Backup Documents 09/09/2014 Item #16F1(C) ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP F cc)
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO j
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. Rachel Brandhorst HHVS RB 9/23/14
2. Jennifer B. Belpedio, ACA Office located in HHVS „
County Attorney Office Department
3. BCC Office Board of County -10
Commissioners /5
4. Minutes and Records Clerk of Court's Office at, .L‘11 1,11
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 Brandhorst Phone Number 252-4230
Contact/ Department r ` /
Agenda Date Item was 9/9/14 ��v1/4.c�`►� Agenda Item Number l/_
Approved by the BCC �� Z�\� k�,��,�1?-� \Y
Type of Document CJMHSA Amendment Number of Original 2 originals*
Attached Documents Attached
PO number or account
number if document is
to be recorded
PRioR RourCD £DGlA►MCJT A.)0-r- CC£PTWD By DcF be ca.wine_ acF 2E4)01 12E3
o21 G,r-3 AILS ro al_ INSTRUCTIONS & CHECKLIST. iC ni , TT*0 A T St' n 1 Time
Initial the Yes column or mark"N/A" in the Not Applicable column,whichever is Yes N/A(Not Disat es
appropriate. (Initial) /Applicable)
1. Does the document require the chairman's original signature? RMB V P2e)2
2. Does the document need to be sent to another agency for additional signatures? If yes, RMB ✓ ( OM.T£.0
provide the Contact Information(Name;Agency;Address; Phone)on an attached sheet. DOC
3. Original document has been signed/initialed for legal sufficiency. (All documents to be AfQ0
signed by the Chairman,with the exception of most letters,must be reviewed and signed
by the Office of the County Attorney. RMB (AS E
4. All handwritten strike-through and revisions have been initialed by the County Attorney's RMBV1
Office and all other parties except the BCC Chairman and the Clerk to the Board V
5. The Chairman's signature line date has been entered as the date of BCC approval rof the RMB Q
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 RMB
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip RMB V/
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 9/9/2014 Land all changes made RMB
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 RM B
BCC, all changes directed by the BCC have been made, and the document is ready for he
Chairman's signature. (J��
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
16F1 C
INSTRUCTIONS & CHECKLIST #2
Please send two original Chairman signed documents to:
Jennifer Benghuzzi
Contract Manager, Business Operations Unit Office of Substance Abuse and Mental Health Florida
Department of Children and Families
1317 Winewood Blvd., Bldg 6, Room 232
Tallahassee, FL 32399-0700
1: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
County of Collier b F 1 (c
CLERK OF THE CJRCWIT COURT
COLLIER COUNT@OURT\HOUSE
3315 TAMIAMI TRL E STE 102 Dwight E. Brock-blerk of Circuit Court P.O. BOX 413044
NAPLES, FL 34112-5324 NAPLES,FL 34101-3044
Clerk of Courts • Comptroller • Auditor ust-dian of County Funds
September 29, 2014
Jennifer Benghuzzi, Contract Manager
Department of Children and Families
1317 Winewood Blvd.
Bldg. 6, Room 232
Tallahassee, FL 32399-0700
Ms. Benghuzzi,
Enclosed are two original Grant Agreements #LHZ46 approved by the Board of
County Commissioners at their September 9, 2014 Regular Meeting. Please
forward for signatures and return a fully executed original back to my office.
Any questions, please contact me at 239-252-8411.
Thank you,
Teresa Cannon, Deputy Clerk
Phone- (239) 252-2646 Fax- (239) 252-2755
Website- www.CollierClerk.com Email- CollierClerk @collierclerk.com
16F1Cc )
LHZ46 Amendment#0001
July 15,2014
THIS AMENDMENT, entered into between the State of Florida, Department of Children and Families, hereinafter
referred to as the "Department," and Collier County Board of County Commissioners, hereinafter referred to as
the"Provider,"amends Grant Agreement#LHZ46.
This amendment adds provisions for proper accountability over state resources and a property clause for the
purchase of tangible personal property.
1. Page 13, EXHIBIT A, SECTION 7: OTHER TERMS, is hereby amended to read:
A-3 Financial Assistance.
If receiving state financial assistance, the Provider shall be in compliance with Section 215.97, Florida Statutes
(F.S.). Expenditures of state financial assistance shall be in compliance with laws, rules and regulations
applicable to expenditures of State funds, including, but not limited to,the Reference Guide for State
Expenditures. The Grant Agreement may be charged only with allowable costs resulting from obligations
incurred during the term of the Grant Agreement. Any balances of unobligated cash that have been advanced or
paid that is not authorized to be retained for direct program costs in a subsequent period must be refunded to the
State.
