Backup Documents 10/28/2014 Item #16J3 ORIGINAL DOCUMENTS CHECKLIST & ROUTING S*P"
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
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.
2.
3. County Attorney Office County Attorney Office JAK 10/28/14
4. BCC Office Board of County
Commissioners V /s)/
5. Minutes and Records Clerk of Court's Office tpOD(Itk 3=3/{p
m
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 Lori Sams J %,..-1/4ccg 1/4c_e_, Phone Number 252-0842
Contact/ Department
Agenda Date Item was 10/28/14 Agenda Item Number 16-J-3
Approved by the BCC
Type of Document Equitable Sharing Agreement Certification Number of Original One
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. (Initial) Applicable)
1. Does the document require the chairman's original signature? JAK
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.
3. Original document has been signed/initialed for legal sufficiency. (All documents to be JAK
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 JAK
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 JAK
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 JAK
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip JAK
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 10/28/14 and all changes made during JAK
the meeting have been incorporated in the attached document. The County ,Iri, •;`
Attorney's Office has reviewed the changes, if applicable.
9. Initials of attorney verifying that the attached document is the version approved by the JAK _
BCC, all changes directed by the BCC have been made, and the document is ready for e
Chairman's signature. � �a�,
PLEASE CONTACT LORI SAMS @ 252-0842 WHEN DOCUMENT IS RE•
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
1 6J 3 .
Ann P. Jennejohn
From: Lori Sams - 1392 <Lori.Sams@colliersheriff.org>
Sent: Friday, October 31, 2014 2:25 PM
To: Ann P.Jennejohn
Subject: RE: Equitable Sharing Agreement and Certification (October 28 Agenda Item #16J3)
If you could e-mail it to me that would be great. I will be by on Monday to pick it up.
Lori Sams
Budget Analyst
X2842
239.252.0842
Lori.Sams@colliersheriff.org
From: Ann P. Jennejohn [mailto:Ann.Jennejohn@collierclerk.com]
Sent: Friday, October 31, 2014 2:24 PM
To: Lori Sams - 1392
Subject: Equitable Sharing Agreement and Certification (October 28 Agenda Item #16J3)
Hi Lori,
I have the Sheriff Office's signed Annual Equitable Sharing Agreement
and Certification that was approved by the Board of County Commissioner's
(Item #16J3)this past Tuesday. Would you like me to put it in inter-office
mail to your attention? Or you can stop by our office to pick it up?
I could also email a copy of it to you until you're able to pick it up, if it's helpful.
Please let me know how you'd like to proceed and what I can do to help.
Thank you!
Ann Jennejohn, Deputy Clerk
Clerk of the Circuit Court
Collier County Board Minutes & Records Dept.
239-252-8406
239-252-8408 (Fax)
Please visit us on the web at www.collierclerk.com
This electronic communication is confidential and may contain privileged information intended solely for the named addressee(s). It may not be
used or disclosed except for the purpose for which it has been sent. If you are not the intended recipient,you must not copy,distribute or take
any action induced by or in reliance on information contained in this message.
Unless expressly stated,opinions in this message are those of the individual sender and not of the Office of the Clerk of the Circuit Court of
Collier County. If you have received this communication in error, please notify the Clerk's Office by emailing helpdesk@ collierclerk.com quoting
the sender and delete the message and any attached documents.The Collier County Clerk's Office accepts no liability or responsibility for any
onward transmission or use of emails and attachments having left the CollierClerk.com domain.
1
1 6J 3
Ann P. Jennejohn
From: Ann P.Jennejohn
Sent: Friday, October 31, 2014 2:44 PM
To: Lori.Sams@colliersheriff.org
Subject: Equitable Sharing Agreement and Certification
Attachments: Equitable Sharing Agreement and Certification.pdf
Hi Lori,
Here's a copy of the Equitable Sharing Agreement.
The original will be ready for your pick-up, whenever
it's convenient for you to stop-by on Monday.
Thank you, have a nice weekend!
