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Backup Documents 03/26/2013 Item #16D 5ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO D THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNA 5 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. ate �ik� Complete routing lines #I through #2 as appropriate for additional signatures, dates, and/or information needed. If the document is already complete with the excention of the Chairman's sienature_ draw a line throueh routine lines #1 through #2_ complete the checklist, and forward to the Countv Attorney Office. Route to Addressees (List in routing order) Office Initials Date 1. Barbetta Hutchinson HHVS Zif 3/27/13 2. Jennifer B. White, ACA County Attorney Office Office located in HHV S Department law 31 at i 13 3. BCC Office Board of County Commissioners YES 4. Minutes and Records Clerk of Court's Office Number of Original 3 modification fo s 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 an, a may need to contact staff for addltt()nal or miSSing Information. Name of Primary Staff Lisa Oien Phone Number 252 -6141 Contact / Department appropriate. Initial Applicable) Agenda Date Item was 3/26/13 Agenda Item Number 16135 Approved by the BCC Does the document need to be sent to another agency for additional signatures? 1fyea, YES Type of Document Modification Forms and Subrecipient Number of Original 3 modification fo s Attached sagreements Documents Attached 2 subrecipii by the Office of the County Attorney. agreements PO number or account All handwritten strike - through and revisions have been initialed by the County Attorney's YES number if document is Office and all other parties except the BCC Chairman and the Clerk to the Board to be recorded The Chairman's signature line date has been entered as the date of BCC approval of the YES ✓ INSTRUCTIONS & CHECKLIST NG�no►ngc .0 W04b, -rof AccamplishPWn" 4 A/Dr* 2 nAc1air1C1 N 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 bo�C �S Cie G � � �► � ^1 c� • t a.�h � as . b3 � o� 0.AA ,l6A4Lrte S4.®ct- %G IA C-A, 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? YES 2. Does the document need to be sent to another agency for additional signatures? 1fyea, YES 3. Original document has been signedlinitiated fbr legal sufficiency. (All Documents to be signed by the Chairman, with the exception of most letters, must be reviewed and signed YES f✓ by the Office of the County Attorney. 4. All handwritten strike - through and revisions have been initialed by the County Attorney's YES 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 YES ✓ 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 YES signature and initials are required. 7. In most cases (some contracts are an exception), the original document and this routing slip . YES 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 zour deadlines! 8. ##*AM and all changes The document was approved by the BCC on 3/26/lL_(J- YES made during the meeting have been incorporated in the attached document. The County Attorney's Office has reviewed the changes, if applicable. * 9. Initials of attorney verifying that the attached document is the version approved by the 1 BCC, all changes directed by the BCC have been made, and the document is ready for th 4W Chairman's signature. NG�no►ngc .0 W04b, -rof AccamplishPWn" 4 A/Dr* 2 nAc1air1C1 N 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 bo�C �S Cie G � � �► � ^1 c� • t a.�h � as . b3 � o� 0.AA ,l6A4Lrte S4.®ct- %G IA C-A, 1605 OFFICE OF THE CO UNTY A TTORNE Y INTEROFFICE MEMORANDUM TO: Board Minutes and Records FROM: Lisa Oien, Grants Coordinator DATE: March 28, 2013 RE: March 26, 2013, Agenda Item 16 D. 5 Please send the three Modi on documents that have the Chairwoman's original signatures to Monique Kabitzke at the DED in Tallahassee for execution. Please add to this the cover letter package. A Fed Ex envelope with the Address for Ms. Kabitzke is included for sending. Please send an original subrecipient agreement to Dottie Cook, Executive Director of Empowerment Alliance of Southwest Florida. And send a copy of the subrecipient agreement to Lisa Oien at Housing Human and Veteran Services. Ms. Cook's contact information is: Dottie Cook Empowerment Alliance of Southwest Florida 750 South 5t' Street Immokalee, Fl. 34142 Phone: (239) 658 -3315 E -mail: easfneaarthlink.net Thank you for your assistance. 1605 MEMORANDUM Date: April 4, 2013 To: Lisa Oien, Grants Coordinator Housing, Human &Veteran Services From: Ann Jennejohn, Deputy Clerk Minutes & Records Department Re: Modification #9 to Subgrant Agreement #07DB- 3V- 09- 21- 01 -ZO1 with Florida's Department of Economic Opportunity to reinstate and extend the agreement and a new subrecipient agreement with The Empowerment Alliance of SWFL for activities associated with that modification including a project at Hatcher's Preserve Attached, is a copy of the agreement referenced above, (Item #16D5) approved by the Collier County Board of County Commissioners March 26, 2013. Per your request, an original copy of the subrecipient agreement was sent to Dottie Cook, Executive Director at the Empowerment Alliance of SWFL and the three (3) original related modification request documents, including your cover letter, were sent via FedEx to Monique Kabitzke with the State of Florida's Department of Economic Opportunity. The Minutes & Records Department will hold the second original copy of the Empowerment Agreement in the Board's Official Record and a copy of the DEO modification request will be included in that record. Thank you. Co per County 1605 Public Services Division Housing, Human & Veteran Services March 26, 2013 Monique Kabitzke, Community Assistance Consultant CDBG, Disaster Recovery Section Florida Department of Economic Opportunity 107 E. Madison Street, MSC 400 Tallahassee, FL 32399 -6508 Re: Disaster Recovery Initiative (DRI) Grant Agreement #07DB- 3V- 09- 21- 01 -ZO1 Modification #9 Dear Ms. Kabitzke, On March 26, 2013, the Board of Collier County Commissioners approved modification #9 to Collier County's Disaster Recovery Initiative Grant Agreement #07DB- 3V- 09- 21- 01 -ZO1. This modification serves to accomplish the following tasks: • Reinstate Agreement • Extend Agreement • Revise Activity Work Plans • Revise Program Budget and Scope of Work • Change the number of Accomplishments and Beneficiaries The modification will reallocate unused funds from Service area #5 and #6 to Service area #2, Hatcher's Preserve. The expansion of the Hatcher's Preserve project will allow for the construction of one home for a low income family impacted by the 2005 storm. The construction of a home will facilitate acquiring residents or beneficiaries for the Hatcher's project. Presented to you are the modification documents in triplicate with the Chairman's original signature. In addition the Request for Amendment form and the Executive Summary for the Board approved item are also included. If you have any questions or concerns please feel free to give me a call. Sincerely, ,� �C - Lisa Oien, Grants Coordinator F-Fousing, Human and Veteran �Services of Collier County 3339 Tamiami Trail East, Suite 211 • Naples, FL 34112 -5361 239 - 252 -CARE (2273) • 239 252 -HOME (4663) • 239 - 252 -CAFE (2233) • 239 - 252 -RSVP (7787) • 239 - 252 -VETS (8387) • www .colliergov.net/humanservices 1605 -W r 'D O c 100"i w ' i p leaf p n a o I o m' Ej FrI o I a Z • °, C I { -- CLl m ml O CL p m) � o.l a mI r a o L4 ❑" ❑ ,►� s6fig.- 6 r If oa 0. r SI8 ❑ ❑, El to e I p I e IN I 1 F i T i � W I g 4b i Ir ❑ �- a ir• . 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N£ CO O M ti O O O N OHO d d o - COO M r O O r r M O CO ' N COD O N :.i r M O r CO r ao �- 69 69 69 64 CA 6'! 64 69 64 t9 m 6F? Cfl c w o C8 y O O O O O O O O O N C co M O 00 102 O m W O N M M O O p r r C) CO O r Cl) a M CO — CO N N M N 7 6%IV 69 69 69 &J. 69 6c! 69 6% 69 6% 6-} 6% m Q) w m o a as °_ cm c_ m d a: m m o cO c m � v > m (0 ? (D O 3 U m g y ' a y in o C` d rn d LL C O U wIx 0: in in 3 m iT a: a' N � r O Cl) O O V V N .- C a � _ 1605 Department of Economic Opportunity — Small Cities Community Development Block Grant Program Modification to Subgrant Agreement ,atnott MODIFICATION NUMBER 9 TO SUBGRANT AGREEMENT BETWEEN THE DEPARTMENT OF ECONOMIC OPPORTUNITY AND COLLIER COUNTY This Modification is made and entered into by and between the State of Florida, Department of Economic Opportunity, ( "the Department "), and Collier County, ( "the Recipient "), to modify DEO/DCA Contract Number 07DB- 3V- 09- 21- 0 1 -ZO1, award dated June 20, 2007 ("the Agreement "). WHEREAS, the Department and the Recipient entered into the Agreement, pursuant to which the Department provided a subgrant of $2,339,882.00 to Recipient under the Small Cities Community Development Block Grant ( "CDBG') Program as set forth in the Agreement; WHEREAS, the Department and the Recipient desire to modify the Agreement; WHEREAS, pursuant to the provisions of Chapter 2011 -142, Laws of Florida, the DCA Division of Housing and Community Development was transferred to the Department of Economic Opportunity effective October 1, 2011; and the parties wish to reflect the new name. NOW, THEREFORE, in consideration of the mutual promises of the parties contained herein, the parties agree as follows: ® Reinstate Agreement 1. The Agreement is hereby reinstated as though it had not expired. ® Extend Agreement Paragraph 3, Period of Agreement is hereby revised to reflect an ending date of January 20, 2014. ® Revise Activity Work Plan 3. The Attachment B, Activity Work Plan section of the Agreement is hereby deleted and is replaced by the revised Attachment B, Activity Work Plan section, which is attached hereto and incorporated herein by reference. ® Revise Program Budget and Scope of Work 4. The Attachment A, Program Budget section of the Agreement is hereby deleted and is replaced by the revised Attachment A, the Program Budget, which is attached hereto and incorporated herein by reference. Department of Economic Opportunity — Small Cities Community Development Block Grant Progr1 6 D 5 Modification to Subgrant Agreement 10n/2011 Modification Number: 9 DEO/DCA Contract Number: 07DB- 3V- 09- 21- 01 -ZO1 Recipient: Collier County Page 2 ❑ Change in Participating Parties 5. The Attachment A, Program Budget section, is hereby modified to delete all references to "(Type in name, if applicable.)," as the Participating Party, and replace them with "(Type in name, if applicable.)" as the Participating Party with the understanding that the Recipient and the new Participating Party will enter into a Participating Party Agreement containing provisions and caveats that meet or exceed the conditions agreed to in the Participating Party Agreement between the Recipient and the original Participating Party. ❑ Inclusion of an Unmet Need as Addressed in the Original Application 6. The Attachment A, Program Budget section of the Agreement is hereby deleted and is replaced by the revised Attachment A, the Program Budget, which is attached hereto and incorporated herein by reference. 