Backup Documents 01/12/2012 Item #16D 1ORIGINAL DOCUMENTS CHECKLIST & ROUTING SL16 D 1
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper. Attach to original document. Original documents should be hand delivered to the Board Office. The completed muting slip and original
documents are to be lonearded to the Board Office only after the Board has taken action on the item.)
ROUTING SLIP
Complete routing lines #I through #4 as appropriate for additional signatures, dates, and/or information needed. If the document is already complete with the
exception of the Chairman's signature, draw aline through routing lines #1 through #4, complete the checklist, and forward to Sue Filson (line #5).
Route to Addressee(s)
(List in routing order)
Office
Initials
Date
l.Jennifer B. White
County Attorney
(Initial)
Applicable)
2. Ian Mitchell, Supervisor
Board of County Commissioners
Agenda Item Number
16D1 /Sire 3523
3. Minutes and Records
Clerk of Court's Office
4.
CoC Shelter Plus Care Subrecipient
Number of Original
5.
Agreement to the Housing Authority
Documents Attached
6.
contracts, agreements, etc. that have been fully executed by all parties except the BCC
(The primary contact is the holder of the original document pending BCC approval. Normally the primary contact is the person who created/prepared the executive
summary. Primary contact information is needed in the event one of the addressees above, including Ian Mitchell, need to contact staff for additional or missing
information. All original documents needing the BCC Chairman's signature are to be delivered to the BCC office only after the BCC has acted to approve the
item.)
Name of Primary Staff
Rosa Munoz, Grants Coordinator
Phone Number
252 -5713
Contact
appro riate.
(Initial)
Applicable)
Agenda Date Item was
January 10, 2012
Agenda Item Number
16D1 /Sire 3523
Approved by the BCC
signed by the Chairman, with the exception of most letters, must be reviewed and signed
Type of Document
CoC Shelter Plus Care Subrecipient
Number of Original
Attached
Agreement to the Housing Authority
Documents Attached
INSTRUCTIONS & CHECKLIST
I: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip WWS Original 9.03.04, Revised 1.26.05, Revised 2.24.05, Revised 9.18.09
Initial the Yes column or mark "N /A" in the Not Applicable column, whichever is
Yes
N/A (Not
appro riate.
(Initial)
Applicable)
1.
Original document has been signed/initialed for legal sufficiency. (All documents to be
RM
signed by the Chairman, with the exception of most letters, must be reviewed and signed
by the Office of the County Attorney. This includes signature pages from ordinances,
resolutions, etc. signed by the County Attorney's Office and signature pages from
contracts, agreements, etc. that have been fully executed by all parties except the BCC
Chairman and Clerk to the Board and possibly State Officials.)
2.
All handwritten strike - through and revisions have been initialed by the County Attorney's
NA
Office and all other parties except the BCC Chairman and the Clerk to the Board
3.
The Chairman's signature line date has been entered as the date of BCC approval of the
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document or the final negotiated contract date whichever is applicable.
4.
"Sign here" tabs are placed on the appropriate pages indicating where the Chairman's
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signature and initials are required.
5.
In most cases (some contracts are an exception), the original document and this routing slip
NA
should be provided Ian Mitchell in the BCC office within 24 hours of BCC approval. 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!
6.
The document was approved by the BCC on January 10, 2012 (enter date) and all
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changes made during the meeting have been incorporated in the attached document.
The County Attorney's Office has reviewed the changes, if applicable.
I: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip WWS Original 9.03.04, Revised 1.26.05, Revised 2.24.05, Revised 9.18.09
16D1
MEMORANDUM
Date: January 19, 2012
To: Rosa Munoz, Grants Coordinator
Housing, Human & Veteran Services
From: Ann Jennejohn, Deputy Clerk
Minutes & Records Department
Re: Subrecipient Agreement with the Collier County Housing
Authority coordinating with the David Lawrence Center
for housing support services funded through a HUD Grant
award approved by the Board on October 11, 2011
Attached is an original copy of the agreement referenced above, (Item #16D1)
approved by the Board of County Commissioners on January 10, 2012.
The Minutes and Record's Department has held the second original agreement
for the Board's Official Record.
If you have any questions, please feel free to contact me at 252 -8406.
Thank you.
Attachment
1601
AGREEMENT BETWEEN COLLIER COUNTY
AND
COLLIER COUNTY HOUSING AUTHORITY
Catalog of Federal Domestic Assistance # 14.235
HUD Grant # FL0394C4DO61000
THIS AGREEMENT is made and entered into by and between Collier County, a political
subdivision of the State of Florida, ( "COUNTY "), and the Collier County Housing Authority, Inc., a
special independent district of the State of Florida, created in accordance with Florida Statute Section
421.27 et seq., having its principal office at 1800 Farmworkers Way, Immokalee, Florida 34142 and
with offices at 5251 Golden Gate Parkway, Naples, Florida 34116, and its Federal Tax Identification
number as 59- 1490555 and DUNS #, 040977514 ( "SPONSOR ").
