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Backup Documents 01/22/2013 Item #16D1 160 11 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Print on pink paper.Attach to original document.Original documents should be hand delivered to the Board Office.The completed routing slip and original documents are to be forwarded to the Board Office only after the Board has taken action en the item.) ROUTING SLIP Complete routing lines#1 through#3 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#3,complete the checklist,and forward to the BCC Office(line#4). Route to Addressee(s) Office Initials Date (List in routing order "� Yg Housing,Human,Veterans Services BH 1/24/13 Department 2. Jennifer B.White,ACA Office located within Housing,Human, Veterans Services Department 8 tki N\zcl 1� 3. County Attorney's Office County Attorney's Office 4. BCC Office Board of County Commissioners Vk S`11 5. Minutes and Records Clerk ofCoure Of a° , A$E SEND CERTIFIED COPY TO 2(5((3 DAMIETTA PRIMARY CONTACT INFORMATION (The primary contact is the holder of the original document pending BCC approval.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,need to contact staff for additional or missing information.All original documents needing the BCC Chairman's signature are to be delivered to the BCC office only after the BCC has acted to ap,rove the item.) Name of Primary Staff Barbetta H chinsonys rz Phone Number 22 Contact c�ri-c� ar-�eccstcloc,. Agenda Date Item was Agenda Item Number Approved by the BCC Type of Document a, g:. it', . . Attached INSTRUCTIONS&CHECKLIST Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is appropriate. Yes N/A(Not (Initial) Applicable) 1. Original document has been signed/initialed for legal sufficiency.(All documents to be signed by the Chairman,with the exception of most letters,must be reviewed and signed by the Office of the County Attprney..This includes signature pages from ordinances,resolutions,etc.signed by the BH County Attorney's Office and signature pages from contracts,agreements,etc.that have been fully executed by all parties except the BCC Chairman and Clerk to the Board and possibly State Officials.) 0 2. All handwritten strike-through and revisions have been initialed by the County Attorney's Office and BH all other parties except the BCC Chairman and the Clerk to the Board 3. The Chairman's signature line date has been entered as the date of BCC approval of the document or BH the final negotiated contract date whichever is applicable. 4. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's signature and BH initials are required. 5. In most cases(some contracts are an exception),the original document and this routing slip should be BH provided to the BCC office within 24 hours of BCC approval.Some documents are time sensitive and require forwarding to Tallahassee within a certain timee or the BCC's actions are nullified.Be aware of your deadlines! 6. The document was approved by the BCC on 1/22/13 and all changes made during the meeting BH have been incorporated in the attached document.The County Attorney's Office has reviewed the changes,if applicable. I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05 «matter numben>/edocument number» 16D i MEMORANDUM Date: February 6, 2013 To: Barbetta Hutchinson, Operations Coordinator Housing, Human & Veteran Services From: Martha Vergara, Deputy Clerk Minutes & Records Department Re: Amendment #3 to Adult Drug Discretionary Grant Program Agreement Attached for your records is a copy of the Agreement referenced above, (Item #16D1) adopted by the Board of County Commissioners on Tuesday, January 22, 2013. If you have any questions, please feel free to contact me at 252-7240. Thank you. Attachment 160 AMENDMENT NO. 3 TO AGREEMENT FOR ADULT DRUG COURT DISCRETIONARY GRANT PROGRAM 2010-DC-BX-0016 CFDA: 16.585 THIS AMENDMENT, made and entered into on this - day of January 2013, to the subject agreement shall be by and between the parties to the original Agreement, David Lawrence Mental Health Center, Inc., EIN 59-2206025, (d/b/a/ David Lawrence Center), authorized to do business in the State of Florida, whose business address is 6075 Bathly Lane, Naples, Florida, 34116, (hereinafter called the "sub-recipient") and Collier County, a political subdivision of the State of Florida, Collier County, Naples (hereinafter called the "County"). Statement of Understanding RE: Adult Drug Court Discretionary Grant Program 2010-DC-BX-0016 In order to continue the services provided for in the original Contract document referenced above, the sub-recipient agrees to amend the Contract as follows: Words Struck Through are deleted;Words Underlined are added: (Dollar amounts have original underlines) WITNESSETH: * * * EXHIBIT "A" SCOPE OF SERVICES * * * B. BUDGET Collier County Housing, Human and Veteran Services is providing a total amount of e - - . . • _ _ . . - . _ • 01877404M) One Hundred Eighty One Thousand One Hundred Sixty-Four and 00/100 Dollars ($181,164.00) for funding the project scope described above for 2010-2013. The sub recipient shall provide a match of Eighty Four Thousand Eight Hundred Four and 00/100 Dollars ($84,804.00) for the entire grant period 2010-2013. The match requirement may be satisfied by providing services, salaries, fringe, rent, office expenditures, cash or in-kind services that are not otherwise used as match for other state or federal dollars The table below, as approved by the grantor agency, provides line items budgeted by Federal Funds, Local Match and Total Line Budget. Reimbursement payments will be made on activities as described within the scope of work. Funds may be used over the entire grant period. Page 1 of 2 1613 1 Modifications to the "Budget Detail Worksheet and Narrative" may only be made if approved in advance using the Department of Justice Grant Adjustment Notice process. Budgeted fund shifts between cost categories and activities shall not be more than 10%. Fund shifts that exceed 10% of a cost category and activity as defined by the Department of Justice Program Office, shall only be made with board approval. BUDGET DETAIL 2010-2013 Line Item Description Grant funds Match from Total Budget From HHVS DLC Contractual $157,060$462820 $0.00 $157,060$160 Other $13,364 $13,844 $0.00 $13,364$, Travel $10,740 $0.00 $10,740 TOTAL $181,164$187,404 $84,804.00* $265,968$208 *Match is allowed to be from any category. IN WITNESS WHEREOF, the Sub-recipient and the County, have each, respectively, by an authorized person or agent, hereunder set their hands and seals on the date and year first above written. ATTEST: . 4 _, BOARD OF COUNTY COMMISSIONERS Dwight E. Brock,t.Iork of Courts COLL COUNTY, F ORIDA B ►Il r Imo! By I A L Dated: , 1 �� Geo Ty. . Hiller, Esq. Attest ak Chairwoman $1011140i - L-4 DAVID LAWRENCE MENTAL First Witness til2.-SP HEALTH CENTER(D/B/A DAVID �B��QCR LAWRENCE CENTER A By: 4i ,_ _ TType/print witness nameT David C. Schimmel J Chief Executive Officer Second Witness /V tet Approved as to form and legal sufficiency: TType/print witness nameT Jennifer B. White cL� Assistant County Attorney .�J Page 2 of 2