Backup Documents 11/15/2016 Item #16D10 16010
COMMUNITY AND HUMAN SERIVCES
INTEROFFICE MEMORANDUM
TO: Board Minutes and Records
FROM: Lisa N. Carr, Grants Coordinator, CHS
DATE: December 5, 2016
RE: Agreements between Area Agency on Aging for Southwest Florida, Inc and
Collier County
Please find attached a fully executed document that was approved by the BCC on the day listed
below for recording in Minutes and Records. Feel free to contact me if you have any questions.
BCC Approved on November15,2016 Item 16D7, 16D8, 16D9 and 16D10.
Thank you for your assistance.
Amendment 001 October 2015 —December 2016 NSIP 203.16.001
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC. 1 6 01 0
NUTRITION SERVICES INCENTIVE PROGRAM
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
THIS AMENDMENT is entered into between the Area Agency on Aging for Southwest Florida, Inc. ("Agency") and
Collier County Board of County Commissioners("Contractor"), amends agreement NSIP 203.16.
The purpose of this amendment is to replace ATTACHMENT I, SECTION 1.2.4 Term of Provision of Services; 3.2.1
Payment Requests and 3.2.3 Date for Final Request for Payment by extending the contract until December 31, 2016,
increase Collier allocation by$24,472.77, amend 4. Contract Amount and wherever stated throughout the contract,
amend Section HI METHOD OF PAYMENT, 3.1 GENERAL STATEMENT OF METHOD OF PAYMENT,add
Section IV SPECIAL PROVISIONS, and revise ATTACHMENT HI by adding the FEIN and DUNS Numbers as
well as the increased allocation
Line denotes completion of above summary
4. Contract Amount:
The Agency agrees to pay for contracted services according to the terms and conditions of this contract in an amount
not to exceed$62,727.77. Any costs or services paid for under any other contract or from any other source are not
eligible for payment under this contract.
1.2.4 Term of Provision of Services
The term of this contract for the delivery of services shall be October 1, 2015 through December 31, 2016.
3.2.1 Payment Requests
All payment requests shall be based on the submission of actual monthly expenditure reports beginning with
the first month of the contract. The due date for the request for reimbursement and report(s) is no later than the
9th day of the month following the month being reported, except for the fmal request for reimbursement, which
is due no later than February 5,2017.
3.23 Date for Final Request for Payment
The fmal request for payment is due to the Agency no later than February 5. 2017. This contract is for services
provided during the 2015 Federal Fiscal Year beginning October 1. 2015 through December 31.2016.
SECTION HI: METHOD OF PAYMENT
GENERAL STATEMENT OF METHOD OF PAYMENT
This is a fixed rate contract. The Agency shall make payment to the Contractor for provision of services up to
a maximum number of units of service and at the prospective rate stated below:
Service to be Provided Unit of Service Unit Rate
Eligible Congregate and 1 unit= 1 meal $.72
Home Delivered Meals
The prospective rate is based on the estimated OAA grant award.
1
0A0
Amendment 001 October 2015 —December 2016 NSIP 203.16.001
COLLIER 1 6 010
Service to be Provided Unit of Service Unit Rate Maximum Units Allocation
Eligible Congregate and 1 unit= 1 meal $.72 87,121 $62,727.77
Home Delivered Meals
This amendment shall be effective September 30, 2016. All provisions in the 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
agreement.
This amendment and all of its attachments are hereby made a part of this agreement.
IN WITNESS WHEREOF, the parties hereto have caused this 3 page amendment to be executed by their officials there
unto duly authorized.
Recipient: COLLIER COUNTY BOARD OF AREA AGENCY ON AGING FOR SOUTHWEST
COUNTY COMMISSIONERS FLORIDA,INC.
SIGNED BY: PP 4 SIGNED BY: `7Z,j&2, 2
NAME: STEVE Y. CARNELL NAME: MARIANNE G LORINI
TITLE: PUBLIC SERVICES DEPARTMENT HEAD TITLE: PRESIDENT/CEO
DATE: October 1 ,2016 DATE: l t 2 7l/Ca
Federal Tax ID: 59-6000558
Fiscal Year Ending Date: 09/30
Approved as to form and legality
Assistant County >rncy
2
:F .
Amendment 001 October 2015 December 2016 NSIP 203.16.001
61310
TACHMENT III
1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO
THIS CONTRACT CONSIST OF THE FOLLOWING:
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
GRANT AWARD (FAIN#): 16AAFLNSIP
DUNS NUMBER :076997790 FEDERAL AWARD DATE: AMOUNT
OCTOBER 28, 2015
Nutrition Services Incentive Program Collier County FGTF 93.053 $62,727.77
TOTAL FEDERAL AWARD $62.727.77
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES
AWARDED PURSUANT TO THIS CONTRACT ARE AS FOLLOWS: N/A
FEDERAL FUNDS:
2 CFR Part 200 Uniform Administrative Requirements,Cost Principles,and Audit Requirement for Federal Awards.
STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS CONTRACT
CONSIST OF THE FOLLOWING:
MATCHING RESOURCES FOR FEDERAL PROGRAMS
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
$0
STATE FINANCIAL ASSISTANCE SUBJECT TO Sec. 215.97,F.S.
PROGRAM TITLE FUNDING SOURCE CSF AMOUNT
TOTAL AWARD
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED
PURSUANT TO THIS CONTRACT ARE AS FOLLOWS:
N/A
3
0
Revised August 2007 1 6 D 10
Attestation Statement
Agreement/Contract Number NSIP 203.16
Amendment Number 001
I, Steve Y. Carnell ,attest that no changes or revisions have been made to the
(Recipient/Contractor representative)
content of the above referenced agreement/contract or amendment between the Area Agency on Aging for
Southwest Florida and
Public Services Department Head
(Recipient/Contractor name)
The only exception to this statement would be for changes in page formatting,due to the differences in
electronic data processing media,which has no affect on the agreement/contract content.
\ 0//1
!Ii 00
' October 13 , 2016
Signature of Recipient/Contractor representative Date
Approved as to form and legality
• ssistant County s% racy
\e
Revised August 2007
pp.