7. The Attachment , Activity Work Plan section of the Agreement is hereby deleted and is replaced by the revised Attachment , Activity Work Plan section, which is attached hereto and incorporated herein by reference. ® Change in Number of Accomplishments and/or Beneficiaries 8. The Attachment A, Program Budget section of the Agreement is hereby deleted and is replaced by the revised Attachment A, the Program Budget, which is attached hereto and incorporated herein by reference. ❑ Reflect Change in Agency from DCA to DEO 9. This modification to the Subgrant Agreement hereby replaces "Department of Community Affairs" with "Department of Economic Opportunity" where appropriate in context. ❑ Other: 1605 Department of Economic Opportunity — Small Cities Community Development Block Grant Program Modification to Subgrant Agreement 1011/2011 Modification Number: 9 DEO/DCA Contract Number: 07DB- 3V- 09- 21- 01 -ZO1 Recipient: Collier County Page 3 All provisions of the Agreement and any attachments thereto in conflict with this Modification shall be and are hereby changed to conform to this Modification, effective as of the date of the execution of this Modification by both parties. All provisions not in conflict with this Modification remain in full force and effect, and are to be performed at the level specified in the Agreement. IN WITNESS WHEREOF, the parties hereto have executed this document as of the dates set herein. Department of Economic Opportunity IM Name: Ken Reecy Title: Assistant Director Division of Community Development Date: ATT &," I: J Q*QHT P. 3ROCK, Clerk rho (,Attest 3$ to S , •signature olily `' Recipien : C li r on ty By: Name: Georgia A.Hiller, Esq Title: Chairwoman, BCC Commissioners Date: j'nQLA-& -% A(, . 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E m� u C a O O i �_ O Gi c c .- O 7 o M N 2:140 a Qc m y o c�� o�� maces 3mintc Z OMB a cow �� Ec . Ey >m= W Um c °mm 'c m$Op�m�mcci C) o asp ct m m av a) m m co w ~ ~ c U mmE comet �cO.cym a O C� to l0 E a) v_ C a E Q a) E Y•-r Nccc a� BEd aS oc .S 0 Q coi U 0 � .� ai U 'a 42 Fp W �k c UJ w f0 00 O O m O OC Q Q 7, N O O O O r W 0 N N O ~ Q O O O O O W�U wo V Z m 0 0 ° 0 0 0 0 g V T rn 0 0 0 0 0 0 C1o1inty of Collier CLERK OF THE. CIW , UIT COURT Dwight E. Brock COLLIER CO Y COO ,RTHOUSE Clerk of Courts 3315 TAMIAMI TRL E STE 102., :. P.O. BOX 413044 NAPLES, FLORIDA '' �.� ;NAPLES, FLORIDA 34112 -5324 34101 -3044 April 4, 2013 Dottie Cook, Executive Director Empowerment Alliance of SWFL 750 South 5th Street Immokalee, FL 34142 16D5 Clerk of Courts Accountant Auditor Custodian of County Funds Re: Subrecipient Agreement between Collier County and The Empowerment Alliance of SWFL for activities associated with DRI Grant # 07DB- 3V- 09- 21- O1- ZO1(Modification #9) for an infrastructure project at Hatcher's Preserve Attached, is an original copy of the agreement referenced above, per request by Grants Coordinator Lisa Oien with Collier County's Housing, Human and Veteran Services Department, approved by the Collier County Board of County Commissioners on Tuesday, March 26. If your office requires further information or have questions, please feel free to contact me at 239 - 252 -8406. Sincerely, Uwt,ct. Wv •C. . Ann Jenn ty Clerk Collier C Minute s & Records Department Phone- (239) 252 -2646 Fax- (239) 252 -2755 Website-.www.CollierClerk.com Email- CollierClerk @collierclerk.com 16D5 Grant # 07DB- 3V- 09- 21 -ZO1 CFDA/CSFA# - 14.228 Subrecipient — The Empowerment Alliance of Southwest Florida Community Development Corporation DUNS # - 101031222 FETI # - 59- 3682139 AGREEMENT BETWEEN COLLIER COUNTY AND The Empowerment Alliance of Southwest Florida Community Development Corporation Hatcher's Preserve THIS AGREEMENT is made and entered into this 26th day of March, 2013, by and between Collier County, a political subdivision of the State of Florida, ( "COUNTY" or "Grantee ") having its principal address as 3339 E. Tamiami Trail, Naples FL 34112, and " The Empowerment Alliance of Southwest Florida Community Development Corporation, a private not - for - profit corporation existing under the laws of the State of Florida, having its principal office at 750 South Fifth Street, Immokalee, Fl 34142. WHEREAS, the COUNTY has entered into an agreement with the State of Florida, Department of Economic Opportunity; and WHEREAS, pursuant to the aforesaid agreement, COUNTY is undertaking certain activities to primarily benefit low and moderate income by addressing hurricane impacted housing, public facility and community development needs; and WHEREAS, The Board of Commissioners of Collier County approved the Collier County Agreement with the Florida Department of Economic Opportunity for $2,339,882 in Community Development Block Grant Disaster Recovery Initiative (DRI) funds relating to Hurricane Wilma and Resolution No. 2007 -144 on May 22, 2007, item #1OL and WHEREAS, the County and the Subrecipient desire to provide the activities specified in exhibit A of this agreement, in accord with the approved 2005 Disaster Recovery Initiatiave Subgrant Agreement Modification #9, simultaneously approved by the County with this Agreement; and WHEREAS, the County desires to engage the subrecipient to implement such undertakings of the Disaster Recovery Initiative (DRI) Program as a valid and worthwhile County purposes. NOW, THEREFORE, in consideration of the mutual benefits contained herein, it is agreed by the Parties as follows: The Empowerment Alliance of Southwest Florida Community Development Corporation DRI 05 -02 Hatcher's Preserve Page 1 of 30 1605 I. SCOPE OF SERVICES - The SUBRECIPIENT shall, in a satisfactory and proper manner and consistent with the proposal as presented by Empowerment Alliance of Southwest Florida Community Development Corporation herein attached to this agreement as "EXHIBIT H ", any standards required as a condition of providing CDBG/DRI funds, as determined by Collier County Housing, Human and Veteran Services (HHVS), perform the tasks necessary to conduct the program as follows: Modification #9 to Disaster Recovery Initiative Grant #07DB- 3V- 09- 21- 01 -ZOI identified and approved the expansion to the Hatcher's Preserve infrastructure project to include the construction of one home to benefit a low income family whose housing has been impacted by a hurricane. Specifically, improvements identified for funding are outlined in the Budget in Section III. The detailed project scope will be contained in the schedule of values awarded in the project's construction contract. The project's construction contract will include details sufficient to document the number, amount and costs associated with all activities for payment. Should there be any variation between the initial proposed home construction and the eventual award for the construction and the associated construction agreement, the construction agreement will prevail for reimbursement. All activities funded with CDBG funds must meet one of the CDBG program's National Objectives: benefit low- and moderate - income persons; aid in the prevention or elimination of slums or blight; or meet community development needs having a particular urgency, as defined in 24 CFR 570.208 II. TIME OF PERFORMANCE Services of the SUBRECIPIENT shall start on the effective date of Modification #9 of DRI Subgrant Agreement #07DB- 3V- 09- 21- 01 -ZO1 and end nine months from that date on, (date to be entered upon DEO modification approval) The term of this Agreement and the provisions herein may be extended by amendment to cover any additional time period during which the SUBRECIPIENT remains in control of CDBG funds or other CDBG assets, including program income. III. AGREEMENT AMOUNT The COUNTY agrees to make available ONE HUNDRED TEN THOUSAND DOLLARS ($110,000) for the use by the SUBRECIPIENT during the Term of the Agreement (hereinafter, the aforestated amount including, without limitation, any additional amounts included thereto as a result of a subsequent amendment(s) to the Agreement, shall be referred to as the "Funds "). All improvements specified in Section 1. Scope of Services shall be performed by SUBRECIPIENT employees, or shall be put out to competitive bidding under a procedure acceptable to the COUNTY and Federal requirements. The SUBRECIPIENT shall enter into contract for improvements with the lowest, responsive and qualified bidder. Contract administration shall be handled by the SUBRECIPIENT and monitored by HHVS, which shall have access to all records and documents related to the project. The budget identified for all improvements is as follows: The Empowerment Alliance of Southwest Florida Community Development Corporation DRI 05 -02 Hatcher's Preserve Page 2 of 30 03 -25 -13 '12 3'' 11' 1605 COUNTY shall reimburse the SUBRECIPIENT for the performance of this Agreement upon completion or partial completion of the work tasks as accepted and approved by HHVS pursuant to the submittal of quarterly progress reports. Payments shall be made to the SUBRECIPIENT when requested as work progresses but, not more frequently than once per month. Payment will be made upon receipt of a proper invoice and in compliance with § 218.70, Florida Statutes, otherwise known as the "Local Government Prompt Payment Act." No payment will be made until approved by HHVS. The following table details the project deliverables and payment schedule. Deliverable DRI FUNDS NOTE* Activities /items /services may include but not be limited to: Submission of monthly invoices on AIA G702- Hatcher's Preserve 1992 form (attached as Exhibit "G ") or All costs associated with the construction of one single family home. $ 110,000 Total $ 110,000 COUNTY shall reimburse the SUBRECIPIENT for the performance of this Agreement upon completion or partial completion of the work tasks as accepted and approved by HHVS pursuant to the submittal of quarterly progress reports. Payments shall be made to the SUBRECIPIENT when requested as work progresses but, not more frequently than once per month. Payment will be made upon receipt of a proper invoice and in compliance with § 218.70, Florida Statutes, otherwise known as the "Local Government Prompt Payment Act." No payment will be made until approved by HHVS. The following table details the project deliverables and payment schedule. Deliverable Payment Schedule Construction activities for home construction Submission of monthly invoices on AIA G702- 1992 form (attached as Exhibit "G ") or equivalent document per contractor's Schedule of Values. Supporting documents must be provided as back up. Final 10% of the construction contract to be released upon Certificate of Completion, final waiver of lien from general contractor and documentation of clients served. IV. NOTICES Notices required by this Agreement shall be in writing and delivered via mail (postage prepaid), commercial courier, or personal delivery or sent by facsimile or other electronic means. Any notice delivered or sent as aforesaid shall be effective on the date of delivery or sending. All notices and other written communications under this Agreement shall be addressed to the individuals in the capacities indicated below, unless otherwise modified by subsequent written notice. COLLIER COUNTY ATTENTION: Lisa Oien, Grant Coordinator 3339 E Tamiami Trail, Suite 211 Naples, Florida 34112 SUBRECIPIENT ATTENTION: Edward R. Olesky, Board Chairman The Empowerment Alliance of Southwest Florida Community Development Corporation. 