Backup Documents 01/09/2018 Item #16D 3 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 D 3
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 Office5791 1 Ju 17
4. BCC Office Board of County ‘,►k,k
Commissioners \r‘r-4z/ t Itcsk
5. Minutes and Records Clerk of Court's Office
Nc\(*- to\i<Z) 3:et° Y)'}'""
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 addit.onal or missing information.
Name of Primary Staff Tanya William Library Director 593-3511
Contact/Department
Agenda Date Item was 1/9/2018 Agenda Item Number 11443
Approved by the BCC 3
Type of Document Facility Use Agreements for Election Day Number of Original 2
Attached Documents Attached
PO number or account n/a
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 signatur, AMP OK add' t\i/O
2. Does the document need to be sent to another agency for as:' 'onal sin.• ? If yes, TW
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 TW
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 TW
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 TW
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 -
signature and initials are required.
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 /
MinuteTraq. 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(-1-I5' and all changes made during N/A is not
the meeting have been incorporated in the attached document. The County �U, art option for
Attorney's Office has reviewed the changes,if applicable. �Ir' this line.
9. Initials of attorney verifying that the attached document is the version approved by the ( N/A N/A is not
V
BCC,all changes directed by the BCC have been made, and the document is ready for the an option for
Chairman's signature. this
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
16D 3
MEMORANDUM
Date: January 11, 2018
To: Tanya Williams,
Collier County Public Library
From: Martha Vergara, Deputy Clerk
Minutes & Records Department
Re: Facility Use Agreements for Election Day
Attached is a scanned copy of the two (2) agreements referenced above, (Item
#16D3) adopted by the Board of County Commissioners on Tuesday, December
12, 2017.
The original has been kept by the Minutes & Records Department as part of the
Board's Official Records.
If you have any questions, please contact me at 252-7240.
Thank you.
Attachment
FACILITY USE AGREEMENT FOR ELECTION DAY 1 6 D 3
Precinct Number 155
This agreement is between, Jennifer J. Edwards, as Supervisor of Elections for Collier County,
Florida and the Collier County Board of County Commissioners described hereafter as the
"Owner."
The parties agree that the following Facility shall be used as a polling place for conducting elections on the dates
specified. This includes the use of the polling room and any areas necessary to access the polling room. Also included is
the use of the parking lot, sidewalks, bathrooms, and for election workers, tables, chairs, and kitchen facilities.
Name of Facility: South Regional Library
Address of Facility: 8065 Lely Cultural Pkwy
Naples, FL 34113
Dates of use for 2018 Election Cycle:
Election Equipment Delivery and Set Up Date Election Date Equipment Retrieval Date
Primary Election August 27, 2018 August 28, 2018 August 29, 2018
General Election November 5, 2018 November 6, 2018 November 7, 2018
1. The owner agrees to notify the SOE prior to any construction/remodel that will impact the polling room and any areas
necessary to access the polling room. Also included is the use of parking lot, sidewalks, bathrooms, and kitchen facilities.
2. The owner agrees to allow voting equipment to be delivered and set up the day prior to election day and removed the day after
the election.
3. The owner agrees to provide access to the voting room no later than 6:00 a.m. on election day and until ALL voting
procedures are complete on election night.
4. The owner agrees that the polling room will be used only by voters and election workers during voting hours in accordance
with Florida Statute 102.031(3)(a).
5. The owner recognizes the solicitation restrictions in accordance with Florida Statute 102.031(4)(a)(b)(c). Owner delegates to
the Supervisor of Election the power to act on his, her, or its behalf in enforcing the above. Further, owner agrees that he/she/it
shall not directly or indirectly place any material prohibited under the above statute within the area described nor authorize or
attempt to authorize any person to do anything which contravenes the intent of the above statutes.
6. The owner agrees to allow our telephone provider to install and/or maintain our permanently dedicated phone line to be used
solely for election purposes. All such fees and costs will be paid by the Supervisor of Elections.
Indemnification Statement: Each party shall be liable for its own actions and negligence and, to the extent permitted by law. The
Supervisor shall indemnify, defend and hold harmless the Owner against any actions, claims or damages arising out of negligent acts
caused by any of its officials or employees in connection with this Agreement, and the Owner shall indemnify, defend and hold
harmless the Supervisor against any actions, claims, or damages arising out of the Owner's negligence in connection with this
Agreement. The foregoing indemnification shall not constitute a waiver of sovereign immunity beyond the limits set forth in Florida
Statutes, Section 768.28, nor shall the same be construed to constitute agreement by either party to indemnify the other party's
negligent,willful or intentional acts or omissions.
Dr-Awr. Mc,N -ark hones 2
Facility contact(s): at Phone No: 52.-'12. and Email Address: O+ENktiE•McAlmkoY4 Q. .