Ann Jennejohn, Deputy Clerk
Clerk of the Circuit Court
Clerk of the Value Adjustment Board
Collier County Minutes & Records Dept.
239-252-8406
239-252-8408 (Fax)
1
1 6 J 3
i\ f OMB Number 1123-0011
Equitable Sharing '' Expires 9-30-2014
r'�
) Agreement and
\� 'f Certification
Police Department 0 Sheriff's Office 0 Task Force (Complete Table A)
Prosecutor's Office 0 National Guard Counterdrug Unit Q Other
`Please fill each required field. Hover mouse over any fillable field for pop-up instructions.
Agency Name:Collier County Sheriffs Office
NCIC/ORI/Tracking Number: F L 0 1 , 1 0 0 0 0
Mailing Address: 3319 E. Tamiami Trail
City: Naples State: FL Zip:34112
Finance Contact: First:Lori Last: Sams
Phone:239-252-0842 E-mail: Lori.Sams@colliersherifforg
Preparer: First:Lori Last: Sams
Same as Phone: 239-252-0842 E-mail: Lori.Sams@colliersheriff.or
Finance Contact g
Independent Public Accountant: E-mail: Julie.Fowler@claconnect.com
Last FY End Date: 09/30/2014 Agency Current FY Budget: $142,092,500.00
New Participant: Read the Equitable Sharing Agreement and sign the Affidavit.
Complete the Annual Certification Report,read the Equitable Sharing Agreement,and sign
• Existing Participant: the Affidavit.
Amended Form: Revise the Annual Certification Report,read the Equitable Sharing Agreement,and sign
the Affidavit.
Annual Certification Report
Summary of Equitable Sharing Activity Justice Funds Treasury Funds`_
1 Beginning Equitable Sharing fund Balance(must match
Ending Equitable Sharing Fund Balance from prior FY) $656,678.67 $385,877.36
2 Federal Sharing Funds Received $42,988.28
3 Federal Sharing Funds Received from Other Law Enforcement
Agencies and Task Forces(To populate,complete Table(3)
4 Other Income
5 Interest Income Accrued Non-Interest Bearing 0
Interest Bearing 0 $1,039.36 $965.90
6 Total Equitable Sharing Funds(total of lines 1 -5) $700,706.31 $386,843.26
7 Federal Sharing Funds.Spent(total of lines a-m below) $316,344.68 $0.00
8 Ending Balance(difference between line 7 and line 6) $384,361.63 $386,843.26
1 Justice Agencies are:FBI,DEA,ATF,USPIS,USDA,DCIS,DSS,and FDA.
2 Treasury Agencies are:IRS,ICE,CBP,TTB,USSS,and USCG.
Page 1 of 5 October 2012
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Summary of Shared Funds Spent Justice Funds Treasury Funds
Ia Total spent on salaries under permitted salary exceptions
b Total spent on overtime
c Total spent on informants,"buy money",and rewards
d Total spent on travel and training
e Total spent on communications and computers
f Total spent on weapons and protective gear
' � I
g Total spent on electronic surveillance equipment $316,344.68
h Total spent on buildings and improvements
Total transfers to other participating state and local law
enforcement agencies(To populate,complete Table C)
Total spent on other law enforcement expenses(To populate,
complete Table D)
k Total Expenditures in Support of Community-Based Programs
(To populate,complete Table E)
I Total Windfall Transfers(To populate,complete Table F)
Total spent on matching grants(To populate,complete
m I Table G)
n Total $316,344.68 $0.00
o I Did your agency receive non-cash assets? Q Yes ® No If yes,complete Table H.
Please fill out the following tables,if applicable.