WHEREAS, the COUNTY has applied to the United States Department of Housing and Urban
Development (HUD) for the Continuum of Care (CoC) Supportive Housing Program (SHP) effective
November 15, 2010 and entered into an agreement with the SPONSOR to act on its behalf in the
oversight and administration of the HUD Grant for the execution and implementation of a CoC Grant
Program in certain areas of Collier County, pursuant to Title IV, Subtitle F, of the McKinney -Vento
Homeless Assistance Act (the McKinney Act), § 42 U.S.C. 11403 — 11407b; 11301 et seq, (the Act),
final rule codified at 24CFR 582 ( "the Rule ").
WHEREAS, the COUNTY believes it to be in the public interest to provide certain activities
to Collier County residents through the SPONSOR according to this Agreement, and
WHEREAS, the COUNTY and SPONSOR, in accordance with HUD requirements, are
undertaking certain activities to primarily benefit persons with disabilities residing in Collier County
who are homeless or at risk of being homeless; and
WHEREAS, the Collier County Department of Housing, Human and Veteran Services
(HHVS) further agrees that it will use due diligence in supervising the SPONSOR to assure that funds
are expended for the purposes intended and that a full accounting for these grants is made; and
WHEREAS, HHVS desires to engage the SPONSOR to implement such undertakings of the
CoC -SHP Program as stated in the approved Shelter Plus Care (S +C) application as valid and
worthwhile County purposes.
NOW, THEREFORE, in consideration of the mutual promises and covenants herein
contained, it is agreed by the Parties as follows:
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I. DEFINITIONS
(A) "COUNTY" means Collier County, and where applicable, it's authorized
representative(s).
(B) "HHVS" means Collier County's Department of Housing, Human and Veteran Services,
and where applicable, its authorized representative(s).
(C) "HHVS Approval" means the written approval of the Department of Housing, Human
and Veteran Services or designee.
(D) "SPONSOR" means the Collier County Housing Authority (CCHA) and where
applicable its authorized representative(s).
(E) "HUD" means the U.S. Department of Housing and Urban Development or a person
authorized to act on its behalf.
(F) "Project" means the work contemplated to be performed as set forth in Exhibit "A."
(G) "CoC means the Continuum of Care Supportive Housing Program
(H) "SHP" means the Supportive Housing Program.
(I) "S +C" means the Shelter Plus Care Program.
(J) "Beneficiaries" means persons who are homeless or at -risk of homelessness.
(K) "TRA" means Tenant Based Rental Assistance.
(L) "SRO" means Single Room Occupancy.
II. SCOPE OF SERVICES
The SPONSOR shall, in a satisfactory and proper manner, as determined by HHVS, perform
the tasks necessary to conduct the program outlined in Exhibit "A," and shall submit each request for
reimbursement using Exhibit `B" along with the monthly submission of Exhibit "C," all of which are
attached hereto and made a part hereof.
III. TIME OF PERFORMANCE
The effective date of this Agreement between the Collier County Housing Authority and
Collier County HHVS shall be January 10, 2012. The services of the SPONSOR shall be undertaken
and completed in light of the purposes of this Agreement. All services required hereunder shall be
completed by the SPONSOR prior to January 10, 2017. Any funds not obligated by the expiration
date of this Agreement shall automatically revert to the COUNTY, as set forth in Section XI.
IV. CONSIDERATION AND LIMITATION OF COSTS
A. The SPONSOR shall be reimbursed by the COUNTY using HUD funding for allowable costs,
determined by the COUNTY, in an amount not to exceed EIGHTY -ONE THOUSAND,
EIGHT HUNDRED FORTY DOLLARS AND 00 /100 (U.S. $81,840) for the services
described in Exhibit "A" The amount of ZERO DOLLARS ($0.00) to be retained by Collier
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County for grant administration. In the event the project costs exceed the stated amount, the
SPONSOR shall be responsible for the excess.
B. All improvements specified in Exhibit "A" shall be performed by SPONSOR employees, or
shall be put out to competitive bidding under a procedure acceptable to the COUNTY and
federal requirements. The SPONSOR shall enter into contract for improvements with the
lowest responsive and responsible bidder. Contract administration shall be handled by the
SPONSOR and monitored by the COUNTY, which shall have access to all records and
documents related to the project.
C. The County shall reimburse the SPONSOR 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 monthly progress reports. Payments shall be made to the
SPONSOR when requested as work progresses but, not more frequently than once per quarter.
Payment will be made upon receipt of a proper invoice and in compliance with § 218.70, Fla.
Stat., otherwise known as the "Local Government Prompt Payment Act." No payment will be
made until approved by HHVS.
D. SPONSOR shall be responsible for providing match funding. SPONSOR shall not seek
reimbursement from the COUNTY general funds for this match funding. The SPONSOR may
be eligible for other federal grant opportunities.
V. NOTICES
All notices required to be given under this Agreement shall be sufficient when delivered to
HHVS at its office, presently located at 3339 E Tamiami Trail, Suite 211, Naples, Florida 34112, and
to the SPONSOR when delivered to its office at the address listed on page one (1) of this Agreement.
VI. GENERAL CONDITIONS
A. IMPLEMENTATION OF PROJECT
The SPONSOR shall implement this Agreement in accordance with applicable Federal, State,
and County laws, ordinances and codes and with the procedures outlined in HHVS' Policies and
Procedures memoranda.
