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Backup Documents 10/08/2013 Item #16D 6ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 16136 TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later than Monday preceding the Hoard meeting. Complete routing lines #1 through #2 as appropriate for additional signatures, dates, and/or information needed. If the document is already complete with the _cn._ .1..... a G— tr..,r... & —fine ui * i thm,oh #) o mntete the checidist and fiorwaid to the County Attorney oft e. Route to Addressee(s) (List in routing order) - Office Initials Date 1. Initial A livable 2. 10/08/13 /, j Agenda Item Number 16D6 j 3. Colleen Greene County Attorney Office N/A 4. BCC Office Board of County Commissioners b $ `� 5. Minutes and Records Clerk of Court's Office Documents Attached PRIMARY CUN'fACl' 11 FUXMArivf+l Normally the primary contact is the person who created/prepared the Executive Summary. Primary contact information is needed in the event one of the addressees above, may ieou w Name of Primary Staff G(mUNA shiln luh a RU. ..... Natali Betancur Phone Number 239 -252 -4 59 Contact / ern Initial A livable Agenda Date Item was 10/08/13 /, j Agenda Item Number 16D6 j by the BCC Does the document need to be sent to another agency for additional signatttres? If yes, N/A -Approved Type of Document Agreement Number of Original 4 Attached Original document has been signed/initialed for legal sufficiency. (All documents to be Documents Attached PO number or account signed by the Chairman, with the exception of most letters, must be reviewed and signed number if document is by the Office of the County Attorney. to be recorded All handwritten strike - through and revisions have been initialed by the County Attorney's _ INSTRUCTIONS & CHECKLIST I: Forms/ County Fors/ BCC Forms/ Original Documents Routing Slip W WS Original 9.03.04, Revised 1.26.05, Key 224.05; Revised 11/30/12 Initial the Yes column or mark "N /A" in the Not Applicable column, whichever is Yes N/A (Not Initial A livable 1. Does the document require the chairman's original signature? NB 2. Does the document need to be sent to another agency for additional signatttres? If yes, N/A pro vide the Contact Information erne; A en ; Address; Phone on an attached sheet. 3. Original document has been signed/initialed for legal sufficiency. (All documents to be NB signed by the Chairman, with the exception of most letters, must be reviewed and signed by the Office of the County Attorney. 4. All handwritten strike - through and revisions have been initialed by the County Attorney's _ Office and all other parties except the BCC Chairman and the Clericto the Board The Chairman's signature line date has been entered as the date of BCC approval of the rNB 5. document or the final n otiated contract date whichever is licable. "Sign here" tabs are placed on the appropriate pages indicating where the Chairman's 6. signature and initials are In most cases (some contracts are an exception), the original document and this routing slip NB 7. should be provided to the County Attorney Office at the time the item is input into SIRE. Some documents are time sensitive and require forwarding to Tallahassee within a certain time frame or the BCC's actions are nullified. Be aware of your deadlines! 8. The document was approved by the BCC on 10/08/13 and all changes made during NB the meeting have been incorporated in the attached document. The County 9. Attorney's Office has reviewed the changes, if applicable. Initials of attorney verifying that the attached document is the version approved by the NB BCC, all changes directed by the BCC have been made, and the document is ready for e Chairman's si I: Forms/ County Fors/ BCC Forms/ Original Documents Routing Slip W WS Original 9.03.04, Revised 1.26.05, Key 224.05; Revised 11/30/12 16D6 MEMORANDUM Date: October 14, 2013 To: Natali Betancur Parks and Rec. Department From: Teresa Cannon, Deputy Clerk Board Minutes & Records Department Re: After School Meals Program Attached for your records are three (3) originals of the document referenced above, (Agenda Item #16D6) adopted by the Board of County Commissioners on Tuesday, October 8, 2013. An original has been kept by the Minutes and Records Department as part of the Board's Official Records. If you have any questions, please feel free to contact me at 252 -8411. Thank you. Attachment 16D6 AFTERSCHOOL MEALS PROGRAM SPONSOR -SITE AGREEMENT FOR UNAFFILIATED SITES S� Alkwesk �kor c � �� �90c ' This agreement is entered into between l n A , hereinafter Nirm of Sponsoring Organza referred to as the "sponsor," and lu ik , hereinafter referred to as the "slte." Name of Sipe �e-AlTi 1. THE SPONSOR AGREES TO: A. Instruct the site to comply with site requirements set forth in the Child Care Food Program (CCFP) Procedure Manual for Afterschool Programs, as revised, and applicable CCFP policy memoranda. B. Train site personnel on program requirements before the site begins participation in the Afterschool Meals Program. The training will cover all required topics, including but not limited to information on meal pattern requirements; recording and maintaining menus, meal counts, and attendance records; and civil rights requirements. C. Offer, at least annually, additional training sessions scheduled at times and places mutually convenient for the sponsor and site. D. Respond to the site's requests