Backup Documents 12/08/2015 Item #16D15 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SL P
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 6 0 1 5
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNA RE
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 Init. Date
1. Barbetta Hutchinson Community and Human 1?—
Services
2. County Attorney Office County Attorney Office
3. BCC Office Board of County �� ��
Commissioners S 1 z.VA
4. Minutes and Records Clerk of Court's Office
p-JJ)is
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 Rachel Bra dhorst,Grant Coordinator, Phone Number 239-252-4 0
Contact/ Department Communi and Human Services
Agenda Date Item was 12/8/15 Agenda Item Number 16D15
Approved by the BCC
Type of Document Memorandums of Understanding Number of Original 3 ✓
Attached Documents Attached
PO number or account
number if document is N/A
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. —(.Fnitial) Applicable)
1. Does the document require the chairman's original signat . MlocI RB
2. Does the document need to be sent to another agency for dditional signatures? If yes, RB V
provide the Contact Information(Name;Agency;Address; 'sone)on an attached sheet.
3. Original document has been signed/initialed for legal sufficiency. • a s u • s 'e RB 1/
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 —1443— N).-4;
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 RB
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 RB V"
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip RB
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 12/8/15 and all changes made during the .� , .`
meeting have been incorporated in the attached document. The County Attorney's -C)19) ""‘-,
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
Instructions
161315
1) There are 3 original MOU's. 2 of the MOU's Please return Chairman signed MOU's to:
Rachel Brandhorst
RSVP Project Director I Criminal Justice Grant Coordinator
Collier County Government I Community and Human Services
3339 E. Tamiami Trail, Bldg. H, Suite 211
Naples, FL 34112
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
16D15
MEMORANDUM
Date: December 14, 2015
To: Rachel Brandhorst, Grant Coordinator
Community & Human Services
From: Ann Jennejohn, Deputy Clerk
Minutes & Records Department
Re: Memorandums of Understanding with Catholic Charities, Children's
Advocacy Center and Pace Center for Girls for their participation in
the Retired and Senior Volunteer Program (RSVP)
Attached for your records are copies of the three (3) memorandums referenced above,
(Item #16D15) approved by the Board of County Commissioners on December 8, 2015.
The original agreements will be held in the Board Minutes and Record Department
for the Official Record.
If you have any questions, please feel free to call me at 252-8406.
Thank you.
Attachments (3)
1 6 0 1 5
,a8,1)R CO
0
Godie r
County ,...,
RSV?
Memorandum of Understanding for the
Retired and Senior Volunteer Program
..of,Collier County and
Volume , .. .
Station: 44011c Ch4617. - ,_bal) ....../....ic c-tba. Cfcittobe a ari-h-c-s or'
/ Q-.1 Ger Coo&-f--td_
Address: 3 174--/ t 4 rY)1 Con I 776( /
City: Ajapie j State: P/ Zip: ,..9(///2■
Phone: 8M5 ici.3 - ock5 9 Fax: 77 Li — oS(: 3
Email:0111,aeolAbk,(4„,dies rc.,,Website: 14/k) -'• C.4.-1 o /;G Ckg‘r14:e.j CC. ()rag._
Period Covered: /6// 3---
I
/ to
This Memorandum of Understanding (MOU) contains basic provisions, which will guide the
working relationship between both parties. This MOU may be amended, in writing, at any time
with concurrence of both parties and must be renegotiated at least every three years.
A. Retired and Senior Volunteer Program will:
1. Do volunteer screening in compliance with County policies and ordinances.
2. Recruit, interview and enroll RSVP volunteers and refer volunteers to the volunteer
station.
3. Provide RSVP orientation and training to volunteer station staff prior to placement of
volunteers and at other times, as needed.
4. Develop publicity for RSVP such as radio, TV, print or verbal presentations
highlighting volunteers' service, accomplishments and impact on the community.
5. Furnish accident, personal liability and excess automobile insurance coverage as
required by program policies. insurance is secondary coverage and is not primary
insurance.
6. Periodically monitor volunteer activities at volunteer station to assess and/or discuss
needs of volunteers and volunteer station.
7. Annually assess volunteer placements to ensure the safety of volunteers as follows:
Throughout the three year duration of this memorandum of understanding an annual
safety assessment will be conducted, including a required e-mail assurance of safety
from each volunteer station covered by this agreement.