The SPONSOR agrees to comply with the requirements of the final rule at 24 CFR Part 582, of
the HUD regulations concerning the CoC -SHP Program and all federal regulations.
Should a project receive additional funding after the commencement of this Agreement, the
SPONSOR shall notify HHVS in writing within thirty (30) days of receiving notification from the
funding source and submit a cost allocation plan for approval by HHVS or its designee within forty -
five (45) days of said official notification.
B. DEBARMENT
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The SPONSOR 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 SPONSOR 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.
C. LOCAL AND FEDERAL RULES, REGULATIONS AND LAWS
The SPONSOR agrees to comply with any applicable laws, ordinances, regulations and orders
of the State, local and Federal governments, including, but not limited to:
1. 24 CFR 582, in the final rule as amended - The regulations governing the CoC -SHP
Requirements.
2. 24 CFR 58 - The regulations prescribing the Environmental Review procedure.
3. Title VI of the 1964 Civil Rights Act, 42 USC § 2000d, et. seq.
4. 24 CFR 107 - The regulations issued pursuant to Executive Order 11063 which
prohibits discrimination and promotes equal opportunity in housing.
5. 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.
6. Title VII of the 1968 Civil Rights Act as amended by the Equal Employment
Opportunity Act of 1972, 42 USC § 2000e, et. seq.
7. Age Discrimination Act of 1975.
8. Contract Work Hours and Safety Standards Act, 40 USC 327 -332.
9. The accessibility requirements, reasonable modification, and accommodation
requirements of the Fair Housing Act and of Section 504 of the Rehabilitation Act of
1973, 29 USC 776(b)(5), as amended.
10. Uniform Relocation Assistance and Real Property Acquisition Policies Act of 1970,
(URA) (42 U.S. C. 4601 -4655 and implementing regulations at 49 CFR Part 24,
Subpart B) as amended.
11. 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.
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12. The SPONSOR 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 583.330(d).
13. In accordance with the requirements of the Flood Disaster Protection Act of 1973 (42
USC 4002), the SPONSOR 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.
14. Executive Order 11914 - Prohibits discrimination with respect to the handicapped in
federally assisted projects.
15. Public Law 100 -430 - the Fair Housing Amendments Act of 1988.
16. OMB A -133 — concerning annual Single Audit.
17. OMB Circulars A -87 and 2 CFR part 225 — which identify cost principles.
18. 24 CFR 85 - Uniform Administrative Requirements for Grants and Agreements to State
and Local Governments.
19. Immigration Reform and Control Act of 1986 as located at 8 USC 1324, et seq. and
regulations relating thereto. Failure by the SPONSOR 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.
20. Chapter 112, Florida Statutes.
21. 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.
22. 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.
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23. Venue - Any suit or action brought by either party to this Agreement against the other
party relating to or arising out of this Agreement must be brought in the appropriate
federal or state courts in Collier County, Florida, which courts have sole and exclusive
jurisdiction on all such matters.
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. The negotiation shall be attended by
representatives of SPONSOR 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. The mediation
shall be attended by representatives of SPONSOR with full decision - making authority
and by COUNTY'S staff person who would make the presentation of any settlement
reached at mediation to COUNTY'S board for approval. Should either party fail to
submit to mediation as required hereunder, the other party may obtain a court order
requiring mediation under § 44.102, Fla. Stat.
D. SUBCONTRACTS
Any work or services subcontracted by the SPONSOR shall be specifically by written contract
or agreement, and such subcontracts shall be subject to each provision of this Agreement and
applicable County, State, and Federal guidelines and regulations. Prior to execution by the SPONSOR
of any subcontract hereunder, such subcontracts must be submitted by the SPONSOR to HHVS for its
review and approval, which will specifically include a determination of compliance with the terms of
the attached Scope of Services set forth in Exhibit "A."
This review also includes ensuring that all consultant contracts and fee schedules meet the
minimum standards as established by the Collier County Purchasing Department, Florida Statutes and
HUD. Reimbursements for such services will be made at SPONSOR cost. None of the work or
services covered by this Agreement, including but not limited to consultant work or services, shall be
subcontracted by the SPONSOR or reimbursed by the COUNTY without written approval of HHVS or
its designee.
E. AMENDMENTS
This Agreement, and any exhibit or attachment, may be amended only by written agreement
executed by the governing boards of both parties, except that County representative(s) may approve
adjustments between line item amounts, scope clarifications, or an extension of time and schedule that
do not change the project, or exceed the amount funded by the County, as stated herein. Any
modifications to this contract shall be in compliance with the County Purchasing Policy and
Administrative Procedures in effect at the time such modifications are authorized.
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F. INDEMNIFICATION
To the maximum extent permitted by Florida law, the SPONSOR shall indemnify and hold
harmless Collier County, its officers and employees from any and all liabilities, damages, losses and
costs, 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 SPONSOR or anyone
employed or utilized by the SPONSOR 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. 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.
G. GRANTEE RECOGNITION
All facilities purchased or constructed pursuant to this Agreement shall be clearly identified as
to funding source. The SPONSOR will include a reference to the financial support herein provided by
HHVS in all publications and publicity. In addition, the SPONSOR will make a good faith effort to
recognize HHVS' support for all activities made possible with funds made available under this
Agreement. The SPONSOR will mount a temporary construction sign for construction projects funded
by HHVS. This design concept is intended to disseminate key information regarding the development
team as well as Equal Housing Opportunity to the general public. The construction sign shall comply
with applicable County codes.