750 South 5th Street Immokalee, Fl. 34142 The Empowerment Alliance of Southwest Florida Community Development Corporation DRI 05 -02 1latcher's Preserve Page 3 of 30 03 -25 -13 f'1":35 I V. ADDITIONAL CONDITIONS AND COMPENSATION 16 D5 The parties acknowledge that the Funds originate from CDBG grant funds from HUD and must be implemented in full compliance with all of HUD's rules and regulations and any agreement between COUNTY and HUD governing CDBG funds pertaining to this Agreement. In the event of curtailment or non - production of said federal funds, the financial sources necessary to continue to pay the SUBRECIPIENT all or any portions of the funds will not be available. In that event, the COUNTY may terminate this Agreement, which termination shall be effective as of the date that it is determined by the County Manager or designee, in his -her sole discretion and judgment, that the Funds are no longer available. In the event of such termination, the SUBRECIPIENT agrees that it will not look to, nor seek to hold the COUNTY, nor any individual member of the County Commissioners and /or County Administration, personally liable for the performance of this Agreement, and the COUNTY shall be released from any further liability to SUBRECIPIENT under the terms of this Agreement. VI. GENERAL CONDITIONS A. SUBCONTRACTS No part of this Agreement may be assigned or subcontracted without the written consent of the COUNTY, which consent, if given at all, shall be at the COUNTY's sole discretion and judgment. B. GENERAL COMPLIANCE The SUBRECIPIENT agrees to comply with the requirements of Title 24 of the Code of Federal Regulations, Part 570 (the U.S. Housing and Urban Development regulations concerning Community Development Block Grants (CDBG)) including subpart K of these regulations, except that (1) the SUBRECIPIENT does not assume the recipient's environmental responsibilities described in 24 CFR 570.604 and (2) the SUBRECIPIENT does not assume the recipient's responsibility for initiating the review process under the provisions of 24 CFR Part 52. The SUBRECIPIENT also agrees to comply with all other applicable Federal, state and local laws, regulations, and policies governing the funds provided under this contract. The SUBRECIPIENT further agrees to utilize funds available under this Agreement to supplement rather than supplant funds otherwise available. C. INDEPENDENT CONTRACTOR Nothing contained in this Agreement is intended to, or shall be construed in any manner, as creating or establishing the relationship of employer /employee between the parties. The SUBRECIPIENT shall at all times remain an "independent contractor" with respect to the services to be performed under this Agreement. The Grantee shall be exempt from payment of all Unemployment Compensation, FICA, retirement, life and/or medical insurance and Workers' Compensation Insurance, as the SUBRECIPIENT is an independent contractor. D. AMENDMENTS The Empowerment Alliance of Southwest Florida Community Development Corporation DRI 05 -02 Hatcher's Preserve Page 4 of 30 03 -25 -13 P1-- - I i 16 D5 The COUNTY or SUBRECIPIENT may amend this Agreement at any time provided that such amendments make specific reference to this Agreement, and are executed in writing, signed by a duly authorized representative of each organization, and approved by the Grantee's governing body. Such amendments shall not invalidate this Agreement, nor relieve or release the Grantee or SUBRECIPIENT from its obligations under this Agreement. The COUNTY may, in its discretion, amend this Agreement to conform with Federal, state or local governmental guidelines, policies and available funding amounts, or for other reasons. If such amendments result in a change in the funding, the scope of services, or schedule of the activities to be undertaken as part of this Agreement, such modifications will be incorporated only by written amendment signed by both Grantee and SUBRECIPIENT. Expiration of Agreement: If the SUBRECIPIENT does not complete the project within the time period, the COUNTY Manager or designee may grant a cumulative time extension of no more than 180 days and modify any subsequent project work plans to reflect the extension. The request must be submitted no later than ninety (90) days prior to end date of this Agreement. E. INDEMNIFICATION To the maximum extent permitted by Florida law, the SUBRECIPIENT shall indemnify and hold harmless Collier County, its officers, agents and employees from any and all claims, liabilities, damages, losses, costs, and causes of action which may arise out of an act, omission, including, but not limited to, reasonable attorneys' fees and paralegals' fees, to the extent caused by the negligence, recklessness, or intentionally wrongful conduct of the SUBRECIPIENT or any of its agents, officers, servants, employees, contractors, patrons, guests, clients, licensees, invitees, or any persons acting under the direction, control, or supervision of the SUBRECIPIENT in the performance of this Agreement. This indemnification obligation shall not be construed to negate, abridge or reduce any other rights or remedies which otherwise may be available to an indemnified party or person described in this paragraph. The SUBRECIPIENT shall pay all claims and losses of any nature whatsoever in connection therewith and shall defend all suits in the name of the COUNTY and shall pay all costs (including attorney's fees) and judgments which may issue thereon. This Indemnification shall survive the termination and/or expiration of this Agreement. This section does not pertain to any incident arising from the sole negligence of Collier County. The foregoing indemnification shall not constitute a waiver of sovereign immunity beyond the limits set forth in Section 768.28, Florida Statutes. F. GRANTEE RECOGNITION /SPONSORSHIPS The SUBRECIPIENT agrees that all notices, informational pamphlets, press releases, advertisements, descriptions of the sponsorships of the Program, research reports and similar public notices prepared and released by the SUBRECIPIENT for, on behalf of, and /or about the Program shall include the statement: "FINANCED BY U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT (HUD), THE FLORIDA DEPARTMENT OF ECONOMIC OPPORTUNITY AND COLLIER COUNTY HOUSING, HUMAN AND VETERAN SERVICES DEPARTMENT" and shall appear in the same size letters or type as the name of the SUBRECIPIENT. This design concept is intended to disseminate key information regarding the development team as well as Equal Housing Opportunity The Empowerment Alliance of Southwest Florida Community Development Corporation DRI 05-02 Hatcher's Preserve Page 5 of 30 o___��_;3 1605 to the general public. Construction signs shall comply with applicable COUNTY codes. G. TERMINATION In accordance with 24 CFR 85.43, the Grantee may suspend or terminate this Agreement if the SUBRECIPIENT materially fails to comply with any terms of this Agreement, which include (but are not limited to), the following: 1. Failure to comply with any of the rules, regulations or provisions referred to herein, or such statutes, regulations, executive orders, and HUD guidelines, policies or directives as may become applicable at any time; 2. Failure, for any reason, of the SUBRECIPIENT to fulfill in a timely and proper manner its obligations under this Agreement; 3. Ineffective or improper use of funds provided under this Agreement; or 4. Submission by the SUBRECIPIENT to the Grantee reports that are incorrect or incomplete in any material respect. In accordance with 24 CFR 85.44, this Agreement may also be terminated for convenience by either the Grantee or the SUBRECIPIENT, in whole or in part, by setting forth the reasons for such termination, the effective date, and, in the case of partial termination, the portion to be terminated. However, if in the case of a partial termination, the Grantee determines that the remaining portion of the award will not accomplish the purpose for which the award was made, the Grantee may terminate the award in its entirety. VII. REVERSION OF ASSETS In the event of a termination of this Agreement or upon expiration of the Agreement and in addition to any and all other remedies available to the COUNTY (whether under this Agreement or at law or in equity) the SUBRECIPIENT shall immediately transfer to the COUNTY any funds on hand at the time of termination (or expiration) and any accounts receivable attributable to the use of CDBG funds. The COUNTY's receipt of any funds on hand at the time of termination shalt not waive the COUNTY's right (nor excuse SUBRECEIPIENT's obligation) to recoup all or any portion of the funds, as the COUNTY may deem necessary. Any real property under the SUBRECIPIENT's control that was acquired or improved in whole or in part with CDBG funds (including CDBG funds provided to the SUBRECIPIENT in the form of a loan) in excess of $25,000 as outlined in 24 CFR 570.505 must either: a. Be used to meet one of the national objectives in 24 CFR 570.208 (formerly section 570.901) until five (5) years after expiration of the term of this Agreement or for such longer period of time as determined to be appropriate by the COUNTY and as memorialized by the COUNTY and the SUBRECIPIENT in an amendment to this Agreement or such instrument as the COUNTY at its discretion determines appropriate; or The Empowerment Alliance of Southwest Florida Community Development Corporation DR] 05 -02 Hatcher's Preserve Page 6 of 30 13F �160 b. If not used in accordance with the above subsection (a) the SUBRECIPIENT shall pay to the COUNTY an amount equal to the current market value of the property less any portion of the value attributable to expenditures of non -CDBG funds for the acquisition of or improvements to, the property. No payment is required after the period of time specified in subsection (a). VIII. INSURANCE SUBRECIPIENT shall not commence any work and/or services pursuant to this Agreement until all insurance required under this Section and outlined in Exhibit "A" has been obtained, and carried, at all times during its performance. IX. ADMINISTRATIVE REQUIREMENTS A. EXAMINATION OF RECORDS The SUBRECIPIENT shall maintain sufficient records in accordance with 24 CFR 570.502 and 570.506 to determine compliance with the requirements of this Agreement, the CDBG Program and all other applicable laws and regulations. This documentation shall include, but not be limited to, the following: B. DOCUMENTATION AND RECORDKEEPING 1. All records required by CDBG/DRI/DEO. 2. All reports, plans, surveys, information, documents, maps, books, records and other data procedures developed, prepared, assembled, or completed by the SUBRECIPIENT for the purpose of this Agreement shall be made available to the COUNTY by the SUBRECIPIENT at any time upon request by the COUNTY or HHVS. Materials identified in the previous sentence shall be in accordance with generally accepted accounting principles, procedures and practices, which sufficiently and properly reflect all revenues and expenditures of funds provided directly or indirectly by this Agreement, including matching funds and Program Income. These records shall be maintained to the extent of such detail as will properly reflect all net costs, direct and indirect labor, materials, equipment, supplies and services, and other costs and expenses of whatever nature for which reimbursement is claimed under the provisions of this Agreement. 