for technical assistance within two (2) days. E. Distribute to the site all necessary CCFP Afterschool Meals Program record keeping forms. F. Collect monthly, all necessary program records for claiming CCFP Afterschool Meals Program reimbursement including, but not limited to, menus for each meal service claimed, Attendance Records, and Meal Count Records including daily meal count documentation if meal counts were recorded on another document and later transferred to the Monthly Meal Count Record form. G. Review the site's Afterschool Meals Program operations to assess compliance with the meal pattern, record keeping, and other program requirements. At least one review will occur during a new site's first four we of CCFP participation. Unless otherwise approved by the Florida Department of Health (DOH), reviews will be conducted at least three times within each 12 -month period and not more than six months will elapse between reviews, even if the reviews occur in different federal fiscal years. H. Maintain records concerning the location and dates of all compliance reviews, problems noted, corrective actions prescribed, and sanctions imposed. 1. Present photo identification when making visits to the site. J. Hold site responsible for compliance with program policies and procedures, and disallow snacks and /or meals not meeting U.S. Department of Agriculture (USDA) meal pattern requirements or not supported by appropriate records. K. Not discriminate against any child because of race, color, national origin, sex, age, or disability. L. Determine the site's area eligibility to participate in the Afterschool Meals Program at least once every five years, and maintain the site's eligibility documentation as directed in the Procedure Manual for Afterschool Programs, as revised. M. Provide snacks and /or prepared meals, and/or pay for catered snacks and/or meals delivered by a DOH registered caterer, to the site at no cost to the site. However, if a site is responsible for the disallowance of snacks and/or meals due to the site's failure to most program requirements, the sponsor may charge the site for the amount that the sponsor paid for the disallowed snacks and/or meals. Revised 6/2013 Pape 1 of 3 A4)16-09 15D6 N. Not charge the site a fee for the sponsor's program services. II. THE SITE AGREES TO: A. W .. -i serve age specific snacks and /or meals that meet program meal pattern requirements. B. Record meal counts within one hour of the end of each snack and /or meal service. C. Claim only those meal types approved by the sponsor for reimbursement. D. Claim reimbursement for no more than one snack and one meal per child per day. E. Maintain copies of all Child Care Food Program (CCFP) Afterschool Meals Program records such as menus, Meal Count Records, Attendance Records, etc. for the current fiscal year and three subsequent fiscal years. Records for the current month and the previous 12 months shall be maintained at the site. Records older than 13 months may be maintained off4ite or stored electronically, but these records shall be made available to staff of the sponsor, the Florida Department of Health (DOH), the U.S. Department of Agriculture (USDA), the Florida Department of Law Enforcement (FDLE), the Florida Department of Financial Services, Division of Public Assistance Fraud, and Early Learning Coalitions upon presentation of proper photo identification. F. Send the previous month's claim documentation (Attendance Records, Monthly Meal Count Records and daily meal count sheets, menus) to the sponsor by the fifth (e) day of each month. If the fifth (5') day of the month falls on a weekend or holiday, these records must be received by the sponsor on the first business day following the weekend/holiday. G. Attend training sessions as required by the sponsor. H. Allow representatives of the sponsor, DOH, USDA, FDLE, the Florida Department of Financial Services, Division of Public Assistance Fraud, and Early Learning Coalitions access to the site during operating hours for the purpose of reviewing CCFP Afterschool Meals Program meal services and/or records. The site will allow such access upon presentation of photo identification whether the review is announced or unannounced. I. Allow representatives of the sponsor, DOH, USDA, FDLE, the Florida Department of Financial Services, Division of Public Assistance Fraud, and Early Learning Coalitions to conduct parental/household contacts regarding the CCFP Afterschool Meals Program. J. If licensed or accredited, maintain a current child care license/accreditatlon and notify the sponsor of any changes (e.g., capacity, hours/days of operation, expiration, revocation, etc.) within two (2) days of a change. K. Maintain current food service inspection documentation (satisfactory inspection report or valid permit/certificate) and notify the sponsor of any food service changes (e.g., food service method, permit expiration or revocation, etc.) within two (2) days of a change. L. Report a change of address or ownership, site closure, and any permanent changes in meal service times to the sponsor immediately. M. Report to the sponsor any pending sale of the site prior to the sale closing date. (Note: This agreement is not transferable to a new owner.) N. Provide all eligible children the same snacks and/or meals at no separate cost to the parent or guardian. O. When requested by the sponsor, distribute to parents