Backup Documents 12/08/2015 Item #16D12 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT T40 1 2
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIG
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. Barbetta Hutchinson Community& Human
Services (CHS) Division
2. County Attorney Office County Attorney Office
3. BCC Office Board of County 7-14
Commissioners410 X45/ I ZX%\CS
4. Minutes and Records Clerk of Court's Office
+41— 1210lr 41:3(/(36q/
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 Jody Paley/ Phone Number 252-2903
Contact/ Department Community&Human rvices
Agenda Date Item was December 8,2015 Agenda Item 16D12
Approved by the BCC Number
Type of Document Third Amendment to Agreement Between Collier Number of Original 3
Attached County and Community Assisted and Supported Documents
Living, Inc.(CASL) Attached
PO number or account
number if document is
to be recorded
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A"in the Not Applicable column,which ver is Yes N/A(Not
appropriate. (Initial) Applicable)
1. Does the document require the chairman's original signature?(F �—I—��p o
2. Does the document need to be sent to another agency for additticanal signatures? If -s, na
provide the Contact Information(Name;Agency;Address;Phone)3iuin-atta ed sheet.
3. Original document has been signed/initialed for legal sufficiency. (All documents to be JSP
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 JSP I V LQ
Office and all other parties except the BCC Chairman and the Clerk to the Board / T
5. The Chairman's signature line date has been entered as the date of BCC approval of the JSP
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 JSP t/
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip JSP
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 12/08/15 and all changes made during JSP
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
16012
MEMORANDUM
Date: December 11, 2015
To: Jody Paley, Grants Coordinator
Community & Human Services
From: Ann Jennejohn, Deputy Clerk
Minutes & Records Department
Re: Grant #M-14-UC-12-0217 Subrecipient Agreement
Amendment No. 3 with Community Assisted and
Supported Living, Inc. (CASL)
Attached please find two (2) of the three (3) original amendment documents that
is referenced above, (Item #16D12) approved by the Board of County Commissioners
on Tuesday, December 8, 2015.
The third original will be held in the Minutes and Records Department for the
Board's Official Record.
If you have any questions, please contact me at 252-8406.
Thank you.
Attachments (2)
16012
Grant#-M-14-UC-12-0217
CFDA/CSFA#- 14.239
SUBRECIPIENT—Community
Assisted and Supported Living,
Inc.
Agreement#HM14-01
DUNS#-940621519
IDIS#492
FEID #-65-0869993
Fiscal Year End: 12/31
Monitoring Deadline: 10/2425
2026
THIRD AMENDMENT TO AGREEMENT BETWEEN COLLIER COUNTY
AND
COMMUNITY ASSISTED AND SUPPORTED LIVING,INC. (CASL)
THIS AMENDMENT is made and entered into this 6 day of 00,c,, 2015, by and
between "Community Assisted and Supported Living, 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 1401 16th Street, Sarasota, Florida 34236 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."
WHEREAS, on September 23, 2014, the COUNTY entered into an agreement with the
HOME Investment Partnerships (HOME) Program funds to be used for the 2014 Community
Assisted and Supported Living, Inc. (CASL) HOME Rehab Project (hereinafter referred to
as the"Agreement"); and
WHEREAS on June 9, 2015, Item #16D17, the COUNTY approved the first
amendment to conform to the Department of Housing and Urban Development's HOME
requirements regarding the records retention period; and
WHEREAS on September 22, 2015, Item #16D7, the COUNTY approved the second
amendment to extend the project completion date in order to achieve full expenditure of HOME
funds; and
WHEREAS, the Parties desire to extend the project completion date in order to achieve
full expenditure of HOME funds and modify housing units to meet ADA Section 504 standards.
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:
Page 1 of 4
CASL
HOME HM14-01
Rehab of multi family properties
Amendment 02
16012
Words Struck Through are deleted; Words Underlined are added
* *
PART I
SCOPE OF WORK
* * *
1.2 PROJECT DETAILS
D. Performance Deliverables
The Following Table Details the Project Deliverables
Program Deliverable Deliverable Supporting Submission Schedule
Documentation
Special Grant Condition Policies Policies as stated in this Within thirty (30) days of
(Section 1.1) agreement Agreement Execution
HQS Inspections Inspection Form Prior to Occupancy and annually
thereafter until 20252026
Insurance Insurance Certificate Exhibit A Annually within thirty (30) days
of renewal until 20252026
Detailed Project Schedule Project Schedule Within thirty (30) days of
Agreement Execution
Project Plans And Specifications Site Plans and Rehabilitation Prior to start of Rehabilitation
Specifications
Income Documentation Exhibit E Prior to Occupancy and
recertification of tenants
annually thereafter until
20252026
Submission of Progress Report Exhibit C&D Monthly until completion of
rehabilitation. Quarterly Reports
until full occupancy. Annually
thereafter until 20252026
Financial and Compliance Audit Exhibit F Annually one hundred eighty
(180) days after FY end until
20252026
Continued Use Certification Continued Use Affidavit Annually until 20252026
Tenant leases Copy of lease document Prior to occupancy
Occupancy and Tenant Income OccupancyNacancy Report Annually until 20252026
Report and Rental Rate Report
Page 2 of 4
CASL
HOME HM14-01
Rehab of multi family properties
Amendment d2
\s.k f t�?)
16012
1.3 TIME OF PERFORMANCE
Services of the SUBRECIPIENT shall start effective the date of the execution of this
agreement and shall end December 31, 2015 March 31, 2016. Rehabilitation activities shall be
completed by 28142016 and the affordability period shall cease in 2824 2026. The term of this
Agreement and the provisions herein may be extended by amendment to cover any additional
time period during which the SUBRECIPIENT remains in control of HOME funds or other
HOME assets, including program income.
1.6 NOTICES
Notices required by this Agreement shall be in writing and delivered via mail (postage
prepaid), commercial courier, or personal delivery or send by facsimile or other electronic
means. Any notice delivered or send as aforesaid shall be effective on the date of delivery or
sending. All notices and other written communications under this Agreement shall be addressed
to the individuals in the capacities indicated below, unless modified by subsequent written
notice.
COLLIER COUNTY
a . . " . . _ .. .. .
ATTENTION: Jody Paley, Grant Coordinator
3339 E Tamiami Trail, Suite 211
Naples,Florida 34112
Email to:
JodyPaley(acolliergov.net
239 252 6141 239-252-2903
* * *
SIGNATURE PAGE ON NEXT PAGE
REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
Page 3 of 4
CASL
HOME HM14-01
Rehab of multi family properties
Amendment#2 a )1/4,r
16012
IN WITNESS WHEREOF, the SUBRECIPIENT and the County, have each,
respectively, by an authorized person or agent, hereunder set their hands and seals on the date
first written above.
ATTEST: BOARD OF COUNTY COMMISSIONERS OF
DWIGHT E:`"BROCK,CLERK COLLIWAFGOUNTY,FLORIDA
_ 1 B
Attest as- 0 C rta�i�`` Clerk TIM NANCE,CHAIRMAN
signatu a oil .., �
Dated: I'ao:6 COMMUNITY ASSISTED AND SUPPORTED
(SEAL) LIVING, C. ( ASL)
By: ! 1
J Sdo Eller,CEO
Witness
Name and Title
Approved as to form and legality:
�.�� •
Jennifer • . Belpedio 032 Lio .
Assistant County Attorney
Item#
Agenda r2,..q
Date
Date 17 4.6
Reed
Page 4 of 4 Depu 1
CASL
HOME HM14-01
Rehab of multi family properties \\.\qi‘ -
Amendment#2