Table A: Members of Task Force
Agency Name NCIC/ORI/Tracking Number
Table B: Equitable Sharing Funds Received from other Agencies
Transferring Agency Name,City,and State Justice Funds Treasury Funds
Agency Name:
NCIC/ORI/Tracking Number:
Table C: Equitable Sharing Funds Transferred to Other Agencies
Receiving Agency Name,City,and State Justice Funds Treasury Funds
Agency Name:
NCIC/ORI/Tracking Number:
Page 2 of 5 October 2012
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Table D: Other Law Enforcement Expenses
Description of Expense Justice Funds Treasury Funds
Table E: Expenditures in Support of Community-Based Programs
Recipient Justice Funds
Table F: Windfall Transfers
Recipient Justice Funds Treasury Funds
fes— if
ii
Table G: Matching Grants
Matching Grant Name Justice Funds Treasury Funds
Table H: Other Non-Cash Assets Received
Source Description of Asset
Justice 0
Treasury 0
Table I: Civil Rights Cases
Name of Case Type of Discrimination Alleged
National 1
0 Race �0 Color ❑ Origin ❑ Gender
1 u Disability ❑ Age 0 Other
Paperwork Reduction Act Notice
Under the Paperwork Reduction Act, a person is not required to respond to a collection of information
unless it displays a valid OMB control number. We try to create accurate and easily understood forms
that impose the least possible burden on you to complete. The estimated average time to complete this
form is 30 minutes. If you have comments regarding the accuracy of this estimate,or suggestions for
making this form simpler,please write to the Asset Forfeiture and Money Laundering Section,
1400 New York Avenue,N.W.,Washington,DC 20005.
Page 3 of 5 October 2012
Veiw.,n 2.1
16J3
Equitable Sharing Agreement
This Federal Equitable Sharing Agreement,entered into among (1)the Federal Government,(2)the above-stated law
enforcement agency("Agency"),and (3)the governing body,sets forth the requirements for participation in the
federal Equitable Sharing Program and the restrictions upon the use of federally forfeited cash, property, proceeds,
and any interest earned thereon,which are equitably shared with participating law enforcement agencies.
By its signatures,the Agency agrees that it will be bound by the statutes and guidelines that regulate shared assets
and the following requirements for participation in the federal Equitable Sharing Program. Receipt of the signed
Equitable Sharing Agreement and Certification (this"Document")is a prerequisite to receiving any equitably shared
cash, property,or proceeds.
1.Submission. This Document must be submitted to aca.submit@usdoj.gov within 60 days of the end of the
Agency's fiscal year. This Document must be submitted electronically with the Affidavit/Signature submitted by fax.
This will constitute submission to the Department of Justice and the Department of the Treasury.
2.Signatories. This agreement must be signed by the head of the Agency and the head of the governing body.
Examples of Agency heads include police chief,sheriff,director,commissioner,superintendent,administrator,
chairperson,secretary,city attorney,county attorney,district attorney,prosecuting attorney,state attorney,
commonwealth attorney,and attorney general. The governing body's head is the person who allocates funds or
approves the budget for the Agency. Examples of governing body heads include city manager, mayor,city council
chairperson,county executive,county council chairperson,director,secretary,administrator,commissioner,and
governor.
3.Uses. Any shared asset shall be used for law enforcement purposes in accordance with the statutes and guidelines
that govern the federal Equitable Sharing Program as set forth in the current edition of the Department of Justice's
Guide to Equitable Sharing for State and Local Law Enforcement(Justice Guide),and the Department of the Treasury's
Guide to Equitable Sharing for Foreign Countries and Federal,State,and Local Law Enforcement Agencies (Treasury
Guide).
4.Transfers. Before the Agency transfers cash,property,or proceeds to other state or local law enforcement
agencies,it must first verify with the Department of Justice or the Department of the Treasury,depending on the
source of the funds,that the receiving agency is a current and compliant Equitable Sharing Program participant.
5.Internal Controls. The Agency agrees to account separately for federal equitable sharing funds received from the
Department of Justice and the Department of the Treasury. Funds from state and local forfeitures and other sources
must not be commingled with federal equitable sharing funds. The Agency shall establish a separate revenue
account or accounting code for state,local,Department of Justice,and Department of the Treasury forfeiture funds.
Interest income generated must be accounted for in the appropriate federal equitable sharing account.