A-4 Property.
The word "property" as used in this section means equipment, fixtures, and other tangible personal property of a
nonconsumable and nonexpendable nature, the value or cost of which is $1,000 or more and the normal
expected life of which is 1 year or more, and hardback-covered bound books that are circulated to students or
the general public, the value or cost of which is $25 or more, and hardback-covered bound books, the value or
cost of which is $250 or more. Each item of property which it is practicable to identify by marking shall be
marked in the manner required by the Auditor General, Each custodian shall maintain an adequate record of
property in his or her custody, which record shall contain such information as shall be required by the Auditor
General. Once each year, on July 1 or as soon thereafter as is practicable, and whenever there is a change of
custodian, each custodian shall take an inventory of property in his or her custody. The inventory shall be
compared with the property record, and all discrepancies shall be traced and reconciled. All publicly supported
libraries shall be exempt from marking hardback-covered bound books, as required by this section. The catalog
and inventory control records maintained by each publicly supported library shall constitute the property record
of hardback-covered bound books with a value or cost of$25 or more included in each publicly supported library
collection and shall serve as a perpetual inventory in lieu of an annual physical inventory. All books identified by
these records as missing shall be traced and reconciled, and the library inventory shall be adjusted accordingly.
When state property will be assigned to a Provider for use in performance of a contract, the title for that property
or vehicle shall be immediately transferred to the Provider where it shall remain until this contract is terminated
or until other disposition instructions are furnished by the Contract Manager. When property is transferred to the
Provider, the Department shall pay for the title transfer. The Provider's responsibility starts when the fully
accounted for property or vehicle is assigned to and accepted by the Provider. Business arrangements made
between the Provider and its subcontractors shall not permit the transfer of title of state property to
subcontractors. While such business arrangements may provide for subcontractor participation in the use and
maintenance of the property under their control, the Department shall hold the Provider solely responsible for the
use and condition of said property. Provider inventories shall be conducted in accordance with Children and
Families Operating Procedure(CFOP)80-2.
16F1 (a)
LHZ46 Amendment#0001
July 15,2014
If any property is purchased by the Provider with funds provided by this contract, the Provider shall inventory all
nonexpendable property including all computers. A copy of which shall be submitted to the Department along
with the expenditure report for the period in which it was purchased. At least annually the Provider shall submit a
complete inventory of all such property to the Department whether new purchases have been made or not.
The inventory shall include, at a minimum, the identification number; year and/or model,: a description of the
property, its use and condition; current location; the name of the property custodian; class code (use state
standard codes for capital assets); if a group, record the number and description of the components making up
the group; name, make, or manufacturer; serial number(s), if any, and if an automobile,the Vehicle Identification
Number(VIN) and certificate number; acquisition date; original acquisition cost;funding source; and, information
needed to calculate the federal and/or state share of its cost.
The Contract Manager must provide disposition instructions to the Provider prior to the end of the contract
period. The Provider cannot dispose of any property that reverts to the Department without the Contract
Manager's approval. The Provider shall furnish a closeout inventory no later than 30 days before the completion
or termination of this contract. The closeout inventory shall include all nonexpendable property including all
computers purchased by the Provider. The closeout inventory shall contain, at a minimum, the same information
required by the annual inventory.
The Provider hereby agrees that all inventories required by this contract shall be current and accurate and reflect
the date of the inventory. If the original acquisition cost of a property item is not available at the time of
inventory, an estimated value shall be agreed upon by both the Provider and the Department and shall be used
in place of the original acquisition cost.
Title (ownership) to and possession of all property purchased by the Provider pursuant to this contract shall be
vested in the Department upon completion or termination of this contract. During the term of this contract, the
Provider is responsible for insuring all property purchased by or transferred to the Provider is in good working
order. The Provider hereby agrees to pay the cost of transferring title to and possession of any property for
which ownership is evidenced by a certificate of title. The Provider shall be responsible for repaying to the
Department the replacement cost of any property inventoried and not transferred to the Department upon
completion or termination of this contract. When property transfers from the Provider to the Department, the
Provider shall be responsible for paying for the title transfer.
If the Provider replaces or disposes of property purchased by the Provider pursuant to this contract,the Provider
is required to provide accurate and complete information pertaining to replacement or disposition of the property
as required on the Provider's annual inventory.
The Provider hereby agrees to indemnify the Department against any claim or loss arising out of the operation of
any motor vehicle purchased by or transferred to the Provider pursuant to this contract.
A formal contract amendment is required prior to the purchase of any property item not specifically listed in the
approved budget.
This amendment shall begin on July 15,2014,or the date on which the amendment has been signed by both parties,
whichever is later.