H. TERMINATION
In event of termination for any of the reasons identified in sub - sections 1 -3 as follows, all
finished or unfinished documents, data studies, surveys, drawings, maps, models, photographs, reports
prepared, and capital equipment secured by the SPONSOR with funds under this Agreement shall be
returned to HHVS or the COUNTY. In the event of termination, the SPONSOR shall not be relieved of
liability to the COUNTY for damages sustained by the COUNTY by virtue of any breach of the
Contract by the SPONSOR, and the COUNTY may withhold any payment to the SPONSOR for set-
off purposes until such time as the exact amount of damages due to the COUNTY from the SPONSOR
is determined.
1. TERMINATION FOR CAUSE
If through any cause either party shall fail to fulfill in timely and proper manner its obligations
under this Agreement, or if either party shall violate any of the covenants, agreements, or stipulations
of this Agreement, either party shall thereupon have the right to terminate this Agreement in whole or
part by giving written notice of such termination to the other party and specifying therein the effective
date of termination. (See 24 CFR 85.43.)
2. TERMINATION FOR CONVENIENCE
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,1
At any time during the term of this Agreement, either party may, at its option and for any
reason, terminate this Agreement upon ten (10) working days written notice to the other party. Upon
termination, the COUNTY shall pay the SPONSOR for services rendered pursuant to this Agreement
through and including the date of termination. (See 24 CFR 85.44.)
3. TERMINATION DUE TO CESSATION
In the event the grant to the COUNTY under Title I of the Housing and Community
Development Act of 1974 (as amended) is suspended or terminated, this Agreement shall be suspended
or terminated effective on the date that HUD specifies.
I. INSURANCE
SPONSOR shall obtain and carry, at all times during its performance under the Contract
Documents, insurance of the types and in the amounts described herein and further set forth in Exhibit
"B" to this Agreement.
J. SPONSOR LIABILITY OBLIGATION
Compliance with the insurance requirements in Exhibit "B" shall not relieve the SPONSOR of
its liability and obligation under this subsection or under any subsection of this contract. The contract
is contingent upon receipt of the insurance documents within fifteen (15) calendar days after the Board
of County Commissioners' approval. If the Insurance certificate is received within the specified
period, but not in the manner prescribed in these requirements, the SPONSOR shall be verbally
notified of the deficiency and shall have an additional five (5) calendar days to submit a corrected
Certificate to the County.
If the SPONSOR fails to submit the required insurance documents in the manner prescribed in
these requirements within twenty (20) calendar days after the Board of County Commissioners'
approval, the SPONSOR shall be in default of the terms and conditions of the contract.
K. INDEPENDENT AGENT AND EMPLOYEES
The SPONSOR agrees that it will be acting as an independent agent and that its employees are
not Collier County employees and are not subject to the County provisions of law applicable to County
employees relative to employments, hours of work, rates of compensation, leave, unemployment and
employee benefits.
VII. ADMINISTRATIVE REQUIREMENTS
A. FINANCIAL MANAGEMENT
The SPONSOR agrees to comply with 24 CFR Part 85and agrees to adhere to the accounting
principles and procedures required therein, utilize adequate internal controls, and maintain necessary
source documentation for all costs incurred. The financial management systems used by recipients
under this program must provide for audits in accordance with the provisions of 24 CFR part 44 (OMB
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Circular A -133). HUD may perform or require additional audits as it finds necessary or appropriate.
B. DOCUMENTATION AND RECORDKEEPING
The SPONSOR shall maintain all records required by HUD.
2. All reports, plans, surveys, information, documents, maps, and other data procedures
developed, prepared, assembled, or completed by the SPONSOR for the purpose of this
Agreement shall be made available to the COUNTY by the SPONSOR at any time upon
request by the COUNTY or HHVS. 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 SPONSOR shall keep all
documents and records for six (6) years after expiration of this Agreement.
The SPONSOR shall submit detailed monthly progress reports to HHVS outlining the
status of specific activities under the project. Each report must account for the total
activity for which the SPONSOR is paid with HUD funds, in part or in whole, and
which is required in fulfillment of their obligations regarding the Project. The progress
reports shall be submitted on the form Exhibit "D," Schedule "D -2."
4. The SPONSOR 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. SPONSOR shall maintain records showing
contractor compliance with the Contract Work Hours and Work Safety Law. Similarly,
the SPONSOR shall maintain records showing compliance with federal purchasing
requirements and with other federal requirements for grant implementation.
5. If indirect costs are charged, the SPONSOR will develop an indirect cost allocation plan
for determining the appropriate SPONSOR'S share of administrative costs and shall
submit such plan to the COUNTY for approval, in a form specified by the COUNTY.
6. Failure to adequately maintain any former CoC funded projects may result in the delay
of processing reimbursement requests for ongoing activities or in the forfeiture of future
CoC funds.
7. The SPONSOR 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.
8. The SPONSOR further agrees that HHVS shall be the final arbiter on the SPONSOR's
compliance with the above.