B. The Volunteer Station Responsibilities will:
Cot pore twoi for
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COMMUNITY
SERVICE****
1 6 0 1 5
- ,^_ ~_�
1. Implement orientation, in-service instruction or special Iraining of volunteers.
2. Interview and make final decision on assignment of volunteers.
3. Furnish velunteers with materials required for000/Qnment. as follows.
- , `
4. Furrfsh volunteers vxithtransportation required during their assignments, as follows:
ii
5. Provide supervision of volunteers on assigifrnents,
M. Provide for adequate safely of volunteers and submit an annual assurance e-mail
upon request by the p ject sponsor.
7. Collect and validate appropriate volunteer reports for submission to RSVP office on a
monthly basis.
8. Investigate and report any accidents and injuries involving RSVP volunteers
immediately to the RSVP office, All reports will be submitted in writing.
C. Other Provisions:
1. Separation from volunteer service: The volunteer station may request the
removal of an RSVP volunteer at anytime. The RSVP volunteer may withdraw
from service at the Volunteer Station or from RSVP at anytime. Discussion of
individual separations will occur among RSVP staff, Volunteer Station staff and
the volunteer to clarify the reoyons, resolve conflicts, or take remedial motkon,
including placement with another Volunteer Station.
2. Letters of Agreement: When in-home assignments of volunteers are made, a
letter of agreement will be signed by the parties involved. The document will
authorize volunteer service in the home and identify specific volunteer activities,
periods and conditions of service.
3. Religious Activities: The Volunteer Station will not request or assign RSVP
volunteers to conduct or engage in religious, sectarian or political activities.
4. Displacement of Employees: The Volunteer Station will not assign RSVP
volunteers to any assignment which would displace employed workers or impair
existing contracts for service.
5. Accessibility and Reasonable Accommodation: The Volunteer Station will
maintain the programs and activities to which RSVP volunteers are assigned
accessible to persons with disabilities (including mobiUiy, hmohng, vimipn, mental
and cognitive impairments or addictions and diseases) and/or limited English
language proficiency and provide reasonable accommodation to allow persons
with disabilities to participate in programs and activities.
O. Prohibition of Discrimination: The Volunteer Station will not discriminate against
RSVP volunteers or in the operation of its programs on the basis of race, color,
national origin, including liniited English proficiency; sex, aQe, political affiliation,
corporal ion Jo)
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sexual wdanta4ion, ndigkm, or on the basis of disability, if the volunteer is a
qualified individual with a disability.
7. Specify, either by written information or verbally, that RSVP volunteers are
participants in the Volunteer Station's program in all publicity featuring such
volunteers, whether it be nad/o. TV, print or verbal presentation. Display an RSVP
placard where it may be viewed by the public.
O. For impact-based umsiQnmeniu, supply data measuring volunteer impact on
community iieeds to Collier County RSVP.
9 Conditions of this Memorandum of Understanding may be amended or
terminated in writing at anytime at the request of either party. It will be reviewed
every three years to permit needed changes.
10. Term. Either party may terminate this Agreement for any reason with thirty (30)
days written notice to the other party.
11. This Agreement is subject to the availability of funds If funds are not available,
the County will provide notice in writing to the Volunteer Station at least thirty
days prior to the termination of the Agreement.
12. This Memorandum of Understanding contains all the terms and conditions
agreed upon by the contracting parties. No other undarotanding, oral or
otherwise, shall be deemed to exist or to bind any of tIle parties hereto
13. This Memorandum of Understanding will be in effect upon dated signature of the
Volunteer Station's Representative and the RSVP Project Director.
14. The total number of RSVP volunteer assign o projected to be available with
the Volunteer Station on an annual basis is � It is projected that these
assignments will be at the following |ncohons, in approximately the following
numbers:
The Volunteer Station representative who will serve as liaison with RSVP and who will be
responsible for volunteer orientation and supervision is:
w' ^
Nanne (Please Phnt): �� ~ . �� /�
Title: r < . ` kit?
Phwne ' 7 — 00S 9'
By signing this 8A[)U.thm Volunteer Station Representative certifies that the station is a
public or nonprofit private organization, or a proprietary health care agency.
Coyol at ion,101
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COMMUNITY
SERV^C^_^°~��^�
1 6 0 1
4:4
1-44
!(:.!
Signatute of Volunteer S atiori
Representative:_
X .
Title:_A-74,1 LVE Date:_o_05
IN WITNESS WHEREOF, the Station Representative and the County, have each respectively,
by an authorized person or agent, hereunder set their hands and seals on the date first written
above.
ATTS 1: - COLLIER COUNTY
DWIGHT E. BROk, CLERK gammmo•■•-'
‘■ e://aorGe
0 1 0 By:
est.a.irrent- ERK TIM NANCE, CHAIRMAN
Signature only.
Approval for term and legality.