Rental Payment Fee is$200.00 dollars Per Election (Payments to be Processed Following each Election). col(ievcauw. Cl•Tv
Does the Owner waive the Rental Payment Fee? YES-Sc NO U
Taxpayer supported facilities,e.g.schools, parks, libraries, etc; are not eli..i. - • receive the rental .. ment fee.
CYN 'TA. \cr. /1 ..
Authorized FacilityRepresitntative Printed Name Authorized Fac. -epresentat e signature
Chairman, ".. d of Co'. y Commissioners
Date Signed Phone Number
la 4
Jennifer J. Edw rds/Collier 0 - y.upervisor of Elections Date Signed
*Please sign document and return to the Supervisor of Elections Office along with P p S tic, :-1r�..� Ci�.
Ap oved as to fo and legality UUU11I1YY CCii►VVVVIERtX_
—) '—'
�✓2____._,__ BY: Attest as to Chum ,-
oepu C1244.016; A-91 iyvN.c1, cinnatllrP 0111V.
FACILITY USE AGREEMENT FOR ELECTION DAY 1 6 D 3
Precinct Number 251
This agreement is between, Jennifer J. Edwards, as Supervisor of Elections for Collier County,
Florida and the Collier County Board of County Commissioners described hereafter as the
"Owner."
The parties agree that the following Facility shall be used as a polling place for conducting elections on the dates
specified. This includes the use of the polling room and any areas necessary to access the polling room. Also included is
the use of the parking lot, sidewalks, bathrooms, and for election workers, tables, chairs, and kitchen facilities.
Name of Facility: Library Headquarters
Address of Facility: 2385 Orange Blossom Dr
Naples, FL 34109
Dates of use for 2018 Election Cycle:
Election Equipment Delivery and Set Up Date Election Date Equipment Retrieval Date
Primary Election August 27, 2018 August 28, 2018 August 29, 2018
General Election November 5, 2018 November 6, 2018 November 7, 2018
1. The owner agrees to notify the SOE prior to any construction/remodel that will impact the polling room and any areas
necessary to access the polling room. Also included is the use of parking lot, sidewalks, bathrooms, and kitchen facilities.
2. The owner agrees to allow voting equipment to be delivered and set up the day prior to election day and removed the day after
the election.
3. The owner agrees to provide access to the voting room no later than 6:00 a.m. on election day and until ALL voting
procedures are complete on election night.
4. The owner agrees that the polling room will be used only by voters and election workers during voting hours in accordance
with Florida Statute 102.031(3)(a).
5. The owner recognizes the solicitation restrictions in accordance with Florida Statute 102.031(4)(a)(b)(c). Owner delegates to
the Supervisor of Election the power to act on his, her, or its behalf in enforcing the above. Further,owner agrees that he/she/it
shall not directly or indirectly place any material prohibited under the above statute within the area described nor authorize or
attempt to authorize any person to do anything which contravenes the intent of the above statutes.
6. The owner agrees to allow our telephone provider to install and/or maintain our permanently dedicated phone line to be used
solely for election purposes.All such fees and costs will be paid by the Supervisor of Elections.
Indemnification Statement: Each party shall be liable for its own actions and negligence and, to the extent permitted by law. The
Supervisor shall indemnify, defend and hold harmless the Owner against any actions, claims or damages arising out of negligent acts
caused by any of its officials or employees in connection with this Agreement, and the Owner shall indemnify, defend and hold
harmless the Supervisor against any actions, claims, or damages arising out of the Owner's negligence in connection with this
Agreement. The foregoing indemnification shall not constitute a waiver of sovereign immunity beyond the limits set forth in Florida
Statutes, Section 768.28, nor shall the same be construed to constitute agreement by either party to indemnify the other party's
negligent,willful or intentional acts or omissions.
A Cz 59
) "2-d'S''i 4.
Facility contact(s): A PtZ-t� RI`frM at Phone No: :Ai',•'tel l and Email Address: h9(2.41-.Qvvi E. .
Rental Payment Fee is$200.00 dollars Per Election (Payments to be Processed Following each Election). Cot l((Neauw.4yct, e,/
Does the Owner waive the Rental Payment Fee? YES_>c NO U
Taxpayer supported facilities,e.g.schools, parks, libraries, etc; are not eli ' eceive the rental ent fee.
Authorized F cility Representative Printed Name Authorized Faci' epresentati gnature
\`q` `41 Chairman, Board of County Commissioners
Date Sign / Phone Number
,7
G
Jennifer J. Etd ards/Colli..r •,. y .upervisor of Elections Date Sig .EST
*Please sign document and return to the Supervisor of Elections Office along wits•• tc,' H.::. a C ERK
oved as to nu and legality j� , �
31- BY. . , a. I ,•in '11 r
Scott R.Teach.Deputy County Attorney signature only.