All provisions in the Grant Agreement and any attachments thereto in conflict with this amendment shall be and are
hereby changed to conform with this amendment.
All provisions not in conflict with this amendment are still in effect and are to be performed at the level specified in the
contract.
This amendment and all its attachments are hereby made a part of the contract.
(,
16j1 (`- ')
LHZ46 Amendment#0001
July 15,2014
IN WITNESS THEREOF, the parties hereto have caused this three (3) page amendment to be executed by their
officials thereunto duly authorized.
PROVIDER: FLORIDA DEPARTMENT OF CHILDREN AND
COLLIER COUNT :OAR, l F COUNTY COMMISSIONERS FAMILIES
SIGNED SIGNED•
BY: � '� r BY:
NAME: To M H f. r* G NAME: Hayden J. Mathieson
TITLE: C-N A 12 M A►J TITLE: Assistant Secretary for Substance Abuse
and Mental Health
DATE: CI I ) 14 DATE:
FEDERAL ID NUMBER: 59-6000558
DW -HT E. BR K, Clerk
Attest.as to Chairman`s
signature only
Approved as to form and legality
a-1-%__A—C4yrney
Assistant County
0-;
A:WAR/. 1 F (c)
4„,
Rick Scott
P. • o State of Florida Governor
Department of Children and Families
Mike Carroll
e6 -�� Interim Secretary
FNANDE
M •FLFAMI LI ES.COM
October 6, 2014
Kimberley Grant
Collier County Housing, Human and Veteran Services
3339 E. Tamiami Trail, Suite 211
Naples, FL 34112
Re: Grant Agreement#LHZ46—Executed Amendment#0001
Dear Ms. Grant:
Enclosed is an original copy of executed Amendment #0001 for the Collier County
Criminal Justice, Mental Health and Substance Abuse (CJMHSA) Reinvestment Grant
Agreement.
If you have any questions, please call me at (850) 717-4348.
Respectfully,
c2,
p co ,.tc7
Jennifer Benghuzzi o -0 w
Grant Manager — r"
N
cn o
cc: Contract File
1317 Winewood Boulevard, Tallahassee, Florida 32399-0700
Mission: Protect the Vulnerable, Promote Strong and Economically Self-Sufficient Families, and
Advance Personal and Family Recovery and Resiliency
16F1 cc)
LHZ46 Amendment#0001
July 15,2014
THIS AMENDMENT, entered into between the State of Florida, Department of Children and Families, hereinafter
referred to as the "Department," and Collier County Board of County Commissioners, hereinafter referred to as
the"Provider,"amends Grant Agreement#LHZ46.
This amendment adds provisions for proper accountability over state resources and a property clause for the
purchase of tangible personal property.
1. Page 13, EXHIBIT A, SECTION 7: OTHER TERMS, is hereby amended to read:
A-3 Financial Assistance.
If receiving state financial assistance,the Provider shall be in compliance with Section 215.97, Florida Statutes
(F.S.). Expenditures of state financial assistance shall be in compliance with laws, rules and regulations
applicable to expenditures of State funds, including, but not limited to,the Reference Guide for State
Expenditures. The Grant Agreement may be charged only with allowable costs resulting from obligations
incurred during the term of the Grant Agreement. Any balances of unobligated cash that have been advanced or
paid that is not authorized to be retained for direct program costs in a subsequent period must be refunded to the
State.
A-4 Property.
The word "property" as used in this section means equipment,fixtures, and other tangible personal property of a
nonconsumable and nonexpendable nature, the value or cost of which is $1,000 or more and the normal
expected life of which is 1 year or more, and hardback-covered bound books that are circulated to students or
the general public, the value or cost of which is $25 or more, and hardback-covered bound books, the value or
cost of which is $250 or more. Each item of property which it is practicable to identify by marking shall be
marked in the manner required by the Auditor General. Each custodian shall maintain an adequate record of
property in his or her custody, which record shall contain such information as shall be required by the Auditor
General. Once each year, on July 1 or as soon thereafter as is practicable, and whenever there is a change of
custodian, each custodian shall take an inventory of property in his or her custody. The inventory shall be
compared with the property record, and all discrepancies shall be traced and reconciled. All publicly supported
libraries shall be exempt from marking hardback-covered bound books, as required by this section. The catalog
and inventory control records maintained by each publicly supported library shall constitute the property record
of hardback-covered bound books with a value or cost of$25 or more included in each publicly supported library
collection and shall serve as a perpetual inventory in lieu of an annual physical inventory. All books identified by
these records as missing shall be traced and reconciled, and the library inventory shall be adjusted accordingly.