• I, Date: J2i1,5
Jennil A. Belpecho
Assistant County Attney
rTtem# ilea5
Agenda .LS,,,js--
Date ""
Date in f.'s-
, ,Jo, Reed -tz
NATIONAL •
COMMUNITY
Peputy Envy,
SERV IC
16015
4,\„‘R Co
CoL ..Gr" Co my
RSVP
Memorandum of Understanding for the
Retired and Senior Volunteer Program
of Collier County and ��
i I d-- A dWo Ca� C�,r�-1 X o-1- CO l i?r Cov\+j
Volunteer I I \
Station: C - ' c v�S acct. 2 v `(- t 5 J O Cooler`
Address: 10 3(0 - 6 ± 14Ve v\te
City: k)o—Oes State: V(- Zip: 3`( 1 02-
Phone: (.12-3R ) 2-(p $3 Fax: g-39 )-(o 3_ 7 q3 1
F-Mail: J �e h.S Co-? C.A.CC 6[ ( ieY' WAsite: W W l�. CGCCd i 2( 0-y5
Period Covered: t 7. 'O( - 15 to C5, - 2,0 0
This Memorandum of Understanding (MOU) contains basic provisions, which will guide the
working relationship between both parties. This MOU may be amended, in writing, at any time
with concurrence of both parties and must be renegotiated at least every three years.
A. Retired and Senior Volunteer Program will:
1. Do volunteer screening in compliance with County policies and ordinances.
2. Recruit, interview and enroll RSVP volunteers and refer volunteers to the volunteer
station.
3. Provide RSVP orientation and training to volunteer station staff prior to placement of
volunteers and at other times, as needed.
4. Develop publicity for RSVP such as radio, TV, print or verbal presentations
highlighting volunteers' service, accomplishments and impact on the community.
5. Furnish accident, personal liability and excess automobile insurance coverage as
required by program policies. Insurance is secondary coverage and is not primary
insurance.
6. Periodically monitor volunteer activities at volunteer station to assess and/or discuss
needs of volunteers and volunteer station.
7. Annually assess volunteer placements to ensure the safety of volunteers as follows:
Throughout the three year duration of this memorandum of understanding an annual
safety assessment will be conducted, including a required e-mail assurance of safety
from each volunteer station covered by this agreement.
B. The Volunteer Station Responsibilities will:
NATIONAL&
COMMUNITY
SERVICE***:.
16D1
*OR C0�,o
fif tier County
RSVP
1. Implement orientation, in-service instruction or special training of volunteers.
2. Interview and make final decision on assignment of volunteers.
3. Furnish volunteers with materials required for assignment, as follows:
es a_s lneec4ecO
4. Furni hr volunteers with transportation required during their assignments, as follows:
/A •
5. Provide supervision of volunteers on assignments.
6. Provide for adequate safety of volunteers and submit an annual assurance e-mail
upon request by the project sponsor.
7. Collect and validate appropriate volunteer reports for submission to RSVP office on a
monthly basis.
8. Investigate and report any accidents and injuries involving RSVP volunteers
immediately to the RSVP office. All reports will be submitted in writing.
C. Other Provisions:
1. Separation from volunteer service: The volunteer station may request the
removal of an RSVP volunteer at anytime. The RSVP volunteer may withdraw
from service at the Volunteer Station or from RSVP at anytime. Discussion of
individual separations will occur among RSVP staff, Volunteer Station staff and
the volunteer to clarify the reasons, resolve conflicts, or take remedial action,
including placement with another Volunteer Station.
2. Letters of Agreement: When in-home assignments of volunteers are made, a
letter of agreement will be signed by the parties involved, The document will
authorize volunteer service in the home and identify specific volunteer activities,
periods and conditions of service.
3. Religious Activities: The Volunteer Station will not request or assign RSVP
volunteers to conduct or engage in religious, sectarian or political activities.
4. Displacement of Employees: The Volunteer Station will not assign RSVP
volunteers to any assignment which would displace employed workers or impair
existing contracts for service.
5. Accessibility and Reasonable Accommodation: The Volunteer Station will
maintain the programs and activities to which RSVP volunteers are assigned
accessible to persons with disabilities (including mobility, hearing, vision, mental
and cognitive impairments or addictions and diseases) and/or limited English
language proficiency and provide reasonable accommodation to allow persons
with disabilities to participate in programs and activities.
6. Prohibition of Discrimination: The Volunteer Station will not discriminate against
RSVP volunteers or in the operation of its programs on the basis of race, color,
national origin, including limited English proficiency; sex, age, political affiliation,
NATIONAL&
COMMUNITY
SERVICE***,
16015
„\OR
47 c
Collier County
RSV?
sexual orientation, religion, or on the basis of disability, if the volunteer is a
qualified individual with a disability.