C. REPORTS, AUDITS, AND EVALUATIONS
Reimbursement will be contingent on the timely receipt of complete and accurate reports
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required by this Agreement, and on the resolution of monitoring or audit findings identified pursuant to
this Agreement.
The SPONSOR agrees that HHVS will carry out periodic monitoring and evaluation activities
as determined necessary. The continuation of this Agreement is dependent upon satisfactory
evaluations. The SPONSOR shall, upon the request of HHVS, submit information and status reports
required by HHVS or HUD to enable HHVS to evaluate said progress and to allow for completion of
reports required. The SPONSOR shall allow HHVS or HUD to monitor the SPONSOR on site. Such
site visits may be scheduled or unscheduled as determined by HHVS or HUD.
SPONSOR will be required to submit its Annual Performance Report (APR) to HHVS annually
by September 13, of each year.
D. ADDITIONAL HOUSING, HUMAN AND VETERAN SERVICES, COUNTY, AND
HUD REQUIREMENTS
The SPONSOR agrees to utilize funds available under this Agreement to supplement rather
than supplant funds otherwise available for specified activities.
E. WRITTEN APPROVALS
(1) All subcontracts and agreements proposed to be entered into by the SPONSOR
pursuant to this Agreement;
(2) All capital equipment expenditures of $1,000 or more;
(3) All out -of -town travel (travel shall be reimbursed in accordance with Chapter
112, Fla. Stat. unless otherwise required by CoC S +C;
(4) All change orders;
(5) All requests to utilize uncommitted funds after the expiration of this agreement
for programs described in Exhibit "A "; and
(6) All rates of pay and pay increases paid out of CoC funds, whether for merit or
cost of living.
F. PURCHASING
All purchasing for services and goods, including capital equipment, shall be made by purchase
order or by a written contract and in conformity with the procedures prescribed by the Federal
Management Circulars A -87, and 24 CFR Part 85.
G. AUDITS AND INSPECTIONS
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States, Local Governments and Non - profit organizations that expend $500,000
or more annually in federal awards shall have a single or program - specific audit
conducted for that year in accordance with OMB A -133. States, Local
Governments and Non- profit organizations expending federal awards of
$500,000 or more under only one federal program may elect to have a program -
specific audit performed in accordance with OMB A -133.
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2. States, Local Governments and Non - profit organizations that expend less than
$500,000 annually in federal awards shall be exempt from an audit conducted in
accordance with OMB A -133, although their records must be available for
review (e.g., inspections, evaluations). These agencies are required by HHVS to
submit "Reduced Scope" audits (e.g., financial audit, performance audits). They
may choose, instead of a Reduced Scope Audit, to have a program audit
conducted for each federal award in accordance with federal laws and
regulations governing the program in which they participate.
3. When the requirements of OMB A -133 apply, or when the SPONSOR elects to
comply with OMB A -133, an audit shall be conducted for each fiscal year for
which federal awards attributable to this contract have been received by the
SPONSOR. A copy of the audit report must be received by HHVS no later than
six months following the end of the SPONSOR's fiscal year.
4. If an audit is required by Section G of this contract, but the requirements of
OMB A -133 do not apply or are not elected, the SPONSOR may choose to have
an audit performed either on the basis of the SPONSOR's fiscal year or on the
basis of the period during which HHVS - federal assistance has been received. In
either case, each audit shall cover a time period of not more than twelve months
and an audit shall be submitted covering each assisted period until all the
assistance received from this contract has been reported. Each audit shall adhere
to all other audit standards of OMB A -133, as these may be limited to cover
only those services undertaken pursuant to the terms of this contract. A copy of
the audit report must be received by HHVS no later than six months following
each audit period.
5. The SPONSOR shall maintain all contract records in accordance with generally
accepted accounting principles, procedures, and practices which shall
sufficiently and properly reflect all revenues and expenditures of funds provided
directly or indirectly by the County pursuant to the terms of this Agreement.
6. The SPONSOR shall include in all HHVS approved subcontracts each of the
recordkeeping and audit requirements detailed in this contract.
I. GRANT CLOSEOUT PROCEDURES
SPONSOR'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,
unspent cash advances, program income balances, and receivable accounts to the COUNTY), and
determining the custodianship of records.
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Page 11 of 30
■
VIII. OTHER PROGRAM REQUIREMENTS
A. OPPORTUNITIES FOR RESIDENTS AND CIVIL RIGHTS COMPLIANCE
The SPONSOR 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 SPONSOR shall comply with Section 3 of the
Housing and Community Development Act of 1968.
B. OPPORTUNITIES FOR SMALL AND MINORITY /WOMEN -OWNED BUSINESS
ENTERPRISES
In the procurement of supplies, equipment, construction, or services, the SPONSOR shall make
a positive effort to utilize small business and minority /women -owned business enterprises of supplies
and services, and provide these sources the maximum feasible opportunity to compete for contracts to
be performed pursuant to this Agreement. To the maximum extent feasible, these small business and
minority /women -owned business enterprises shall be located in or owned by residents of the CoC areas
designated by Collier County in the Annual Consolidated Plan approved by HUD.