When state property will be assigned to a Provider for use in performance of a contract, the title for that property
or vehicle shall be immediately transferred to the Provider where it shall remain until this contract is terminated
or until other disposition instructions are furnished by the Contract Manager. When property is transferred to the
Provider, the Department shall pay for the title transfer. The Provider's responsibility starts when the fully
accounted for property or vehicle is assigned to and accepted by the Provider. Business arrangements made
between the Provider and its subcontractors shall not permit the transfer of title of state property to
subcontractors. While such business arrangements may provide for subcontractor participation in the use and
maintenance of the property under their control,the Department shall hold the Provider solely responsible for the
use and condition of said property. Provider inventories shall be conducted in accordance with Children and
Families Operating Procedure(CFOP)80-2.
1
I6F1Ca)
..
LHZ46 Amendment#0001
July 15,2014
If any property is purchased by the Provider with funds provided by this contract, the Provider shall inventory all
nonexpendable property including all computers. A copy of which shall be submitted to the Department along
with the expenditure report for the period in which it was purchased.At least annually the Provider shall submit a
complete inventory of all such property to the Department whether new purchases have been made or not.
The inventory shall include, at a minimum, the identification number; year and/or model,: a description of the
property, its use and condition; current location; the name of the property custodian; class code (use state
standard codes for capital assets); if a group, record the number and description of the components making up
the group; name, make, or manufacturer;serial number(s), if any,and if an automobile, the Vehicle Identification
Number(VIN) and certificate number; acquisition date; original acquisition cost;funding source; and, information
needed to calculate the federal and/or state share of its cost.
The Contract Manager must provide disposition instructions to the Provider prior to the end of the contract
period. The Provider cannot dispose of any property that reverts to the Department without the Contract
Manager's approval. The Provider shall furnish a closeout inventory no later than 30 days before the completion
or termination of this contract. The closeout inventory shall include all nonexpendable property including all
computers purchased by the Provider. The closeout inventory shall contain, at a minimum, the same information
required by the annual inventory.
The Provider hereby agrees that all inventories required by this contract shall be current and accurate and reflect
the date of the inventory. If the original acquisition cost of a property item is not available at the time of
inventory, an estimated value shall be agreed upon by both the Provider and the Department and shall be used
in place of the original acquisition cost.
Title (ownership) to and possession of all property purchased by the Provider pursuant to this contract shall be
vested in the Department upon completion or termination of this contract. During the term of this contract, the
Provider is responsible for insuring all property purchased by or transferred to the Provider is in good working
order. The Provider hereby agrees to pay the cost of transferring title to and possession of any property for
which ownership is evidenced by a certificate of title. The Provider shall be responsible for repaying to the
Department the replacement cost of any property inventoried and not transferred to the Department upon
completion or termination of this contract. When property transfers from the Provider to the Department, the
Provider shall be responsible for paying for the title transfer.
If the Provider replaces or disposes of property purchased by the Provider pursuant to this contract,the Provider
is required to provide accurate and complete information pertaining to replacement or disposition of the property
as required on the Provider's annual inventory.
The Provider hereby agrees to indemnify the Department against any claim or loss arising out of the operation of
any motor vehicle purchased by or transferred to the Provider pursuant to this contract.
A formal contract amendment is required prior to the purchase of any property item not specifically listed in the
approved budget.
This amendment shall begin on July 15,2014,or the date on which the amendment has been signed by both parties,
whichever is later.
All provisions in the Grant Agreement and any attachments thereto in conflict with this amendment shall be and are
hereby changed to conform with this amendment.
All provisions not in conflict with this amendment are still in effect and are to be performed at the level specified in the
contract.
This amendment and all its attachments are hereby made a part of the contract.
2
0
16F1cc)
LHZ46 Amendment#0001
July 15,2014
IN WITNESS THEREOF, the parties hereto have caused this three (3) page amendment to be executed by their
officials thereunto duly authorized.
PROVIDER: FLORIDA DEPARTMENT OF CHILDREN AND
COLLIER COUNy :OAR. "F COUNTY COMMISSIONERS FAMILIES
SIGNED SIGNED
BY: — r BY: % L
k),Ne 061,
NAME: To M 1-)g N#1 t4G NAME: + on J. MathieseR-
t ec, (-
TITLE: <,I1 A 12 M A 1J TITLE: Ass+eta4t-gesr4itapv for Substance Abuse
n and Mental Health
DATE: 1q114-- DATE: I C)/D5/1 t/
FEDERAL ID NUMBER: 59-6000558
ATTEST:
mW HT E: 8R K, Clerk
Attest s to Chairman's
signa ilreonly.
Approved as to form and legality
Assistant County ey
3