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Backup Documents 05/24/2016 Item #11F
ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 11 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. Michelle Rubbo Community &Human �- J+r Services (CHS) Division / (o 2. County Attorney Office County Attorney Office 10,4?) 51(. 1Y. 3. BCC Office Board of County 1 .r b' i fir Commissioners 4 .} 4. Minutes and Records Clerk of Court's Office 0 s(Iti110 '�: ZI prh 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 Rosa Munoz, CHS , Phone Number 252-5713 Contact/ Department s. Zq ti (P Agenda Date Item was V/ Agenda Item Number ‘.� 4_t ( , _r' Approved by the BCC Type of Document 1. Amendment#1 to Habitat for Humanity Number of Original r' Attached Agreement(Scattered Sites Acquisition Documents Attached 2015) 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,whichever is Yes N/A(Not appropriate. = (Initial) Applicable) 1. Does the document require the chairman's original signature? damped signature k RM 2. Does the document need to be sent to another agency for additialt signatures?' If yes, N/A 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 RM 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 N/A 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 RM 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 RM signature and initials are required. 7. In most cases(some contracts are an exception),the original document and this routing slip RM 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 05710716 and all changes made RM during the meeting have been incorporated in the attached docume t. "The County Attorney's Office has reviewed the changes,if applicable. -?/ `)//uc (----(?)11 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 11F MEMORANDUM Date: May 25, 2016 To: Rosa Munoz, Grant Coordinator Community & Human Services From: Teresa Cannon, Deputy Clerk Minutes & Records Department Re: Amendment #1 to Habitat for Humanity Agreement— Scattered Sites Acquisition Project Grant #B-15-UC-12-0016 Attached are two (2) original amendments to the agreement referenced above, (Item #11F) approved by the Board of County Commissioners on Tuesday, May 24, 2016. An original has been kept by the Minutes and Records Department for the Official Records of the Board. If you have any questions, please feel free to contact me at 252-8411. Thank you. Attachment hF 1F8 FAIN# B-15-UC-12-0016 Federal Award Date Est. 10/2015 Federal Award Agency HUD CFDA Name Community Development Block Grant CFDA/CSFA# 14.218 Total Amount of Federal $500,000 Funds Awarded Subrecipient Name Habitat for Humanity of Collier County, Inc. DUNS# 080676690 FEIN# 59-1834379 R& D No Indirect Cost Rate No Period of Performance 10/01/2015-07/31/2016 Fiscal Year End 6/30 Monitor End: 09/2026 FIRST AMENDMENT TO AGREEMENT BETWEEN COLLIER COUNTY AND HABITAT FOR HUMANITY OF COLLIER COUNTY,INC. THIS Amendment is entered into this day off4A12016, by and between HABITAT FOR HUMANITY OF COLLIER COUNTY, INC., a private not-for-profit corporation existing under the laws of the State of Florida, herein after referred to as SUBRECIPIENT and Collier County, Florida, hereinafter to be referred to as"COUNTY," collectively stated as the "Parties." WHEREAS, on October 27, 2015, the COUNTY entered into an Agreement for awarding Community Development Block Grant Program funds to be used for Scattered Sites Acquisition Project (hereinafter referred to as the"Agreement"); and WHEREAS,the Parties desire to amend the Agreement to shift remaining project funds between line items in order to fully expend awarded funds. 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: Words Stray-It-Through are deleted; Words Underlined are added Habitat for Humanity CD1S-01-IDIS#514 Scattered Sites Acquisition Page 1 Amendement#1 0 i F PART I SCOPE OF WORK 1.2 PROJECT DETAILS A. Project Description/Project Budget Line Items: Current CDBG Budget Shift Proposed New Budget request Budget Project Component 1:Scattered Sites $450,000.00 $49,900.00 $499,900.00 Acquisition Purchase of vacant lots located throughout Collier County; appraisal, inspections, survey, environmental and closing costs. Project Component 2: Project Delivery $50,000.00 ($49,900.00) $100.00 The SUBRECIPIENT will complete program management and other project compliance activities conducted by staff or contracted party. Total $500,000.00 0 $500,000.00 * * * E. Payment Deliverables Payment Deliverable Payment Supporting Documentation Submission Schedule Project Component 1: Scattered Sites Submission of monthly invoices and At time of aquisition Acquisition backup as evidenced by HUD Purchase of vacant lots located 1/invoice/closing documents/deed throughout Collier County; to also restriction, note, mortgage/banking include but not limited to those cost documents/Exhibit B and any associated with the acquisition, additional documentation as survey, appraisal, inspection and requested environmental. There will be no retainage held on this component Project Component 2: Project Submission of monthly invoices and Monthly Delivery: Program management and backup as evidenced by/banking compliance related activities in documents/time sheets/Exhibit B and support of project implementation any additional documentation as performed by in house staff or requested Habitat for Humanity CD15-01-IDIS#514 Scattered Sites Acquisition Amendement#1 Page 2 0 contracted 3rd party 10% up to a total of X000 Q will be withheld from component#2 invoice 10% of Component #2 invoice up to $5,000.00 0 will be retained and released upon documentation that a CDBG National Objective has been met. Failure on behalf of the subrecipient in achieving the national objective under this agreement will require repayment of the entire CDBG investment under this agreement.All homes shall be constructed and occupied no later than July 2021. SIGNATURE PAGE TO FOLLOW ON NEXT PAGE REMAINDER OF PAGE INTENTIONALLY LEFT BLANK Habitat for Humanity CD15-01-IDIS#514 Scattered Sites Acquisition Amendement#1 Page 3 0 jj , 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: BOAR F COUNTY OMMISSIONERS OF COLLIER DWIGHT E. BROCK,CLERK COU FLORIDA • ° s Z1-14240 By; Attest to chpfjti?t Ierk DONNA FIALA,CHAIRMAN signature only, Approval Date: NA IAy tO12d%S.• _7Sgl/_ HABITAT FOR HUMANITY OF COLLIER COUNTY,INC. Dated: �C `P (SEAL) By: -- Nick Kouloheras,V.P.of Land Development Approved as to form and legality: Jennifer A. Belpedio Assistant County Attorney C Habitat for Humanity CD15-01-IDIS#514 Scattered Sites Acquisition Amendement#1 Page 4 0 11 F CDOV) w 7F: • • •r- O w .p w w V hF'I F +... 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