C. CONFLICT OF INTEREST
The SPONSOR covenants that no person who presently exercises any functions or
responsibilities in connection with the Project, has any personal financial interest, direct or indirect, in
the target 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 SPONSOR. Any possible conflict of interest on the part of the SPONSOR 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.
D. PUBLIC ENTITY CRIMES
As provided in § 287.133, Fla. Stat. by entering into this Agreement or performing any work in
furtherance hereof, the SPONSOR 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), Fla. Stat.
2010 -CoC Shelter Plus Care
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Page 12 of 30
r � 1
E. DRUG -FREE WORKPLACE REQUIREMENTS
The SPONSOR must certify that it will provide drug -free workplaces in accordance with the
Drug -Free Workplace Act of 1988 (41 USC 701).
F. CERTIFICATION REGARDING LOBBYING
The undersigned certifies, to the best of his or her knowledge and belief, that:
1. 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.
2. 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.
3. 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 SPONSORS
shall certify and disclose accordingly.
G. REAL PROPERTY
Any real property acquired by the SPONSOR 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, subpart B, and, and 24 CFR 582.335
shall be subject to the provisions of CoC including, but not limited to, the provisions on use and
disposition of property. Any real property within the SPONSOR's control, which is acquired or
improved in whole or part with CoC funds in excess of $25,000, must adhere to HUD Regulations at
24 CFR 570.505.
IX. ENVIRONMENTAL CONDITIONS
A. AIR AND WATER
The SPONSOR agrees to comply with the following requirements:
1. Clean Air Act, 41 USC 7401, et seq.
2010 -CoC Shelter Plus Care
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Page 13 of 30
I
2. Federal Water Pollution Control Act, 33 USC 1251, et seq., as amended.
B. FLOOD DISASTER PROTECTION
In accordance with the requirements of the Flood Disaster Protection Act of 1973 (42 USC
4002), the SPONSOR 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.
C. LEAD -BASED PAINT
The SPONSOR 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.
D. HISTORIC PRESERVATION
The SPONSOR agrees to comply with the Historic Preservation requirements set forth in the
National Historic Preservation Act of 1966, as amended (16 USC 470) and the procedures set forth in
36 CFR 800, Advisory Council on Historic Preservation Procedures for Protection of Historical
Properties.
X. CONDITIONS FOR RELIGIOUS ORGANIZATIONS
CoC funds may not be used for religious activities or provided to primarily religious
organizations. Section 24 CFR 582.115 specifies the limitations on CoC funds.
XI. REVERSION OF ASSETS
Upon expiration of the Agreement, the SPONSOR shall transfer to the COUNTY any CoC
S +C funds on hand at the time of expiration, any accounts receivable attributable to the use of CoC
S +C funds, and any non - expendable personal property that was purchased with CoC funds. Any real
property under SPONSOR control will be covered by the regulations 24 CFR 582.
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.
XIII. COUNTERPARTS OF THE AGREEMENT
This Agreement, consisting of thirty (30) enumerated pages, which include the exhibits
referenced herein, shall be executed in two (2) counterparts, each of which shall be deemed to be an
2010 -CoC Shelter Plus Care
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Page 14 of 30
iboi
original, and such counterparts will constitute one and the same instrument.
XIV. ENTIRE UNDERSTANDING
This Agreement and its provisions merge any prior agreements, if any, between the parties and
constitutes the entire understanding. The parties hereby acknowledge that there have been and are no
representations, warranties, covenants, or undertakings other than those expressly set forth herein.
2010 -CoC Shelter Plus Care
FL0394C4DO61000
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Signature Page To Follow
Page 15 of 30
ib o ;.
IN WITNESS WHEREOF, the SPONSOR and the County, have each, respectively, by an authorized
person or agent, hereunder set their hands and seals on this ly of ' UCL , 20
ATTEST: ' ''I � I'
DWIGHT �' IQ tjCLERK
E
f �!`
'Ark
Y
Dated:
(SEjkL)
First Witness:
Pr C G(YLi G�
Type /print witness name
Witness:
s.-, -
Type /print witness name
2010 -CoC Shelter Plus Care
FL0394C4DO61000
CCHA
BOARD OF COUNTY COMMISSIONERS OF
COLLIER COUNTY, FLORIDA
By: tk (/j,
FRED W. COYLE, CHAI N
COLLIER COUNTY HOUSING AUTHORITY
By:
NSOR Signature
Esmeralda Serrata, Executive Director
Type /print SPONSOR name and title
Approved as to form and legal sufficiency:
Jennifer B. White
Assistant County Attorney
Page 16 of 30
Item # L \�+—
Agenda �..J�'�.,�1
Date 1� W
Date
Recd
16n1
EXHIBIT "A"
SCOPE OF SERVICES
COLLIER COUNTY HOUSING AUTHORITY
In Partnership with the David Lawrence Center
FL -606 New Shelter Plus Care Project
FL0394C4DO61000
Operating and Supportive Services
A. PROJECT SCOPE:
On October 11, 2011, the BCC approved the HUD FY 2010 Continuum of Care Supportive Housing
Program's (CoC -SHP) Shelter Plus Care (S +C) renewal grant. The S +C program is designed to link
rental assistance to supportive services for hard to serve homeless persons with disabilities (primarily
those who are seriously mentally ill; have chronic problems with alcohol, drugs, or both; or have
acquired immunodeficiency syndrome (AIDS) and related diseases and their families. The program
provides grant funds to be used for rental assistance for permanent housing for homeless persons with
disabilities. Supportive services are services that address the special needs of eligible person(s); and
provides appropriate services or assists such persons in obtaining appropriate services, including health
care, mental health treatment, alcohol and other substance abuse services, child care services, case
management services, counseling, supervision, education, job training, and other services essential for
achieving and maintaining independent living.