3. Upon completion of all work contemplated under this Agreement copies of all documents and records relating to this Agreement shall be surrendered to HHVS if requested. In any event the SUBRECIPIENT shall keep all documents and records in an orderly fashion in a readily accessible, permanent and secured location for (6) years after expiration of this Agreement, as required by the CDBG supplemental conditions provided by the Department of Economic Opportunity with the following exception: if any litigation, claim or audit is started before the expiration date of the for six (6) year period, the records will be maintained until all litigation, claim or audit findings involving these records are resolved. The COUNTY shall be informed in writing if an agency ceases to exist after closeout of this Agreement of the address where the records are to be kept as outlined in 24 CFR 85.42. 4. The SUBRECIPIENT shall maintain records showing compliance with the Davis -Bacon Law, including files containing contractor payrolls, employee interviews, Davis -Bacon wage rates, and administrative cross - referencing. SUBRECIPIENT shall maintain records showing contractor The Empowerment Alliance of Southwest Florida Community Development Corporation DRI 05 -02 Hatcher's Preserve Page 7 of 30 >_� -13 PI ., , t 6 D 5 compliance with the Contract Work Hours and Work Safety Law. Similarly, the SUBRECIPIENT shall maintain records showing compliance with federal purchasing requirements and with other federal requirements for grant implementation. The SUBRECIPIENT will be responsible for the creation and maintenance of income eligible files on clients served and documentation that all households are eligible under HUD Income Guidelines. The SUBRECIPIENT agrees that HHVS shall be the final arbiter on the SUBRECIPIENT's compliance. 6. The SUBRECIPIENT shall document how the National Objective(s) as defined in 24 CFR 570.208 and the eligibility requirement(s) under which funding has been received, have been met. These also include special requirements such as necessary and appropriate determinations as defined in 24 CFR 570.209, income certification, and written Agreements with beneficiaries, where applicable. C. REPORTS AND EVALUATIONS (MONITORING) Reimbursement may be contingent on the timely receipt of complete and accurate reports required by this Agreement, and on the resolution of monitoring findings identified pursuant to this Agreement as deemed necessary by the County Manager or designee. During the term, SUBRECIPIENT shall submit quarterly progress reports to the COUNTY on the 15'h day of January, April, July and October respectively for the prior quarter period end. As part of the report submitted in October, the SUBRECIPIENT also agrees to include, a comprehensive final report covering the agreed -upon Program objectives, activities and expenditures and including, but not limited to, beneficiaries served and performance data on client feedback with respect to the goals and objectives set forth in Exhibit "D ". Exhibit "D" contains an example reporting form to be used in fulfillment of this requirement. Other reporting requirements may be required by the County Manager or their designee in the event of Program changes; the need for additional information or documentation arises; and /or legislative amendments are enacted. Reports and /or requested documentation not received by the due date shall be considered delinquent and may be cause for default and termination of this Agreement. During the term, SUBRECIPIENT shall submit an annual audit monitoring report (Exhibit E) to the COUNTY no later than 180 days after the SUBRECIPIENT's fiscal year end. The SUBRECIPIENT agrees that HHVS will carry out no less than one (1) annual on -site monitoring visit and evaluation activities as determined necessary. At the COUNTY's discretion, a desk top review of the activities may be conducted in lieu of an on -site visit. The continuation of this Agreement is dependent upon satisfactory evaluations. The SUBRECIPIENT shall, upon the request of HHVS, submit information and status reports required by HHVS, DEO or HUD to enable HHVS to evaluate said progress and to allow for completion of reports required. The SUBRECIPIENT shall allow HHVS or HUD to monitor the SUBRECIPIENT on site. Such site visits may be scheduled or unscheduled as determined by HHVS or HUD. D. ADDITIONAL HOUSING, HUMAN AND VETERAN SERVICES, COUNTY, DEO AND HUD REQUIREMENTS The SUBRECIPIENT agrees to utilize funds available under this Agreement to supplement rather than The Empowerment Alliance of Southwest Florida Community Development Corporation DR] 05 -02 Hatcher's Preserve Page 8 Of 30 J 16 05 OJ )5- 15 P 1 supplant funds otherwise available for specified activities. All purchasing for services and goods, including capital equipment, shall be made by purchase order or by a written contract and in compliance with thresholds of the Collier County Purchasing Policy, as shown below. Should there be a conflict; the Purchasing Policy Thresholds will prevail. Dollar Range $ Quotes Under $3K No Quote Required Above $3K to $I OK 3 Written Quotes Above $1 OK to $50K 3 Written Quotes Above $50K Request for Proposal (RFP) Invitation To Bid (ITB) F. AUDITS AND INSPECTIONS At any time during normal business hours and as often as the COUNTY (and/or its representatives) may deem necessary, the SUBRECIPIENT shall make available all records, documentation and any other data relating to all matters covered by the Agreement for review, inspection or audit. G. PROGRAM - GENERATED INCOME Any "Program Income" (as such term is defined under applicable Federal regulations) gained from any activity of the SUBRECIPIENT funded by CDBG funds shall be reported to the COUNTY, utilized by the SUBRECIPIENT and shall be in compliance with 24 CFR 570.504(c) in the operation of the Program. H. GRANT CLOSEOUT PROCEDURES SUBRECIPIENT's obligation to the COUNTY shall not end until all closeout requirements are completed. Activities during this closeout period shall include, but not be limited to: making final payments, disposing of program assets (including the return of all unused materials, equipment, program income balances, and receivable accounts to the COUNTY), and determining the custodianship of records. In addition to the records retention outlined in Section X.B.3, the SUBRECIPIENT shall comply with Section 119.021 Florida Statutes regarding records maintenance, preservation and retention. X. OTHER PROGRAM REQUIREMENTS A. OPPORTUNITIES FOR RESIDENTS AND CIVIL RIGHTS COMPLIANCE The SUBRECIPIENT agrees that no person shall be excluded from the benefits of, or be subjected to, discrimination under any activity carried out by the performance of this Agreement on the basis of race, color, disability, national origin, religion, age, familial status, or sex. Upon receipt of evidence of such discrimination, the COUNTY shall have the right to terminate this Agreement. To the greatest extent feasible, lower- income residents of the project areas shall be given opportunities for training and employment; and to the greatest feasible extent eligible business concerns located in or owned in substantial part by persons residing in the project areas shall be awarded contracts in connection with the project. The SUBRECIPIENT shall comply with Section 3 of the Housing and Community Development Act of 'The Empowerment Alliance of Southwest Florida Community Development Corporation DRI 05 -02 Hatcher's Preserve Page 9 of 30 1968. 1605 B. OPPORTUNITIES FOR SMALL AND MINORITY/WOMEN -OWNED BUSINESS ENTERPRISES The SUBRECIPIENT will use its best efforts to afford small businesses, minority business enterprises, and women's business enterprises the maximum practicable opportunity to participate in the performance of this contract. As used in this contract, the terms "small business" means a business that meets the criteria set forth in section 3(a) of the Small Business Act, as amended (15 U.S.C. 632), and "minority and women's business enterprise" means a business at least fifty -one (51) percent owned and controlled by minority group members or women. For the purpose of this definition, "minority group members" are Afro - Americans, Spanish- speaking, Spanish surnamed or Spanish - heritage Americans, Asian - Americans, and American Indians. The SUBRECIPIENT may rely on written representations by businesses regarding their status as minority and female business enterprises in lieu of an independent investigation. C. PROGRAM BENEFICIARIES At least fifty -one percent (51 %) of the beneficiaries of a project funded through this Agreement must be low- and moderate - income (LMI) persons. This specific project must benefit a minimum of three (3) LMI persons. If the project is located in an entitlement city, as defined by HUD, or serves beneficiaries countywide, more than thirty percent (30 %) of the beneficiaries directly assisted under this Agreement must reside in unincorporated Collier County or in municipalities participating in the County's Urban County Qualification Program. D. AFFIRMATIVE ACTION PLAN The SUBRECIPIENT agrees that it shall be committed to carry out pursuant to the COUNTY's specifications an Affirmative Action Program in keeping with the principles as provided in President's Executive Order 11246 of September 24, 1966. The COUNTY shall provide Affirmative Action guidelines to the SUBRECIPIENT to assist in the formulation of such program. The SUBRECIPIENT shall submit a plan for an Affirmative Action Program for approval prior to the award of funds. E. CONFLICT OF INTEREST The SUBRECIPIENT covenants that no person under its employ who presently exercises any functions or responsibilities in connection with the Project, has any personal financial interest, direct or indirect, in the Project areas or any parcels therein, which would conflict in any manner or degree with the performance of this Agreement and that no person having any conflict of interest shall be employed by or subcontracted by the SUBRECIPIENT. The SUBRECIPIENT covenants that it will comply with all provisions of 24 CFR 570.611 "Conflict of Interest", and the State and County statutes, regulations, ordinance or resolutions governing conflicts of interest. Any possible conflict of interest on the part of the SUBRECIPIENT or its employees