Backup Documents 07/08/2014 Item #16D 2 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 6 0
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 2
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. Jennifer A. Belpedio, ACA County Attorney Office c '� 1 10'1#
2. BCC Office Board of County
Commissioners V\`��
3. Minutes and Records Clerk of Court's Office „�'' I -'
VW/
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 Gino Santabarbara,Grant Coordinator Phone Number 239-252-2399
Contact/ Department
Agenda Date Item was July 8,2014 Agenda Item Number 16D2
Approved by the BCC
Type of Document Subrecipient amendment - Catholic Number of Original 1 ✓'
Attached Charities Documents Attached
PO number or account
number if document is Y(re .
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? 2
2. Does the document need to be sent to another agency for additional signatures? If yes,
provide the Contact Information(Name; Agency;Address; Phone)on an attached sheet. a�
3. Original document has been signed/initialed for legal sufficiency. (All 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 County Attorney's
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 _ n
document or the final negotiated contract date whichever is applicable. �Jl'
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's M n
signature and initials are required. o�
7. In most cases(some contracts are an exception),the original document 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 frame or the BCC's actions are nullified. Be aware of your deadlines!
8. The document was approved by the BCC on July 8,2014and all changes made during (�
the meeting have been incorporated in the attached document. The County 9,,
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 fo 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
160 2
Grant#-E-12-UC-12-0024E
CFDA/CSFA#- 14.231
Subrecipient-Catholic Charities of
Collier-county Collier-countyy Diocese of Venice,Inc.
DUNS#-877686501
FETI#-59-2473176
FISCAL YEAR END: June 30th
IDIS#434
MONITORING END DATE: 8 31 14 9-
30-14
AMENDMENT NO.3 TO AGREEMENT BETWEEN COLLIER COUNTY
AND
CATHOLIC CHARITIES,DIOCESE OF VENICE,INC.
. uLj
THIS AMENDMENT, made and entered into on this 71-''day of June, 2014 is by and between the parties to
the original Agreement, Catholic Charities, Diocese of Venice, Inc., (hereinafter called the "Subrecipient")
authorized to do business in the State of Florida, whose business address is 2210 Santa Barbara Boulevard,
Naples, FL 34116, and Collier County, a political subdivision of the State of Florida (hereinafter called the
"County")having its principal address as 3339 E. Tamiami Trail,Naples FL 34112.
Statement of Understanding
RE: EMERGENCY SOLUTIONS GRANT
In order to continue the services provided for in the original Agreement document referenced above, the parties
agree to amend the Agreement as follows:
Words Struck Through are deleted; Words Underlined are added:
(Dollar amounts have original underlines)
WITNESSETH:.
WHEREAS, on March 12, 2013, Agenda Item No. 16.D.2, the County approved an agreement between
the Subrecipient and County to use Emergency Solutions Grant funds to assist low income households with
rental assistance to avoid homelessness;
WHEREAS, on the 28th day of May 2013, Agenda item No. 16.D.5, the County approved amendment
No. 1 between the Subrecipient and the County;
WHEREAS,on the 11th day of March 2014, Agenda item No. 16.D.4, the County approved amendment
No. 2 between the Subrecipient and the County;
WHEREAS, it is now necessary to further amend the Agreement to provide for a time extension and to
correct the entity name of the Subrecipient; and
1
1602
NOW, THEREFORE, in consideration of the mutual benefits contained herein, it is agreed by the
Parties as follows:
1. Paragraph II of the Agreement is amended as follows:
II. TIME OF PERFORMANCE
Services/Activities of the SUBRECIPIENT shall start on the 12th day of March, 2013 and end
on the 3l ay of ugust-30th day of September,2014. The services/activities of the SUBRECIPIENT
shall be undertaken and completed in light of the purposes of this Agreement. Any funds not obligated
by the expiration date of this Agreement shall automatically revert to the COUNTY.
2. All references in the Agreement to "Catholic Charities of Collier County, Diocese of Venice, Inc." are
hereby amended to"Catholic Charities,Diocese of Venice, Inc."
* * *
IN WITNESS WHEREOF, the COUNTY and SUBRECIPIENT, have each, respectively, by an authorized
person or agent,hereunder set their hands and seals on the date and year first above written.
ATTEST: � BOARD OF COUNTY COMMISSIONERS
Dwight E. Brock,Clerkeb(`courts COLLIER r•UNTY. FLORIDA
Dated: . 1 20i '' �'' TO 'HENN G, CH AN
(SEAL)!k eSt as to I airman /
sig a only.
AI CATHOLIC CHARITIES, DIOCESE OF
VENICE, INC.
First Witness
d 4) l de- By II
TT e/print ss nameT Print: S1, ry
�� Title: (l, L-
I �
Second Witness '7 11
A J e2 Approved as to form and legality:
TType/print witness namet
Jennifer A. Belped o
Assistant County A ey
130114-
2