The Housing Human and Veteran Services (HHVS) department is providing CoC S +C funding to the
Collier County Housing Authority (CCHA) who will collaborate with the David Lawrence Mental
Health Center (DLC) to provide permanent supportive housing through tenant based housing choice
vouchers with wrap- around mental health supportive services for chronically homeless individual
adults and families over a period of five years.
Funding will be used for the following activities:
Administrative Costs: Up to Eight percent (8 %) of the grant amount or SIX
THOUSAND FIVE HUNDRED FORTY -SEVEN AND 20/100 DOLLARS ($6,547.20)
can be used to pay the cost of administering the housing assistance. Eligible administrative
activities include: Processing rental payments to landlords, examining participant income
and family composition, providing housing information and assistance, inspecting units for
compliance with housing quality standards, and receiving into the program new
participants. This administrative allowance does NOT include the cost of
administering the supportive services of the grant (e.g. cost of preparing the
application, reports or audits required by HUD) are NOT eligible activities under an
S +C grant.
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1601
2. Tenant Based Rental Assistance (TRA): Rental assistance which permits participants to
choose housing of an appropriate size in which to reside. Rental subsidies are provided for
five years. Up to 25% of the rental assistance awarded may be spent in any of the five
years.
S +C funding in the amount of $81,840.00 will be utilized via housing vouchers to assist
two (2) housing SRO /units - two (2) eligible low income chronically homeless persons with
disabilities, with rent, security and /or utility deposits. The maximum amount of funds for
the security deposit may not exceed two months' rent for the unit. A written agreement
regarding the terms and conditions of the security deposit must be maintained by the
SPONSOR for review by Housing, Human and Veteran Services (HHVS) staff. The utility
deposit assistance may be provided in conjunction with a security deposit and /or monthly
rental assistance. The utility deposit assistance may be used only for utilities permitted
under the Section 8 utility allowance.
3. Supportive Services: addresses the special needs of eligible persons and provides
appropriate services or assists such persons in obtaining services including health care,
mental health treatment, alcohol and other substance abuse services, child care services,
case management services, counseling, supervision, education, job training, and other
essential services for achieving and maintaining independent living.
The David Lawrence Center will provide the supportive services through comprehensive
case management services. The case management of chronically homeless persons is
intensive and is provided through a multidisciplinary team and includes an assessment of
complex, multiple needs, and linking to and monitoring of ongoing services. The target
population for this shelter plus care project includes persons with mental health, substance
abuse, or co- occurring disabilities who are at risk of institutionalization. DLC will provide
outreach to locate program participants and will provide wraparound services to
participants according to individualized needs. The DLC's services are partially funding
through a Project to Assist with Transition from Homelessness (PATH) grant. Along with
assistance of the Collier County Housing Authority, case management services will also
include interventions with landlords as needed to ensure smooth transitions into permanent
housing and to facilitate or maintain mutually effective long term relationships.
Match funding: Per 24 CFR Part 582.110 the Sponsor must certify that it will provide or
ensure the provision of supportive services, including funding the services itself if the
planned resources do not become available for any reason, appropriate to the needs of the
population being served, and at least equal in value to the aggregate amount of rental
assistance funded by HUD. The match is overall, not year by year. Each participant need
not receive the same amount of services as rental assistance. The match is not component
by component, but overall. The SPONSOR must provide documentation regarding match
funding for purposes of the CoC- SHP -S +C Program. The match funding will be met by the
David Lawrence Center utilizing a Projects to Assist with Transition from Homelessness
(PATH) Grant in the amount of $81,840.00. They will provide referrals, case management
2010 -CoC Shelter Plus Care
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Page 18 of 30
16 D1
and wrap around mental health services to qualified individuals, including collaborating
with other community agencies.
The SPONSOR will be required to submit an Annual Performance Report (APR) to HHVS
by September 13th, of each year.
The SPONSOR will be responsible for the following:
a. The creation and maintenance of the income eligibility file on the new position, and
documentation that the person/household is eligible under HUD Income Guidelines.
b. Prior to occupancy, the SPONSOR shall require and maintain income qualification and
proof of legal residency for all households. The SPONSOR shall maintain these files
for HHVS' staff review upon request. The anticipated annual household income of the
participant shall be verified and not exceed the income limits as mandated by the U.S.
Department of Housing and Urban Development (HUD).
c. The SPONSOR shall maintain Rent Reasonableness documentation.
d. The SPONSOR shall require and maintain HQS inspections and Lead Based Paint
documentation (when applicable) per 24 CFR 882.109.
The project activities will meet the U.S. Department of Housing and Urban Development's
national objective to provide safe, decent, affordable housing.
