBRECIPIENT upon
termination of the contract and destroy any duplicate public records that are exempt or
confidential and exempt from public records disclosure requirements. All records stored
electronically must be provided to the COUNTY in a format that is compatible with the
information technology systems of the public agency.
Part IV "General Provisions", Section 4.19 "Uniform Administrative Requirements", is hereby amended as
follows:
4.19 24 CFR 84 - Uniform Administrative Requirements for Grants and Agreements with Institutions of
Higher Education, Hospitals and Other Non-Profit Organizations and specified by the following
subsections: http://www.law.cornell.edu/cfr/text/24/part-84
o Section 84.53(b), Retention and Access Requirements for Records. Section 84.53(b) applies
with the following exceptions:
• The retention period referenced in 84.53(b) pertaining to individual CDBG activities
shall be three five years; and
• The retention period starts from the date of submission of the annual performance and
evaluation report, as prescribed in 24 CFR 91.520, in which the specific activity is
reported on for the final time rather than from the date of submission of the final
expenditure report for the award;
(Signature Page to Follow)
David Lawrence Mental Health Center,Inc.
CDBG(CD14-07PS)
Community Access Administrative Services Program Page 2 of 3
1 6 0 17_
IN WITNESS WHEREOF, the Subreeipient and the County, have each, respectively, by an authorized pelrson
or agent, hereunder set their hands and seals on the date first written above.
AT`T`EST.
BOARD OF COUNTY COMMISSIONERS OF
I)WIGH" ' BROCK, CLERK COLLIER CQfl FLORIDA
€ /.. vol Bv,
TIM NANCE, CHAIRMAN 1
Dated: Vi xJ
Attest as to Cha1tiaii s
signature only.
}
DAVID LAWRENCE MENTAL HEALTH CENTER,
INC_, d/b/a DAVID LAWRENCE CENTER
By: Ad 01
SC : l' B S,•- IIIEE EXECUTIVE
OFFICER FOR
DAVID LAWRENCE MENTAL HEALTH
CENTER,INC.,d/b/a DAVID LAWRENCE
CENTER
Approved as to form and legality:
(ennijr A. 8elpek%
Assistant County Attorney
f� E
ii
}
David I a wre€nce Mental Health Center,Inc
CDDC(CD14-07PS)
Community Access,Administrative Services Program Page 3 of
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