shall be disclosed in writing to HHVS provided, however, that this paragraph shall be interpreted in such a manner so as not to unreasonably impede the statutory requirement that maximum opportunity be provided for employment of and participation of low and moderate - income residents of the project target area. XI. CONDITIONS FOR RELIGIOUS ORGANIZATIONS The Empowerment Alliance of Southwest Florida Community Development Corporation DRI 05 -02 Hatcher's Preserve Page 10 of 30 16D5 03 -L5 -1 CDBG funds may be used by religious organizations or on property owned by religious organizations only in accordance with requirements set in Section 24 CFR 570.2000). The SUBRECIPIENT shall comply with First Amendment Church/State principles as follows: a. It will not discriminate against any employee or applicant for employment on the basis of religion and will not limit employment or give preference in employment to persons on the basis of religion b. It will not discriminate against any person applying for public services on the basis of religion and will not limit such services or give preference to persons on the basis of religion c. It will retain its independence from Federal, State and local governments and may continue to carry out its mission, including the defmition, practice and expression of its religious beliefs, provided that it does not use direct CDBG funds to support any inherently religious activities, such as worship, religious instruction or proselytizing d. The funds shall not be used for the acquisition, construction or rehabilitation of structures to the extent that those structures are used for inherently religious activities. Where a structure is used for both eligible and inherently religious activities, CDBG funds may not exceed the cost of those portions of the acquisition, construction or rehabilitation that are attributable to eligible activities in accordance with the cost accounting requirements applicable to CDBG funds in this part. Sanctuaries, chapels, or other rooms that a CDBG funded religious congregation uses as its principal place of worship, however, are ineligible for CDBG funded improvements. XII. SEVERABILITY Should any provision of the Agreement be determined to be unenforceable or invalid, such a determination shall not affect the validity or enforceability of any other section or part thereof. 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 this 261' day of March, 2013. The Empowerment Alliance of Southwest Florida Community Development Corporation DRi 05 -02 I latcher's Preserve Page I 1 of 30 ATTEST: DWIGHT F. 13 VCK, CLERK. Ift on DatQd: fi The Empowerment Alliance or Southwest Florida Community Development Corporation DRI 05-02 ) hucher's Preserve 03 - 215) -13 P 11 2 : 3 6 1 i" I BOARD OF COtfNTY COMMISSrITERS OF COLLIER COUNTY, FLORIDA ) A I / By: GEORGIA ABILLER, E CHAIRWOMAN The Empowerment Alliance of Southwest Florida Community DeyX4qVM on .S�� -"-� — — �rporati By: E d w �ar d RH sky, Approved as to form and legal sufficiency: Jennifer B. White Assistant County Attorney Page 12 of 30 item # Vw. V Agenda Date Date Redd AC Ddputy Clerk 1605 16D5 1 EXHIBIT "A" INSURANCE REQUIREMENTS The SUBRECIPIENT shall furnish to Collier County, c/o Housing, Human and Veteran Services Department, 3339 E. Tamiami Trail, Suite 211, Naples, Florida 34112, Certificate(s) of Insurance evidencing insurance coverage that meets the requirements as outlined below: Workers' Compensation as required by Chapter 440, Florida Statutes. 2. Commercial General Liability including products and completed operations insurance in the amount of $1,000,000 per occurrence and $2,000,000 aggregate. Collier County must be shown as an additional insured with respect to this coverage. 3. Automobile Liability Insurance covering all owned, non -owned and hired vehicles used in connection with this contract in an amount not less than $1,000,000 combined single limit for combined Bodily Injury and Property Damage. Collier County shall be named as an additional insured. DESIGN STAGE (IF APPLICABLE) In addition to the insurance required in I — 3 above, a Certificate of Insurance must be provided as follows: 4. Professional Liability Insurance in the name of the SUBRECIPIENT or the licensed design professional employed by the SUBRECIPIENT in an amount not less than $1,000,000 per occurrence /$1,000,000 aggregate providing for all sums which the SUBRECIPIENT and/or the design professional shall become legally obligated to pay as damages for claims arising out of the services performed by the SUBRECIPIENT or any person employed by the SUBRECIPIENT in connection with this contract. This insurance shall be maintained for a period of two (2) years after the certificate of Occupancy is issued. Collier County shall be named as an additional insured. CONSTRUCTION PHASE (IF APPLICABLE) In addition to the insurance required in 1 — 4 above, the SUBRECIPEENT shall provide or cause its Subcontractors to provide original certificates indicating the following types of insurance coverage prior to any construction: Completed Value Builder's Risk Insurance on an "All Risk" basis in an amount not less than one hundred (100 %) percent of the insurable value of the building(s) or structure(s). The policy shall be in the name of Collier County and the SUBRECIPIENT. 6. In accordance with the requirements of the Flood Disaster Protection Act of 1973 (42 U.S.C. 4001), the Subrecipient shall assure that for activities located in an area identified by the Federal Emergency Management Agency (FEMA) as having special flood hazards, flood insurance under the National Flood Insurance Program is obtained and maintained as a condition of financial assistance for acquisition or construction purposes (including rehabilitation). The Empowerment Alliance of Southwest Florida Community Development Corporation DRI 05 -02 Hatcher's Preserve Page 13 of 30 >>>_25-13 1605 OPERATION/MANAGEMENT PHASE (IF APPLICABLE) After the Construction Phase is completed and occupancy begins, the following insurance must be kept in force throughout the duration of the loan and /or contract: 7. Workers' Compensation as required by Chapter 440, Florida Statutes. 8. Commercial General Liability including products and completed operations insurance in the amount of $1,000,000 per occurrence and $2,000,000 aggregate. Collier County must be shown as an additional insured with respect to this coverage. 9. Automobile Liability Insurance covering all owned, non -owned and hired vehicles used in connection with this contract in an amount not less that $1,000,000 combined single limit for combined Bodily Injury and Property Damage. Collier County as an additional insured. 10. Property Insurance coverage on an "All Risk" basis in an amount not less than one hundred (100 %) of the replacement cost of the property. Collier County must be shown as a Loss payee with respect to this coverage as their interest may appear (A.T.I.M.A.) 11. Flood Insurance coverage for those properties found to be within a flood hazard zone for the full replacement values of the structure(s) or the maximum amount of coverage available through the National Flood Insurance Program (NFIP). The policy must show Collier County as a Loss Payee A.T.I.M.A. The Empowerment Alliance of Southwest Florida Community Development Corporation DRI 05-02 Hatcher's Preserve Page 14 of 30 P1 » I iJ 1605 EXHIBIT "B" COLLIER COUNTY HOUSING, HUMAN AND VETERAN SERVICES REQUEST FOR PAYMENT SECTION I: REQUEST FOR PAYMENT Sub recipient Name: The Empowerment Alliance of Southwest Florida Community Development Corporation Sub recipient Address: 750 South 5`" Street Immokalee Fl. 34142 Project Name: Hatcher's Preserve Project No: DRI 05 -02 Payment Request # Dollar Amount Requested: SECTION II: STATUS OF FUNDS 1. Grant Amount Awarded 2. Sum of Past Claims Paid on this Account 3. Total Grant Amount Awarded Less Sum Of Past Claims Paid on this Account 4. Amount of Previous Unpaid Requests 5. Amount of Today's Request 6. Current Grant Balance (Initial Grant Amount Awarded Less Sum of all requests) $ $110,000 I certify that this request for payment has been made in accordance with the terms and conditions of the Agreement between the COUNTY and us. To the best of my knowledge and belief, all grant requirements have been followed. Signature Date Title Authorizing Grant Coordinator Supervisor. Dept Director The Empowerment Alliance of Southwest Florida Community Development Corporation DRI 05-02 Hatcher's Preserve (approval authority under $14,999) (approval required $15,000 and above) Page 15 of 30 6) * 2 5 - 'I 1�5 P I ' : _3 6 116 D5 EXHIBIT "C" RELEASE AND AFFIDAVIT FORM The SUBRECIPIENT certifies for itself and its contractors, subcontractors, vendors, successors and assigns, that all charges for labor, materials, supplies, lands, licenses and other expenses for which COUNTY might be sued or for which a lien or a demand against any payment bond might be filed, have been satisfied and paid. This Release and Affidavit is given in connection with the SUBRECIPIENT's (progress /final) Request for Payment. Witness: Foln Print name and title STATE OF COUNTY OF Empowerment Alliance of Southwest Florida ITS: Board Chairman DATE: The foregoing instrument was acknowledged before me this day of , 20_,, by as of A Choose Not - For - Profit, or Corporation or Municipality on behalf of Choose Not - For - Profit, Corporation or Municipality . He /She is personally known to me OR has produced as identification and who did (did not) take an oath. My Commission Expires: (Signature) Name: _ (Legibly Printed) (AFFIX OFFICIAL SEAL) The F,mpowerment Alliance of Southwest Florida Community Development Corporation DRI 05 -02 Hatcher's Preserve Notary Public, State of- Page 16 of 30 Commission No.: 03 -25 -13 P12•36 IN 1605 EXHIBIT "W QUARTERLY PROGRESS REPORT Sub - recipients: Please fill in the following shaded areas of the report • Agency ThelnpctrtTNEtnkAiflance of.tGthweat,FjgCla Commurdy�fAprtlt# , Name: Corporatibti. Date: • Project Title: . Hatchet's Preserve _._ . • Program Alternate Contact: . Dottie Cook " ;_ _ .:.,... .::` Contact moo= Please list the outcome goal {s) from your;approved application &suit - recipient sgreetnent anit irtdicate t, meeting those The Empowerment Alliance of Southwest Florida Community Development Corporation DRI 05 -02 Hatcher's Preserve Page 17 of 30 'rhe Empowerment Alliance of Southwest Florida Community Development Corporation DRI 05 -02 Hatcher's Preserve Page 18 of 30 03 -25 -13 P12:36 I 6n5, - • <; Is thig;project still in compliance. with the original, 'proJect schedule? If more than 2 months behind schedule, must submit a 2. new Timeline fora royal. • s S • • i _. , • If no, explain: 1 Since agreement date, of the persons assisted, how many.... a. ...now have new access (continuing) to this service or benefit b. ... now has improved access to this service or benefid C. ...now receive a service of benefit • • • TOTAL: 0 4. • ' ` What funding sou'r'ces,-are applied for this` eriod l ro ram: ear? ' d • Section 108 Loan Guarantee , DRUDREF ' } .. • Other Consolidated Plan Funds r CDBG • Other Federal Funds x ESG • State /Local Funds HOME _ ;_ w.r • $ Total amount $ • Total Other Funds - of Funds 'rhe Empowerment Alliance of Southwest Florida Community Development Corporation DRI 05 -02 Hatcher's Preserve Page 18 of 30 1605 03-25-13 P12:36 IN EXHIBIT "D" r QUARTERLY PROGRESS REPORT 5. What In the total number of UNDUPLICATED clients served this quarter, If applicable? a. Total No. of adult females served: O Total No. of females served under 18: 0 b. Total No. of adult males served: Q..........:: Total No. of males served under 18: 0 TOTAL: 0 TOTAL: 0 c. Total No. of families served: D .Total No. of female head of household: s. What is the:toffiIn . umber of UNDUPLICATED clients served since October, if applica ble? a. Total number of adult females served :Total number of females served under 18: 0 b. Total number of adult males served ( ,Total number of males served under 18: ti TOTAL: 0 TOTAL: 0 c. Total No. of families served: i Total No. of female head of household: Q Complete EITHER question #7 OR Na. Complete question 07 if your program only serves clients in one or more of the listed HUD Presumed Benefit categories. Complete question #8 if any client in your program does not fall into a Presumed Benefit category. DO NOT COMPLETE BOTH QUESTION 7 AND 8. 