copies of CCFP Afterschool Meals Program materials. Revised 8/2013 Page 2 of 3 A- 016-09 16,06 O. When requested by the sponsor, distribute to parents copies of CCFP Afterschool Nutrition Program materials. P. Not discriminate against any child because of race, color, national origin, sex, age, or disability. Q. The site agrees to use the U.S. Department of Homeland Security's E- Verify system, httr)s:He- verify.uscis.aov /emg, to verify the employment eligibility of: 1. All persons employed during the agreement term by the site to perform employment duties within Florida; 2. All persons (including subcontractors) assigned by the site to perform work pursuant to this agreement. III. THE SPONSOR AND SITE MUTUALLY AGREE: A. Effective Date This agreement shall begin on the latest date on which both parties have signed the agreement. B. Termination 1. Termination at Will This agreement may be terminated by either party or the Florida Department of Health without cause upon no less than thirty (30) days notice in writing to the other party, unless a lesser time is mutually agreed upon in writing by the parties. Said notice shall be delivered by certified mail, return receipt requested, or in person with proof of delivery. 2. Termination Because of Lack of Funds In the event funds to finance this agreement become unavailable and the Florida Department of Health terminates the sponsor's contract, the sponsor may terminate this agreement upon no less than twenty - four (24) hours notice in writing to the site. Said notice shall be delivered by certified mail, return receipt requested, or in person with proof of delivery. I have read the above agreement and I understand each section and paragraph. IN WITNESS THEREOF, the parties have caused this three (3) page agreement to be executed by their undersigned officials as duly authorized. Board of County Co, ssioners, Collier County, Florida Site Owner /D' tor Geor i A. Hiller Es Chairwoman Mailing Addr ss 3 99 Ea t Tamiami Trail, Ste. L1s63, Naples, FL 34112 Signature Date \00� Date IrCh Z Sponsor Representative Title / ro vea& Signature 7 � Date � gnsor must ensure that both signature boxes ar s to form At Re y BR K "'Oerk Page 3 of 3 Assistant Cotes r es as airman's cinriatura only 15D6 AFTERSCHOOL MEALS PROGRAM SPONSOR -SITE AGREEMENT FOR UNAFFILIATED SITES This agreement is entered into between p u i _Q �`� °rti , hereinafter 1 Name of Sponsoring Organization referred to as the "sponsor," and , hereinafter referred to as the "site." Name �Si<e . Cpif✓X I. THE SPONSOR AGREES TO: A. Instruct the site to comply with site requirements set forth in the Child Care Food Program (CCFP) Procedure Manual for Afterschool Programs, as revised, and applicable CCFP policy memoranda. B. Train site personnel on program requirements before the site begins participation in the Afterschool Meals Program. The training will cover all required topics, including but not limited to information on meal pattern requirements; recording and maintaining menus, meal counts, and attendance records; and civil rights requirements. C. Offer, at least annually, additional training sessions scheduled at times and places mutually convenient for the sponsor and site. D. Respond to the site's requests for technical assistance within two (2) days. E. Distribute to the site all necessary CCFP Afterschool Meals Program record keeping forms. F. Collect monthly, all necessary program records for claiming CCFP Afterschool Meals Program reimbursement including, but not limited to, menus for each meal service claimed, Attendance Records, and Meal Count Records including daily meal count documentation if meal counts were recorded on another document and later transferred to the Monthly Meal Count Record form. G. Review the site's Afterschool Meals Program operations to assess compliance with the meal pattern, record keeping, and other program requirements. At least one review will occur during a new site's first four weeks of CCFP participation. Unless otherwise approved by the Florida Department of Health (DOH), reviews will be conducted at least three times within each 12 -month period and not more than six months will elapse between reviews, even if the reviews occur in different federal fiscal years. H. Maintain records concerning the location and dates of all compliance reviews, problems noted, corrective actions prescribed, and sanctions imposed. I. Present photo identification when making visits to the site. J. Hold site responsible for compliance with program policies and procedures, and disallow snacks and/or meals not meeting U.S. Department of Agriculture (USDA) meal pattern requirements or not supported by appropriate records. K. Not discriminate against any child because of race, color, national origin, sex, age, or disability. L. Determine the site's area eligibility to participate in the Afterschool Meals Program at least once every five years, and maintain the site's eligibility documentation as directed in the Procedure Manual for Afterschool Programs, as revised. M. Provide snacks and/or prepared meals, and/or pay for catered snacks and/or meals delivered by a DOH registered caterer, to the site at no cost to the site. However, if a site is responsible for the disallowance of snacks and /or meals due to the Site's failure to meet program requirements, the sponsor may charge the site for the amount that the sponsor paid for the