7. Specify, either by written information or verbally, that RSVP volunteers are
participants in the Volunteer Station's program in all publicity featuring such
volunteers, whether it be radio, TV, print or verbal presentation. Display an RSVP
placard where it may be viewed by the public,
8. For impact-based assignments, supply data measuring volunteer impact on
community needs to Collier County RSVP.
9. Conditions of this Memorandum of Understanding may be amended or
terminated in writing at anytime at the request of either party. It will be reviewed
every three years to permit needed changes.
10. Term. Either party may terminate this Agreement for any reason with thirty (30)
days written notice to the other party.
11. This Agreement is subject to the availability of funds. If funds are not available,
the County will provide notice in writing to the Volunteer Station at least thirty
days prior to the termination of the Agreement.
12. This Memorandum of Understanding contains all the terms and conditions
agreed upon by the contracting parties. No other understanding, oral or
otherwise, shall be deemed to exist or to bind any of the parties hereto.
13. This Memorandum of Understanding will be in effect upon dated signature of the
Volunteer Station's Representative and the RSVP Project Director.
14. The total number of RSVP volunteer assignments projected to be available with
the Volunteer Station on an annual basis is t E . It is projected that these
assignments will be at the following locations, in approximately the following
numbers: ,n
Sl e-v 0C cc ge c `c1A
ev�2v. 1.•f �-ieS �If��_ _< < �► 1Rr�
The Volunteer Station representative who will serve as liaison with RSVP and who will be
responsible for volunteer orientation and supervision is:
Name (Please Print):—3ca.Eof ��t1 i.e (-5-7Yitc∎ M.' 1'
Title: C
Phone: � ( -a Xo3— g3 ?G ad-ir
By signing this MOU, the Volunteer Station Representative certifies that the station is a
public or nonprofit private organization, or a proprietary health care agency.
NATIONAL&
COMMUNITY
SERVICE***
o
16015
c�04 R CO,pA
Collier County
RSVP
Signature of Volunteer S .ti.
Representative: I'
Date: l y 2-L1 d 1C-
IN WITNESS WHEREOF, the Station Representative 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: , t,: COLLIER COUNTY
DWIGHT E. BROOK, CLERK
CLERK TIM NANCE, CHAIRMAN
signature on
Approval for form and legality:
�` ®\
v .. Date: t Z / g / Is
��
Jenne er A. Belpei
Assistant County ney ) \\trp
\�
NATIONAL&
COMMUNITY
SERVICE
16015
4c. ito
Coiner County
RSVP
Memorandum of Understanding for the
Retired and Senior Volunteer Program
of Collier County and
r C-si s , ma
Volunteer
Station: ( a‘b:e� ms 2er)2r2
Address: I Lao Al• /vL /.
City: tLl?ml al State: Zip: 3''"/7
Phone: ( Si)a� 2'4 2 - Fax:
E-Ma ii:/ /F/a/I/ '8, L'4t713 ___Website: LC010147. e"C4°■ r■ o1
,
Period Covered: /0///,..?v/5 to ,/��a.0/
This Memorandum of Understanding (MOU) contains basic provisions, which will guide the
working relationship between both parties. This MOU may be amended, in writing, at any time
with concurrence of both parties and must be renegotiated at least every three years.
A. Retired and Senior Volunteer Program will:
1. Do volunteer screening in compliance with County policies and ordinances.
2. Recruit, interview and enroll RSVP volunteers and refer volunteers to the volunteer
station.
3. Provide RSVP orientation and training to volunteer station staff prior to placement of
volunteers and at other times, as needed.
4. Develop publicity for RSVP such as radio, TV, print or verbal presentations
highlighting volunteers' service, accomplishments and impact on the community.
5. Furnish accident, personal liability and excess automobile insurance coverage as
required by program policies. Insurance is secondary coverage and is not primary
insurance.
6. Periodically monitor volunteer activities at volunteer station to assess and/or discuss
needs of volunteers and volunteer station.
7. Annually assess volunteer placements to ensure the safety of volunteers as follows:
Throughout the three year duration of this memorandum of understanding an annual
safety assessment will be conducted, including a required e-mail assurance of safety
from each volunteer station covered by this agreement.
B. The Volunteer Station Responsibilities will:
NATIONAL&
COMMUNITY
SERVICE***
16015
4' '91,,
coq
f
*
Coil ie County
RSVP
1. Implement orientation, in-service instruction or special training of volunteers.
2. Interview and make final decision on assignment of volunteers.
3. Furnish volunteers with materials required for assignment, as follows:
4. Furnish volunteers with {rans ortation required during their assignments, as follows:
Ai .