7. PRESUMED BENEfIC1ARY DATA . 8. OT►iER BENEI?ICiARY DATA INCOME ;RM/�,E Indicate the total number of IMMEMIZAZED- Indicate the total number of UNDUPLICATED persons persons served since October f who fall into served since October 1 who fall into each income each presumed benefit category (the total category (the total shoufd equal the total In question #6) : should equal the total in question #6) : Report as: Report as: Abused Children Homeless Person Battered Spouses Persons w/ HIV /AIDS Elderly Persons Veterans Chronically/ Mentally ill Physically Disabled Adults Other -Youth 0 Extremely low Income (0 -30 %) 0 tLow Income (31 -50 %) 0 . ?Moderate Income 0 iAbove Moderate Income ( >80 %) TOTAL: 0 TOTAL: 0 9. Raclal Si Et.iinle Datai (if applicab[e) Please indicate how many UNDUPLICATED clients served since October fall into each race category. In addition to each race category, please indicate how many persons in each race category consider themselves Hispanic (Total Race column should equal the total cell). RACE ETHNICITY White . - Black/African American of whom, how many are Hispanic? Asian w American Indian /Alaska Native O Native Hawaiian/Other Pacific Islander , 0 American Indian /Alaskan Native & White 4 Black/African American & White.:...Q 0 Am. Indian /Alaska Native & Black/African Am 0 Other Multi- racial 0 Other "0 TOTAL: 0 Name: Title: The Empowerment Alliance of Southwest Florida Community Development Corporation DRI 05 -02 Hatcher's Preserve Page 19 of 30 Signature: Your ty name ere represen s your a ec ronic signature ofwhom, how many are Hispanic? of whom, how many are Hispanic? Q - ofwhom, how many are Hispanic? ofwhom, how many are Hispanic? ofwhom. how many are Hispanic? of whom, how many are Hispanic? of whom, how many are Hispanic? 0 [; ofwhom, how many are Hispanic? of whom, how many are Hispanic? 0 of whom, how many are Hispanic? 0 TOTAL HISPANIC Page 19 of 30 Signature: Your ty name ere represen s your a ec ronic signature EXHIBIT "E" ANNUAL AUDIT MONITORING REPORT OMB Circular A -133 Audits of States, Local Governments, and Non- Profit Organizations requires the Collier County Housing, Human and Veterans Services Department to monitor our sub recipients of federal awards 1.605 compliance with federal laws and regulations. Accordingly, we are requiring that you check one. of ,the following, provide all appropriate documentation regarding your organization's compliance with the audit J. -25 -13 P12 :36 !, The Empowerment Alliance of Southwest Fiscal Year Ending Dec. 31, 20.1 EXHIBIT "E" ANNUAL AUDIT MONITORING REPORT OMB Circular A -133 Audits of States, Local Governments, and Non- Profit Organizations requires the Collier County Housing, Human and Veterans Services Department to monitor our sub recipients of federal awards and determine whether they have met the audit requirements of the circular and whether they, are in compliance with federal laws and regulations. Accordingly, we are requiring that you check one. of ,the following, provide all appropriate documentation regarding your organization's compliance with the audit requirements, sign and date this form, The Empowerment Alliance of Southwest Fiscal Year Ending Dec. 31, 20.1 Sub recipient Florida Community Development Period and 2012 Name Corporation FY 1/1 to 12/31 When available Total State Financial Assistance Expended during most recently completed Fiscal Year Total Federal Financial Assistance Expended during most $ ', recently completed Fiscal Year Check Appropriate Boxes We have exceeded the $500,000 federal /state expenditure threshold for our fiscal year ending ❑ as indicated above and have completed our Circular A -133 audit. A copy of the audit report and management fetter is attached. We exceeded the $500,000 federal /state expenditure threshold for our fiscal year ending as indicated above and expect to complete our Circular A -133 audit by . Within 30 days of completion of the A -133 audit, we will provide a copy of the audit report and management letter. We are not subject to the requirements of OMB Circular A -133 because we: ❑ Did not exceed the $500,000 federal /state expenditure threshold for the fiscal year indicated above ❑ Are a for - profit organization ❑ Are exempt for other reasons — explain An audited financial statement is attached and if applicable, the independent auditor's management letter. ..r ..�:..e � Mr%n ninn 1 findings were I hereby certify that Signature Print Name and Title notea, plea5e U"WvSv d 4V vs any - Certification Statement above information. is true and accurate,' Date The Empowerment Alliance of Southwest Florida Community Development Corporation DRI 05 -02 Hatcher's Preserve Page 20 of 30 I _3 !,- � P `:,� 5 1 6 D 5 EXHIBIT "F" LOCAL, STATE AND FEDERAL RULES, REGULATIONS AND LAWS 1. 24 CFR 570, as amended - The regulations governing the expenditure of Community Development Block Grant (CDBG) funds. 2. 24 CFR 58 - The regulations prescribing the Environmental Review procedure. 3. Section 104(b) and Section 109 of Title I of the Housing and Community Development Act of 1974 as amended 4. Title VI of the Civil Rights Act of 1964 as amended, Title VIII of the Civil Rights Act of 1968 as amended 5. 24 CFR 570.601 Subpart K - The regulations issued pursuant to Executive Order 11063 which prohibits discrimination and promotes equal opportunity in housing. 6. Executive Order 11246 ( "Equal Employment Opportunity "), as amended by Executive Orders 11375 and 12086 - which establishes hiring goals for minorities and women on projects assisted with federal funds and as supplemented in Department of Labor regulations. 7. Title VII of the 1968 Civil Rights Act as amended by the Equal Employment Opportunity Act of 1972, 42 USC § 2000e, el. seq. The SUBRECIPIENT will, in all solicitations or advertisements for employees placed by or on behalf of the SUBRECIPIENT, state that it is an Equal Opportunity or Affirmative Action employer. 8. 24 CFR 135 — Regulations outlining requirements of Section 3 of the Housing and Urban Development Act of 1968, as amended. Compliance with the provisions of Section 3 of the HUD Act of 1968, as amended, and as implemented by the regulations set forth in 24 CFR 135, and all applicable rules and orders issued hereunder prior to the execution of this contract, shall be a condition of the Federal financial assistance provided under this contract and binding upon the COUNTY, the SUBRECIPIENT and any of the SUBRECIPIENT's Sub - recipients and subcontractors. Failure to fulfill these requirements shall subject the COUNTY, the SUBRECIPIENT and any of the SUBRECIPIENT's Sub - recipients and subcontractors, their successors and assigns, to those sanctions specified by the Agreement through which Federal assistance is provided. The SUBRECIPIENT certifies and agrees that no contractual or other disability exists that would prevent compliance with these requirements. The SUBRECIPIENT further agrees to comply with these "Section 3" requirements and to include the following language in all subcontracts executed under this Agreement: "The work to be performed under this Agreement is a project assisted under a program providing direct Federal financial assistance from HUD and is subject to the requirements of Section 3 of the Housing and Urban Development Act of 1968, as amended (12 U.S.C. 1701). Section 3 requires that to the greatest extent feasible opportunities for training and employment be given to low- and very low- income residents of the project area, and that contracts for work in connection with the project The Empowerment Alliance of Southwest Florida Community Development Corporation DRI OS -02 Hatcher's Preserve Page 21 of 30 1605 be awarded to business concerns that provide economic opportunities for low- and very low- income persons residing in the metropolitan area in which the project is located." The SUBRECIPIENT further agrees to ensure that opportunities for training and employment arising in connection with a housing rehabilitation (including reduction and abatement of lead -based paint hazards), housing construction, or other public construction project are given to low - and very low - income persons residing within the metropolitan area in which the CDBG - funded project is located; where feasible, priority should be given to low- and very low- income persons within the service area of the project or the neighborhood in which the project is located, and to low - and very low - income participants in other HUD programs; and award contracts for work undertaken in connection with a housing rehabilitation (including reduction and abatement of lead -based paint hazards), housing construction, or other public construction project to business concerns that provide economic opportunities for low - and very low- income persons residing within the metropolitan area in which the CDBG- funded project is located; where feasible, priority should be given to business concerns that provide economic opportunities to low- and very low - income residents within the service area or the neighborhood in which the project is located, and to low- and very low- income participants in other HUD programs. The SUBRECIPIENT certifies and agrees that no contractual or other legal incapacity exists that would prevent compliance with these requirements. 9. Age Discrimination Act of 1975, Executive Order 11063, and Executive Order 11246 as amended by Executive Orders 11375, 11478, 12107 and 12086. 10. Contract Work Hours and Safety Standards Act, 40 USC 327 -332. 11. Section 504 of the Rehabilitation Act of 1973, 29 USC 776(b) (5), 24 CFR 570.614 Subpart K. 12. The Americans with Disabilities Act of 1990 13. Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970, as amended. 14. 