disallowed snacks and/or meals. Revised 6/2013 page 1 of 3 A- 016.09 1406 N. Not charge the site a fee for the sponsor's program services. II. THE SITE AGREES TO: A. Nfi■irlrFserve age specific snacks and/or meals that meet program meal pattern requirements. B. Record meal counts within one hour of the end of each snack and/or meal service. C. Claim only those meal types approved by the sponsor for reimbursement. D. Claim reimbursement for no more than one snack and one meal per child per day. E. Maintain copies of all Child Care Food Program (CCFP) Afterschool Meals Program records such as menus, Meal Count Records, Attendance Records, etc. for the current fiscal year and three subsequent fiscal years. Records for the current month and the previous 12 months shall be maintained at the site. Records older than 13 months may be maintained off -site or stored electronically, but these records shall be made available to staff of the sponsor, the Florida Department of Health (DOH), the U.S. Department of Agriculture (USDA), the Florida Department of Law Enforcement (FDLE), the Florida Department of Financial Services, Division of Public Assistance Fraud, and Early Leaming Coalitions upon presentation of proper photo Identification. F. Send the previous month's claim documentation (Attendance Records, Monthly Meal Count Records and daily meal count sheets, menus) to the sponsor by the fifth (5'") day of each month. If the fifth (5'") day of the month falls on a weekend or holiday, these records must be received by the sponsor on the first business day following the weekend/holiday. G. Attend training sessions as required by the sponsor. H. Allow representatives of the sponsor, DOH, USDA, FDLE, the Florida Department of Financial Services, Division of Public Assistance Fraud, and Early Learning Coalitions access to the site during operating hours for the purpose of reviewing CCFP Afterschool Meals Program meal services and/or records. The site will allow such access upon presentation of photo identification whether the review is announced or unannounced. I. Allow representatives of the sponsor, DOH, USDA, FDLE, the Florida Department of Financial Services, Division of Public Assistance Fraud, and Early Learning Coalitions to conduct parental/household contacts regarding the CCFP Afterschool Meals Program. J. if licensed or accredited, maintain a current child care license/accreditation and notify the sponsor of any changes (e.g., capacity, hours/days of operation, expiration, revocation, etc.) within two (2) days of a change. K. Maintain current food service inspection documentation (satisfactory inspection report or valid permit(certificate) and notify the sponsor of any food service changes (e.g., food service method, permit expiration or revocation, etc.) within two (2) days of a change. L. Report a change of address or ownership, site closure, and any permanent changes in meal service times to the sponsor immediately. M. Report to the sponsor any pending sale of the site prior to the sale closing date. (Note: This agreement is not transferable to a new owner.) N. Provide all eligible children the same snacks and/or meals at no separate cost to the parent or guardian. O. When requested by the sponsor, distribute to parents copies of CCFP Afterschool Meals Program materials. Revised 612013 Page 2 of 3 A -016-09 L 16D6 P. Not discriminate against any child because of race, color, national origin, sex, age, or disability. Q. The site agrees to use the U.S. Department of Homeland Security's E- Verify system, https:He- verify.uscis.gov /emf), to verify the employment eligibility of: 1. All persons employed during the agreement term by the site to perform employment duties within Florida; 2. All persons (including subcontractors) assigned by the site to perform work pursuant to this agreement. III. THE SPONSOR AND SITE MUTUALLY AGREE: A. Effective Date This agreement shall begin on the latest date on which both parties have signed the agreement. B. Termination 1. Termination at Will This agreement may be terminated by either party or the Florida Department of Health without cause upon no less than thirty (30) days notice in writing to the other party, unless a lesser time is mutually agreed upon in writing by the parties. Said notice shall be delivered by certified mail, return receipt requested, or in person with proof of delivery. 2. Termination Because of Lack of Funds In the event funds to finance this agreement become unavailable and the Florida Department of Health terminates the sponsor's contract, the sponsor may terminate this agreement upon no less than twenty - four (24) hours notice in writing to the site. Said notice shall be delivered by certified mail, return receipt requested, or in person with proof of delivery. I have read the above agreement and I understand each section and paragraph. IN WITNESS THEREOF, the parties have caused this three (3) page agreement to be executed by their undersigned officials as duly authorized. Board of County Co issioners, Collier County, Florida Site Owner/QOector I Geor is A. Hiller Esq., Chairwoman Mailing Add ess� 3 99 E st Tamiami Trail, Ste. 3a0f3, Naples, FL 34112 Signature 1 !I U�� Date Da" Sponsor Representative Title Signa Sponsor must ensure that both signature boxes are complete A i TEST =§ DV# BF100W Berk cin��drP.;EN1�V.•, Ap rove as to form and legality V Ax��— Page 3 of 3 Assistant County IA00ey