The Agency agrees that such accounting will be subject to the standard accounting requirements and practices
employed for other public funds as supplemented by requirements set forth in the current edition of the Justice Guide
and the Treasury Guide, including the requirement in the Justice Guide to maintain relevant documents and records for
five years.
The misuse or misapplication of shared resources or the supplantation of existing resources with shared assets is
prohibited. Failure to comply with any provision of this agreement shall subject the recipient agency to the sanctions
stipulated in the current edition of the Justice or Treasury Guides,depending on the source of the funds/property.
6.Audit Report. Audits will be conducted as provided by the Single Audit Act Amendments of 1996 and OMB
Circular A-133. The Department of Justice and Department of the Treasury reserve the right to conduct periodic
random audits.
Page 4 of 5 October 2012
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16J3 4;
Affidavit - Existing Participant
Under penalty of perjury,the undersigned officials certify that they have read and understand their obligations under
the Equitable Sharing Agreement and that the information submitted in conjunction with this Document is an accurate
accounting of funds received and spent by the Agency under the Justice and/or Treasury Guides during the reporting
period and that the recipient Agency is in compliance with the National Code of Professional Conduct for Asset Forfeiture.
The undersigned certify that the recipient Agency is in compliance with the nondiscrimination requirements of the
following laws and their Department of Justice implementing regulations: Title VI of the Civil Rights Act of 1964(42 U.S.C.
§2000d et seq.),Title IX of the Education Amendments of 1972(20 U.S.C.§ 1681 et seq.),Section 504 of the Rehabilitation
Act of 1973(29 U.S.C.§794),and the Age Discrimination Act of 1975(42 U.S.C.§6101 et seq.),which prohibit
discrimination on the basis of race,color,national origin,disability,or age in any federally assisted program or activity,or
on the basis of sex in any federally assisted education program or activity. The Agency agrees that it will comply with all
federal statutes and regulations permitting federal investigators access to records and any other sources of information as
may be necessary to determine compliance with civil rights and other applicable statutes and regulations.
During the past fiscal year: (1) has any court or administrative agency issued any finding,
judgment, or determination that the Agency discriminated against any person or group in
violation of any of the federal civil rights statutes listed above;or(2) has the Agency entered
into any settlement agreement with respect to any complaint filed with a court or
administrative agency alleging that the Agency discriminated against any person or group in
violation of any of the federal civil rights statutes listed above? Yes No
If you answered yes to the above question,complete Table I
Agency Head Governing Body He
Signature: :) ,:,,c k Signature:
Name: Kevin J. Rambosk Name: Tom Henning
Title: Sheriff / y Title: Chairman, BCC
Date: /-q1,-:,,/ r y Date:
E-mail: hq@colliersheriff.net E-mail: TomHenningopcolliergov.net
Subscribe to Equitable Sharing Wire: Lori.Sams@colliersheriff.org
The Equitable Sharing Wire is an electronic newsletter that
gives you important,substantive,information regarding
Equitable Sharing policies,practices,and procedures.
Final Instructions:
Step 1: Click to save for your records Step 3: Email the XML file to aca.submit@usdoj.gov
Step 2: Click to save in XML format Step 4: Scan&email this Affidavit to aca.affidavit@usdoj.gov
(Email subject line must include Agency NCIC/ORI Code)
FOR AGENCY USE ONLY
Entered by 1 1 11 11 11 11 11 11 11 1111111 11 111 1 11 111 1 11 1 111111 1 1
Entered on
O FY End: 09/30/2014 Date Printed: October 10,2014 11:51
® NCIC: FLO110000 Agency: Collier County Sheriffs Office Phone:239-252-0842
O
State:FL Preparer: Lori Sams E-mail: Lori.Sams@colliersheriff.org
A •'
DWIGHT E.B•OCK,CLERK Page 5 of 5 Appr -COM and legality: October 2012
Ili Version 2.1
1 f I C •. Jeffrey,.'. kow
Count Att.rney