Backup Documents 11/10/2015 Item #16J3 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP1
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 6 ,1 3
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. County Attorney Office County Attorney Office JAK ..Wt37I5
/,/119
4. BCC Office Board of County rrI
Commissioners �KJ,
5. 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 Lori Sams,She ff's Dept. 252-0842
Contact/ Department
Agenda Date Item was 11/10/15 Agenda Item Number 16-J-3
Approved by the BCC
Type of Document Equitable Sharing Agreement Number of Original Two
Attached 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 STAMP OK JAK
2. Does the document need to be sent to another agency for additional signatures? If yes, JAK
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 JAK
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 JAK
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 JAK
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 JAK
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip JAK
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 11/10/15 and all changes made during JAK
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 t - �1
BCC,all changes directed by the BCC have been made,and the document is ready fo the
Chairman's signature. e.
Please contact Lori Sams (252-0842)when ready. She needs one original.
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
1 61 3
MEMORANDUM
Date: November 16, 2015
To: Lori Sams,
Collier County Sheriffs Office
From: Martha Vergara, Deputy Clerk
Minutes & Records Department
Re: Equitable Sharing Agreement & Certification
Attached you will find one (1) original of the document referenced above (Agenda Item
#16J3) approved by the Board of County Commissioners on Tuesday, November 10,
2015.
The second original has been kept by the Board's Minutes and Records Department as
part of the Board's Official Record.
If you have any questions, please call me at 252-7240.
Thank you.
Attachment
, , 16J 3
(,,,, _-
A _„...01.0,..„tOMB Number 113-0011
,,.:._.„:1,-.,,,,,..,.-....03,.::0i,
�` �. Equitable Sharing Expires 'lanuary31,2018
Agreement and
Certification ta
i 7g
Police Department .• Sheriff's Office - Task Force (Complete Table A)
Prosecutor's Office ;-- National Guard Counterdrug Unit Other
*Please fill each required field. Hover mouse over any fillable field for pop-up instructions.
Agency Name:Collier County Sheriffs Office
NCIC/ORI/Tracking Number: F L 0 1 1 0 0 0 0
Mailing Address: 3319 E. Tamiami Trail
City:Naples State: FL Zip: 34112
Finance Contact: First:Lori Last: Sams
Phone:239-252-0842 Email: Lori.Sams@colliersheriff.org
Preparer: First:Lori Last: Sams
Same as
X❑ Finance Contact Phone: 239-252-0842 Email: Lori.Sams@colliersheriff.org
Last FY End Date: 09/30/2015 Agency Current FY Budget: $152,607,400.00
,-` New Participant: Read Equitable Sharing Agreement and sign Affidavit
16J 3
Summary of Shared Funds Spent Justice Funds Treasury Funds
a Law enforcement operations and investigations
b Training and education
c Law enforcement,public safety,and detention facilities
d Law enforcement equipment
e Joint law enforcement/public safety operations
f Contracting for services
g Law enforcement travel and per diem
h Law enforcement awards and memorials
i Drug,gang,and other education or awareness programs
j Matching grants (Complete Table C)
k Transfers to other participating law enforcement agencies
(Complete Table D)
I Support of community-based programs (Complete Table E)
m Non-categorized expenditures (Complete Table F) $65,067.28
n Salaries (Complete Table G)
Total: $65,067.28
Please fill out the following tables,if applicable.
Table A: Members of Task Force
Agency Name NCIC/ORI/Tracking Number
Table B: Equitable Sharing Funds Received from other Agencies
Transferring Agency Name,City,and State Justice Funds Treasury Funds
Agency Name:
NCIC/ORI/Tracking Number:
Table C: Matching Grants
Matching Grant Name Justice Funds Treasury Funds
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Table D: Transfers to Other Participating Law Enforcement Agencies
Receiving Agency Name,City,and State Justice Funds Treasury Funds
Agency Name:
NCIC/ORI/Tracking Number:
Table E: Support of Community-based Programs
Recipient Justice Funds Treasury Funds
Table F: Expenditures not Categorized in(a)-(n)Above
Description Justice Funds Treasury Funds
Electronic Surveillance Equipment $65,067.28
Table G: Salaries
Salary Type Justice Funds Treasury Funds
C Overtime C' Match for Federal Salary Grant
C DARE/SRO Officer C Federal Task Force Replacement Officer
Table H: Civil Rights Cases
Name of Case Type of Discrimination Alleged
E Race E Color E National 0 Gender
Origin
E Disability EI Age E Other
Paperwork Reduction Act Notice
Under the Paperwork Reduction Act, a person is not required to respond to a collection of information
unless it displays a valid OMB control number. We try to create accurate and easily understood forms that
impose the least possible burden on you to complete. The estimated average time to complete this form is
30 minutes. If you have comments regarding the accuracy of this estimate, or suggestions for making this
form simpler,please write to the Asset Forfeiture and Money Laundering Section:
1400 New York Avenue,N.W.,Washington, DC 20005.
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16J3
Equitable Sharing Agreement
This Federal Equitable Sharing Agreement,entered into among (1)the Federal Government,(2)the above-stated law
enforcement agency("Agency"),and (3)the governing body,sets forth the requirements for participation in the
federal Equitable Sharing Program and the restrictions upon the use of federally forfeited cash,property,proceeds,
and any interest earned thereon,which are equitably shared with participating law enforcement agencies.