29 CFR Parts 3 and 5 - Regulations which prescribe the payment of prevailing wages and the use of apprentices and trainees on federally assisted projects as mandated by the Davis -Bacon Act. HUD Form 4010 must be included in all construction contracts funded by CDBG. (See 42 USC 276a and 24 CFR 135.1 l (c)). 15. Executive Order 11914 - Prohibits discrimination with respect to the handicapped in federally assisted proj ects. 16. Executive Order 11625 and U.S. Department of Housing and Urban Development Circular Letter 79 -45 - which prescribes goal percentages for participation of minority businesses in Community Development Block Grant Contracts. 17. The SUBRECIPIENT agrees to comply with the non - discrimination in employment and contracting opportunities laws, regulations, and executive orders referenced in 24 CFR 570.607, as revised by Executive Order 13279. The applicable non - discrimination provisions in Section 109 of the HCDA are still applicable. The Empowerment Alliance of Southwest Florida Community Development Corporation DRI 05 -02 Hatcher's Preserve Page 22 of 30 -13 16 05 18. Public Law 100 -430 - the Fair Housing Amendments Act of 1988. 19, 24 CFR 84 - Uniform Administrative Requirements for Grants and Agreements with Institutions of Higher Education, Hospitals and Other Non - Profit Organizations and specified by the following subsections: • Subpart A — General; • Subpart B — Pre -Award Requirements, except for 84.12, Forms for Applying for Federal Assistance; • Subpart C — Post -Award Requirements, except for: o Section 84.22, Payment Requirements- Grantees shall follow the standards of 85.20(b)(7) and 85.21 in making payments to SUBRECIPIENTs; o Section 84.23, Cost Sharing and Matching; o Section 84.24, Program Income — in lieu of 84.24 CDBG SUBRECIPIENTs shall follow 570.504; o Section 84.25, Revision of Budget and Program Plans; o Section 84.32, Real Property — In lieu of 84.32, CDBG SUBRECIPIENTs shall follow 570.505; o Section 84.34(g), Equipment — In lieu of the disposition provisions of 84.34(8) the following applies: • In all cases in which equipment is sold, the proceeds shall be program income (pro- rated to reflect the extent to which CDBG funds were used to acquire the equipment); and • Equipment not needed by the SUBRECIPIENT for CDBG activities shall be transferred to the recipient for the CDBG program or shall be retained after compensating the recipient; o Section 84.51(b), (c), (d), (e), (f) and (h), Monitoring and Reporting Program Performance; o Section 84.52, Financial Reporting; o Section 84.53(b), Retention and Access Requirements for Records. Section 84.53(b) applies with the following exceptions: ■ The retention period referenced in 84.53(b) pertaining to individual CDBG activities shall be four years; and ■ The retention period starts from the date of submission of the annual performance and evaluation report, as prescribed in 24 CFR 91.520, in which the specific activity is reported on for the final time rather than from the date of submission of the final expenditure report for the award; o Section 84.61, Termination - In lieu of the provisions of 84.61, CDBG SUBRECIPIENTs shall comply with 570.503(b)(7); and • Subpart D — After - the -Award Requirements — except for 84.71, Closeout Procedures 20, 24 CFR 85 - Administrative Requirements for Grants and Agreements to State and Local Governments shall be followed for sub recipients that are governmental entities. 21. Immigration Reform and Control Act of 1986 as located at 8 USC 1324, et seq. and regulations relating thereto. Failure by the SUBRECIPIENT to comply with the laws referenced herein shall constitute a breach of this agreement, and the County shall have the discretion to unilaterally terminate this agreement immediately. The Empowerment Alliance of Southwest Florida Community Development Corporation DRI 05 -02 Hatcher's Preserve Page 23 of 30 J7 7 116 D5 ,)31-25-1 pl� 22. Prohibition Of Gifts To County Employees - No organization or individual shall offer or give, either directly or indirectly, any favor, gift, loan, fee, service or other item of value to any County employee, as set forth in Chapter 112, Part III, Florida Statutes, Collier County Ethics Ordinance No. 2004 -05, as amended, and County Administrative Procedure 5311. 23. Order of Precedence - In the event of any conflict between or among the terms of any of the Contract Documents, the terms of the Agreement shall take precedence over the terms of all other Contract Documents, except the terms of any Supplemental Conditions shall take precedence over the Agreement. To the extent any conflict in the terms of the Contract Documents cannot be resolved by application of the Supplemental Conditions, if any, or the Agreement, the conflict shall be resolved by imposing the more strict or costly obligation under the Contract Documents upon the Contractor at Owner's discretion. 24. Dispute Resolution - Prior to the initiation of any action or proceeding permitted by this Agreement to resolve disputes between the parties, the parties shall make a good faith effort to resolve any such disputes by negotiation. Any situations when negotiations, litigation and/or mediation shall be attended by representatives of SUBRECIPIENT with full decision - making authority and by COUNTY'S staff person who would make the presentation of any settlement reached during negotiations to COUNTY for approval. Failing resolution, and prior to the commencement of depositions in any litigation between the parties arising out of this Agreement, the parties shall attempt to resolve the dispute through Mediation before an agreed -upon Circuit Court Mediator certified by the State of Florida. Should either party fail to submit to mediation as required hereunder, the other party may obtain a court order requiring mediation under § 44.102, Florida Statutes. The litigation arising out of this Agreement shall be Collier County, Florida, if in state court and the US District Court, 20th Judicial Court of Florida, if in federal court. BY ENTERING INTO THIS AGREEMENT, COLLIER COUNTY AND THE SUBRECIPIENT EXPRESSLY WAIVE ANY RIGHTS EITHER PARTY MAY HAVE TO A TRIAL BY JURY OF ANY CIVIL LITIGATION RELATED TO, OR ARISING OUT OF, THIS AGREEMENT. 25. The SUBRECIPIENT agrees to comply with the following requirements: a. Clean Air Act, 41 USC 7401, et seq. b. Federal Water Pollution Control Act, 33 USC 1251, et seq., as amended. 26. In accordance with the requirements of the Flood Disaster Protection Act of 1973 (42 USC 4002 and 24 CFR 570.605 Subpart K), the SUBRECIPIENT shall assure that for activities located in an area identified by FEMA as having special flood hazards, flood insurance under the National Flood Insurance Program is obtained and maintained. If appropriate, a letter of map amendment (LOMA) may be obtained from FEMA, which would satisfy this requirement and/or reduce the cost of said flood insurance. 27. The SUBRECIPIENT agrees that any construction or rehabilitation of residential structures with assistance provided under this contract shall be subject to HUD Lead -Based Paint Poisoning Prevention Act found at 24 CFR 570.608, Subpart K. 28. The SUBRECIPIENT agrees to comply with the Historic Preservation requirements set forth in the National Historic Preservation Act of 1966, as amended (16 U.S.C. 470) and the procedures set forth in 36 CFR Part 800, Advisory Council on Historic Preservation Procedures for Protection of Historic Properties, insofar as they apply to the performance of this agreement.. The Empowerment Alliance of Southwest Florida Community Development Corporation DRI 05-02 Hatcher's Preserve Page 24 of 30 6 a In general, this requires concurrence from the State Historic Preservation Officer for all rehabilitation and demolition of historic properties that are fifty years old or older or that are included on a federal, state or local historic property list. 29. The SUBRECIPIENT must certify that it will provide drug -free workplaces in accordance with the Drug - Free Workplace Act of 1988 (41 USC 701). 30, The SUBRECIPIENT certifies that neither it, nor its principals, is presently debarred, suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any Federal Department or agency; and, that the SUBRECIPIENT shall not knowingly enter into any lower tier contract, or other covered transaction, with a person who is similarly debarred or suspended from participating in this covered transaction as outlined in 24 CFR 570.609, Subpart K. 31. The SUBRECIPIENT agrees to comply with the following OMB Circulars whichever is applicable, and agrees to adhere to the accounting principles and procedures required therein, utilize adequate internal controls, and maintain necessary source documentation for all costs incurred. States local governments and Indian Tribes follow: • A -87 for Cost Principles • A -102 for Administrative Requirements Educational Institutions (even if part of a State or local government) follow: • A -21 for Cost Principles • A -110 for Administrative Requirements Non - Profit Organizations follow: • A -122 for Cost Principles • A -110 for Administrative Requirements 32. Audits shall be conducted annually and shall be submitted to the COUNTY one hundred eighty (180) days after the end of the SUBRECIPIENT's fiscal year. The SUBRECIPIENT shall comply with the requirements and standards of OMB A -133, Audits of States, Local Governments, and Non -Profit Organizations. If this Agreement is closed out prior to the receipt of an audit report, the COUNTY reserves the right to recover any disallowed costs identified in an audit after such closeout. 33. Any real property acquired by the SUBRECIPIENT for the purpose of carrying on the projects stated herein, and approved by the COUNTY in accordance with the Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970 and 49 CFR 24.101, shall be subject to the provisions of CDBG including, but not limited to, the provisions on use and disposition of property. Any real property within the SUBRECIPIENT control, which is acquired or improved in whole or part with CDBG funds in excess of $25,000, must adhere to the CDBG Regulations at 24 CFR 570.505. In accordance with the DRI Administrative Plan, a ten (10) year depreciating lien for the homeowner will be filed as a security instrument for the work performed and funded with the grant. 