5. Provide supervision of volunteers on assignments.
6. Provide for adequate safety of volunteers and submit an annual assurance e-mail
upon request by the project sponsor.
7. Collect and validate appropriate volunteer reports for submission to RSVP office on a
monthly basis.
8. Investigate and report any accidents and injuries involving RSVP volunteers
immediately to the RSVP office. All reports will be submitted in writing.
C. Other Provisions:
1. Separation from volunteer service: The volunteer station may request the
removal of an RSVP volunteer at anytime. The RSVP volunteer may withdraw
from service at the Volunteer Station or from RSVP at anytime. Discussion of
individual separations will occur among RSVP staff, Volunteer Station staff and
the volunteer to clarify the reasons, resolve conflicts, or take remedial action,
including placement with another Volunteer Station.
2. Letters of Agreement: When in-home assignments of volunteers are made, a
letter of agreement will be signed by the parties involved. The document will
authorize volunteer service in the home and identify specific volunteer activities,
periods and conditions of service.
3. Religious Activities: The Volunteer Station will not request or assign RSVP
volunteers to conduct or engage in religious, sectarian or political activities.
4. Displacement of Employees: The Volunteer Station will not assign RSVP
volunteers to any assignment which would displace employed workers or impair
existing contracts for service.
5. Accessibility and Reasonable Accommodation: The Volunteer Station will
maintain the programs and activities to which RSVP volunteers are assigned
accessible to persons with disabilities (including mobility, hearing, vision, mental
and cognitive impairments or addictions and diseases) and/or limited English
language proficiency and provide reasonable accommodation to allow persons
with disabilities to participate in programs and activities.
6. Prohibition of Discrimination: The Volunteer Station will not discriminate against
RSVP volunteers or in the operation of its programs on the basis of race, color,
national origin, including limited English proficiency; sex, age, political affiliation,
NjATIONAL&
COMMUNITY
SERVICE***
16015
Scot R C04)
* cR
COIL County
RSUR
sexual orientation, religion, or on the basis of disability, if the volunteer is a
qualified individual with a disability.
7. Specify, either by written information or verbally, that RSVP volunteers are
participants in the Volunteer Station's program in all publicity featuring such
volunteers, whether it be radio, TV, print or verbal presentation. Display an RSVP
placard where it may be viewed by the public.
8. For impact-based assignments, supply data measuring volunteer impact on
community needs to Collier County RSVP.
9. Conditions of this Memorandum of Understanding may be amended or
terminated in writing at anytime at the request of either party. It will be reviewed
every three years to permit needed changes.
10. Term. Either party may terminate this Agreement for any reason with thirty (30)
days written notice to the other party.
11. This Agreement is subject to the availability of funds. If funds are not available,
the County will provide notice in writing to the Volunteer Station at least thirty
days prior to the termination of the Agreement.
12. This Memorandum of Understanding contains all the terms and conditions
agreed upon by the contracting parties. No other understanding, oral or
otherwise, shall be deemed to exist or to bind any of the parties hereto.
13. This Memorandum of Understanding will be in effect upon dated signature of the
Volunteer Station's Representative and the RSVP Project Director.
14. The total number of RSVP volunteer assignments projected to be available with
the Volunteer Station on an annual basis is ) It is projected that these
assignments will be at the following locations, in approximately the following
numbers: //--
uTtY7i n .
The Volunteer Station representative who will serve as liaison with RSVP and who will be
responsible for volunteer orientation and supervision is:
Name (Please Print): /l '4A/toe"
Title: J O t 4?fl ✓ (ft./clef-2
Phone: rya _ c5-'1/0 6
By signing this MOU, the Volunteer Station Representative certifies that the station is a
public or nonprofit private organization, or a proprietary health care agency.
NATIONAL&
COMMUNITY
SERVICE***
1 6 1 P.
R Co
4' 414'
CO e. ier County
ftsve
Signature of Volunteer Station
Representative: '11401}LA 141)0_414)
Title: J)Jt(JJ 3 06
Date: 1— tS
ate:
IN WITNESS WHEREOF, the Station Representative 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: COLLIER COUNTY
DWIGHT E. BROCK, CLERK
btf att 11)ttest as to By:
tYtLERK TIM NANCE, CHAIRMAN
J ta,
ApgntifeoflIn arW
Date:
Jenni r A. Belpedth4
Assistant County At . --y 0.3)
Corporatioi Jo?
NATIONAL&
COMMUNITY
SERVICE