By submission of this form,the Agency agrees that it will be bound by the statutes and guidelines that regulate
shared assets and the following requirements for participation in the Department of Justice and Department of the
Treasury Equitable Sharing Programs. Receipt of the signed Equitable Sharing Agreement and Certification (this
"Document") is a prerequisite to receiving any equitably shared cash,property,or proceeds.
1.Submission. This Document must be submitted to aca.submit@usdoj.gov within 60 days of the end of the
Agency's fiscal year. This Document must be submitted and signed electronically. This will constitute submission to
the Department of Justice and the Department of the Treasury.
2.Signatories. This agreement must be electronically signed by the head of the Agency and the head of the
governing body. Examples of Agency heads include police chief,sheriff,director,commissioner,superintendent,
administrator,chairperson,secretary,city attorney,county attorney,district attorney,prosecuting attorney,state
attorney,commonwealth attorney,and attorney general. The governing body's head is the head of the agency that
appropriates funding to the Agency. Examples of governing body heads include city manager,mayor,city council
chairperson,county executive,county council chairperson,director,secretary,administrator,commissioner,and
governor. The governing body head cannot be from the law enforcement agency and must be from a separate entity.
3.Uses. Any shared asset shall be used for law enforcement purposes in accordance with the statutes and guidelines
that govern the Department of Justice and the Department of the Treasury Equitable Sharing Programs as set forth in
the current edition of the Guide to Equitable Sharing for State and Local Law Enforcement Agencies(Guide).
4.Transfers. Before the Agency transfers funds to other state or local law enforcement agencies,it must first verify
with the Department of Justice that the receiving agency is a current and compliant Equitable Sharing Program
participant. Transfers of tangible property are not permitted.
5.Internal Controls. The Agency agrees to account separately for federal equitable sharing funds received from the
Department of Justice and the Department of the Treasury. Funds from state and local forfeitures,joint law
enforcement operations funds,and other sources must not be commingled with federal equitable sharing funds.
The Agency agrees that such accounting will be subject to the standard accounting requirements and practices
employed by the Agency's jurisdiction as supplemented by requirements set forth in the current edition of the Guide,
including the requirement to maintain relevant documents and records for five years.
The misuse or misapplication of shared resources or supplantation of existing resources with shared assets is
prohibited. The Agency must follow its jurisdiction's procurement policies when expending shared funds. Failure to
comply with any provision of this agreement shall subject the recipient agency to the sanctions stipulated in the
current edition of the Guide.
6.Audit Report. Audits will be conducted as provided by the Single Audit Act Amendments of 1996 and OMB
Circular A-133. The Department of Justice and the Department of the Treasury reserve the right to conduct periodic
random audits or reviews.
7.Freedom of Information Act. Information provided in this Document is subject to the FOIA requirements of the
Department of Justice and the Department of the Treasury.
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Affidavit
/-
A, VILA
Name: 4111. al. Title: (3&/;1,bC
Email: hq@colliersheriff.net
To the best of my knowledge and belief,the information provided on this form is true and accurate and has been reviewed and authorized by the
Law Enforcement Agency Head whose name appears above. Entry of the Agency Head name above indicates his/her acceptance of and
agreement to abide by the policies and procedures set forth in the Guide to Equitable Sharing for State and Local Law Enforcement Agencies,
including ensuring permissibility of expenditures and following all required procurement policies and procedures. Entry of the Agency Head name
above also indicates his/her acceptance of and agreement to abide by requirements set forth in this Equitable Sharing Agreement,and any policies
or procedures issued by the Department of Justice or the Department of the Treasury related to the Asset Forfeiture or Equitable Sharing
Programs. The Law Enforcement Head also certifies that no items on the Prohibited List,as detailed in"Recommendations Pursuant to Executive
Order 13688",were purchased with equitable sharing funds after May 18,2015.
Governing Body Head Electronic Signature
���Name: 11/10/15 Title: CSRNAN
TIM NANCE
Email: TiffiNance@colliergov.net
To the best of my knowledge and belief,the agency's current fiscal year budget reported on this form is true and accurate and the Governing Body
Head whose name appears above certifies that the agency's budget has not been supplanted as a result of receiving equitable sharing funds. Entry
of the Governing Body Head name above indicates his/her acceptance of and agreement to abide by the policies and procedures set forth in the
Guide to Equitable Sharing for State and Local Law Enforcement Agencies,this Equitable Sharing Agreement,and any policies or procedures issued
by the Department of Justice or the Department of the Treasury related to the Asset Forfeiture or Equitable Sharing Programs.
® I certify that I am authorized to submit this form on behalf of the Agency Head and the Governing Body Head.
Final Instructions:
Step 1: Click to save for your records Step 3: Email the XML file to aca.submit@usdoj.gov
Step 2: Click to save in XML fr rnlat
Approvp,1as t -forth and legality Page 5 of 5 A February 2015
DWIGHT1 ,, , , ,
E,:ROCK CLE ` Version 3.1
1i,
Jeffrey A.' la .kow, County Attorney �lsck -►..
Attest as to Chalrm
signature only.