34. As provided in § 287.133, Florida Statutes by entering into this Agreement or performing any work in furtherance hereof, the SUBRECIPIENT certifies that it, its affiliates, suppliers, subcontractors and consultants who will perform hereunder, have not been placed on the convicted vendor list maintained by the State of Florida Department of Management Services within the 36 months immediately preceding the date hereof. This notice is required by § 287.133 (3) (a), Florida Statutes. The Empowerment Alliance of Southwest Florida Community Development Corporation DRI 05 -02 Hatcher's Preserve Page 25 of 30 - 1605 35. No Federal appropriated funds have been paid or will be paid, by or on behalf of the undersigned, to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with the awarding of any Federal contract, the making of any Federal grant, the making of any Federal loan, the entering into of any cooperative agreement, and the extension, continuation, renewal, amendment, or modification of any Federal contract, grant, loan, or cooperative agreement. If any funds other than Federal appropriated funds have been paid or will be paid to any person for influencing or attempting to influence an officer or employee of any agency, a Member of Congress, an officer or employee of Congress, or an employee of a Member of Congress in connection with this Federal contract, grant, loan, or cooperative agreement, the undersigned shall complete and submit Standard Form -LLL, "Disclosure Form to Report Lobbying," in accordance with its instructions. The undersigned shall require that the language of this certification be included in the award documents for all sub - awards at all tiers (including subcontracts, sub - grants, contracts under grants, loans, and cooperative agreements) and that all SUBRECIPIENTS shall certify and disclose accordingly. 36. Travel reimbursement will be based on the U.S. General Services Administration (GSA) per diem rates in effect at the time of travel. 37. Any rule or regulation determined to be applicable by HUD /DEO. 38, Florida Statutes 713.20, Part 1, Construction Liens 39, Florida Statutes 119.021, Records Retention. 40. The Disaster Recovery Initiative Grant Agreement #07DB- 3V- 09- 21- 01 -ZO1 between Collier County and the Florida Department of Economic Opportunity by reference is incorporated into this agreement. The Empowerment Alliance of Southwest Florida Community Development Corporation DR] 05 -02 Hatcher's Preserve Page 26 of 30 ;)x-25 -1� I'1:% :37 IiJ EXHIBIT "G" AIA G702 -1992 Form The Empowerment Alliance of Southwest Florida Community Development Corporation DRI OS -02 Hatcher's Preserve Page 27 of 30 16 O,f 5, 0-5-25 -13 i'12:37 I J 0, A Document G702" "- 1992 Instructions Application and Certificate for Payment GENERAL INFORMATION Purpose auul Related Dueumenls AIA DOCILInClli C1702, Application and Certificate fur Payment, is lu he used in cogitmction with AiA Dticumenl G703, Continuation Sheet. T'hesce d0CLITIWIAS are designed (u be used on it Prcijeca where. it Contractor has a direct Agreement with the 0wrier. Procedures 141r (heir use are cnvercd iu A1A Document A201. General Condition, of the Contract for Construction. TJse of Current Ducurnerms Prior to using any ATA Contract Docurltc.nf, users shtruld consult www.aia.tng or it local ATA component t) verify the must recent edition. Reproductions Thus docnnictti is a copyrighted work and play ilnt he reproduced or excerpted front without the express written perntissiun or the AiA. There is no implied llermission Io reproduce. Illis (footmen(. nor clues membership in The American Inslitttle oCArchilects conrer an_v further rights to reproduce this doctmirm. The ATA hereby grams the purchaser it limited liccuse to reproduce a nloxililunr of ten copies of a completed x702. bill only for use in connection with a pardelli 1. prgiect. The AIA "fill not permit reprudtic6on outside of the limited iiLVIISC for reproduction granted above. except upon written requcs( and receipt of writicn permission from the AiA. Rights to reproduce the dot:ulnent may vary lily users or ATA software. l-icensed ATA N(ftwll -e tAcis should consult the F.nd User License Agreement (ELJI-A). T'o report copyright violations of AIA Contract Documents. c- 111.1il The American Institute of Architects' legal counsel. copyrightCvaia.org. COMPLETING THE G702 FORM After the Contractor has completed AIA Docantent C3703, Continuation Shcet. sununary information should be transferred to AiA DUetlrlCnt 6702, Application and Certificate for Payment. The C'unt'actur should sign 6702, have it notarized. and submit it. together with 0703, to the Architect. The Architect should review 0702 and 67(:)3 and, il'they our acceptable, conlpiew the Architect's Certificate for Payment on 0702. The Archilecli may certify a dilTerent amount than that applied for, pw'suanl to Sections 9.5 and 9.6 of A201. The Architect should than initial all figures on G702 and 6703 that have been changed to conform to the amount certified and attach an explanation. The completed 6702 and G703 should be lilrwardel to the Owner. MAKING PAYMENT The 0WHel 41101.1Id Wilke payment lirecily to the Contractor based on the Itrnounl certified by the Architect on AIA L)ocument 6702. Application and Certificate for Payment. The completed form coaulins the nlune and address of the Contractor. Payment should not be merle to any other party unless specifically indicated url 6702. EXECUTION OF THE DOCUMENT Persons executing the document Should indictuc the capacity in Which they are acting 6.e., president. secmlary. partner, etc.) and tile, authority under which they are executing the document. Where appropriate. it copy of the resolution authorizing the individual to act on hchalf of the f ir111 or entity should he attached. -- — AIA Document G702TM - 1992. Copyright (0 1953, 1903. I9ob, 1971 , 1978, 1983 and 1992 by'Tho American Institute of Architects. All rights reserved. W = s AIA' Document Is protected by U.S. Copyright Law and Intornational Treaties. Unauthorized reproduction or distribution of this AIA° Document, or any portion of it, may result in severe civil and criminal penalties, and will be prosecutad to the maximum extent possible under the law. Purchasers Are psnnilled to rnprndtxa ten (10) cop(cs of this documoM When completed. To report copyright vioiarlons of AIA Contract Documanir;, a -mAll The American Institute of Archilecta' tagat counsel, copyright@ain.org. The Empowerment Alliance of Southwest Florida Community Development Corporation DRI 05 -02 Hatcher's Preserve Page 28 of 30 J ✓- I i 1605 12U.--AIA Document G702'" -1992 Application and Certificate for Payment TO OWNER: PROJECT: APPLICATION NO: Distrlbutfon to: PERIOD TO: OWNER ❑ CONTRACT fOR: ARCHITECT D FROM CONTRACTOR: VIAARCHITECT: CONTRACT DATE: CONTRACTOR ❑ PROJECT NOS: 1 FIELD ❑ OTHER ❑ CONTRACTOR'S APPLICATION FOR PAYMENT Application is made for payment, as shown below, in connection with Orr. Cotilrul. Continuation Shah AIA Document 6703, is attached, 1, ORIGINAL CONTRACT SUM ........................ ............................... 2, Net change by Change Orders ................ ............................... S 3. CONTRACT SUM TO DATE (Line I _ +. ? ) .......... ............................... S d. TOTAL COMPLETED $ STORED TO DATE (Coltunn G cm 6703) ............. 5, RETAINAGE: a, tb of Cony)lel.NI Work i.Coluran D + E on G70.3) 5 b, r{. nl Shoed Malt-nal tColuuu Foil 67031 $ 'fatal Rrtainaie O.ioex 5,1 •1 5b or Total in Cohnnn I of (1703i....... ti 6. TOTAL EARNED LESS RETAINAGE .... ............................... Linc A Leos Linc 5 T'u1a11 _ 7. LESS PREVIOUS CERTIFICATES FOR PAYMENT ...................... 5 i f -irle b fruit pr',or Celti icate) 8, CURRENT PAYMENT DUE .................. I.......................... Is 9, BALANCE TO FINISH, INCLUDING REfAINAGE (Line 3 loss Lin, 6) F CHANGE ORDER SUMMARY ADDITIONS DEDUC FIONS fWal,hangrs approved In previous nn;nUts by Own: Tntal appt;wed this kloolh S $ M- _ S $ TOTALS NET CH ANUS b� CI1anLk Older 'S.... S 'flu• undersigned Conhaclor certifies lbal to Ilse best of the Cootrxior'% knowledge, information and belief the Work covered by this Application for Payluiew has been completed in accordance with file Contract Documeuts, that all 3ininus have hern paid by the Contractor fin Wnrk for which previous Certificates for Pavrnenl ivere issued and payolenls received from the Owlier, and that culrenl paymtenl shown herein is now due. CONTRACTOR: gy: Date: Stale nf: Cmumv nf: Suhs,rilkxl and sworn to before me this day of Votan Public: MY Conuiii ±lion expires: ARCHITECT'S CERTIFICATE FOR PAYMENT I n accordance u•ilh the [brat Documents, based col on -site observations and the data comprising this application. the Architect certifies to The Owner that to the hest of the Architect's knowledge, ildunudinn and belief the Work- has progressed as indicated, the quality of the Work is in accordance with the Contrx:t DW -1111 nls, and the Contnlchnr is entitled to paymmni of the Ah101LINTCF.RTIFIED. AMOUNTCERTIFIED ...................... -., .................. ......... I........................ S ±Auurfr el1d ntulirm if itnurrae rediirrd di fferx, Cunt rkr annum applied. htifird rdi ((,Soria• nn ,lit Applirefien and on the Continrartion Sheri Burl are clanged fo conform frith the (1autrotl rectified.) ARCHITECT: 'Ibis Certificate is not negotiahle.'Ihe ,"10UN1' CIRrIFIfiD is playable only to the Conuacmr nalu d bercin. Issuance, payment and act'eptance of payux l t arc without prejudice lo any rights of the Otwn r ter Cturactor under this Contract AIA Document G7021° -1992. Copyright P 1953, 1963, 1965. ' 971, 1978;19E3 etb 1992 by The Amudcan hls6hue of Arch feels. All rights raserved, WARNItNG: This AIA` noannent Is proacvaed by U.S. Copyrighl Lary and Intnrnaliomil Twall:;s. Urrnuiliowed leprodoction or dhu:bulion of Ihls AIA" Document, or any portion of )t, may result In severe clvll and ciinnlnal penalilos, and Wit be prosecuted to the maximum extent possible under the law. purchasers are pencilled to reproduce len (10) wp>ies of !his document when conlDleled. To report copyrighl violations of AIA Contract Dacorrrents, a -msi The Arnerican Ins6ttne ol Aichitecl;' legal w msel. cnpyricl`rf0�aa.urq. '11Te Empowerment Alliance of Southwest Florida Community Development Corporation DRI 05 -02 Hatcher's Preserve Page 29 of 30 1605 93 -25 -1� P12 :37 11'1 CONTINUATION SHEET .11:1 DOCUMENT 6;03 (Instructions on reverse side) PAGE OF RVES AIA Document G 702, APPLICATION AND CERTIFICATE FOR P-il MF\ T. APPLICATION AO.: containing Contractors signed Certification, is attached. APPLICATION MrE! In tabulations below, amouns are zwed to the nearest dollar. PERIOD TO: L:se Column I on Contracts Where 4arialsle retainage for li ;e items may apply, ARCH1TECi'S PRQiECT NO.: g C D C F G ,C i i r i WOKC01'PLETF.D t`ATERIALS I TOTAL e�4CCF ` I PREJE \TLl' COI PLETED i0 RFT91 \AGE iTEni i DF.SCi PT10\ OF if ORK I jCHED'uLED S'.�LT VALUE ' FROM, PREF!0[j I STOREt AND STORED iG _ Cj r1VSH (IF \:4RLaBLEi ti 0. I APPLIGATION PHIS PERIOD ! • I TO DATE (C - G) rL,tTEt 1 (D + Ej I D OR E} (D +E +F} I I I f 1 i i � j I i I 1 I I I � i j I I i I I i � l t E i 1 I � I ALA DOCUMENT 6703 s CONTi:UATIOS SHEET FOR G702 # IM EDITION - AU4 - Y'v— - T'E ?NIFRICA.N INSTITUTE TE OF.aKF.I M, i =,) Xff YQKK AA rXUE, r:.a., NVASHUNGn)N, D.0 1003 ;M @ WARNING: UnFased photocopftq violates U.S. cop tht laws and will subject the vidabr to tegd prosecution. G703 -1992 CAUTION: You should use an original AIA document which has this caution printed in red. An original assures that changes will not be obscured as may occur when documents are reproduced, The Empowerment Alliance of Southwest Florida Community Development Corporation DRI OS -O2 Hatcher's Preserve Page 30 of 30