B. BUDGET:
Collier County Housing, Human and Veteran Services is providing Eighty One Thousand Eight
Hundred Forty and 00 /100 Dollars ($81,840.00) in CoC- Supportive Housing Shelter Plus Care
funding for the project scope described above. The matching funds requirement per 24 CFR
Part 582.110 of $81,840 will be met by the David Lawrence Center through supportive
services. The match funds must be shown in writing as invoices are presented in the aggregate
by supportive services that are equal in value to the amount of rental assistance.
Line Item Description HOME Funds Matching Funds
Eligible Administrative Activities $ 6,547.20
Salaries, & Benefits
Executive Director
Tenant Based Rental Activities $ 75,292.80
Rent
Security Deposit
Utilities
Supportive Services $81,840.00
Comprehensive Case Management by
DLC Staff. Along with the CCHA, Case
Management will also include
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1601
interventions with landlords for
permanent housing.
Total CoC -SHP S +C Funding $ 81,840.00
Total Match Funding $81,840.00
TOTAL PROJECT AMOUNT
$ 163,680.00
Any modifications to this contract shall be in compliance with the County Purchasing Policy
and Administrative Procedures in effect at the time such modifications are authorized.
C. PROJECT WORK PLAN:
The following Project Work Plan is in effect for program monitoring requirements only and as
such, is not intended to be used as a payment schedule.
Date Start
Date End
Work Plan
12/2011
12/2016
DLC Selection of qualified recipient(s)
12/2011
12/2016
Perform administration functions for the CoC -SHP S +C
DLC staff to submit proof of
Program
12/2011
12/2016
Demonstrate administration of program with staff
timesheets and rental, security & utility assistance
through rental assistance payment requests and begin
selection of tenant
12/2011
12/2016
Begin rental, security deposit and utility assistance
12/2011
12/2016
Completion of all S +C assistance until grant funds are
expended
D. PAYMENT SCHEDULE:
The following table details the project deliverables and payment schedule.
Deliverable
Payment Schedule
Staff to administer the S +C
Upon monthly invoicing of allowable expenses
program; provide rental
assistance; and demonstration
TRA assistance
DLC staff to submit proof of
Equal to amount submitted for TRA and
Supportive Service match
administrative costs on a monthly basis
2010 -CoC Shelter Plus Care
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Page 20 of 30
EXHIBIT "A -1"
CHANGE BY LETTER
COLLIER COUNTY GOVERNMENT
Collier County Housing, Human and Veteran Services
Public Services Division
Date
Contact Name
Name of Firm
Address
RE: Zero Dollar Contract Change Notification
Re: Contract # and Title of Contract
Project #
Purchase Order #
Dear Contact Name:
User Name
Address
NAPLES, FLORIDA Zip code
PHONE: (239) Phone #
FAX (239) Fax #
16D1
By copy of this letter, the above referenced contract is being issued a zero dollar ($0.00) change as indicated below:
r The above referenced contract time is hereby extended by Number of days calendar days. The new completion date
shall be on or before month and date, Year.
By extending this contract, the County is not relieving your firm of its obligations to perform work in a timely and
satisfactory manner or any consequences resulting from failing to do so. Collier County hereby reserves all legal rights,
including, but not limited to, rights to terminate, suspend or elect any other appropriate course(s) of action should
circumstances warrant with regard to the referenced contract.
Additional Staffing Categories Professional Position(s) Hourly Rate(s)
r Draw against Allowance (specify allowance item and identify specific items and quantities)
Other: Scope Clarifications as indentified in Schedule B -1, "Clarifications in Scope ", (attached).
Sincerely,
Your name
Title
cc: Contract Specialist Name Contract Specialist, Purchasing Department
Suzanne Boothby, Clerk's Grants Department
2010 -CoC Shelter Plus Care
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Page 21 of 30
1601.
EXHIBIT "B"
INSURANCE REQUIREMENTS
The SPONSOR 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:
1. Workers' Compensation as required by Chapter 440, Florida Statutes.
2. Public Liability Insurance on a comprehensive basis in an amount no less than $300,000
per occurrence for combined Bodily Injury and Property Damage. 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 $300,000 per occurrence for combined
Bodily Injury and Property Damage.
DESIGN STAGE (IF APPLICABLE)
In addition to the insurance required in 1 — 3 above, a Certificate of Insurance must be provided
as follows:
4. Professional Liability Insurance in the name of the SPONSOR or the licensed design
professional employed by the SPONSOR in an amount not less than $300,000 per occurrence
providing for all sums which the SPONSOR and /or the design professional shall become legally
obligated to pay as damages fro claims arising out of the services performed by the SPONSOR or any
person employed by the SPONSOR in connection with this contract. This insurance shall be
maintained for a period of two (2) years after the certificate of Occupancy is issued.
CONSTRUCTION PHASE (1F APPLICABLE)
In addition to the insurance required in 1 — 4 above, the SPONSOR shall provide or cause its
Subcontractors to provide original policies indicating the following types of insurance coverage prior
to any construction:
5. 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 SPONSOR.
6. Flood Insurance shall be provided for those properties found to be within a flood hazard
zone, in an amount not less than the full replace values of the completed structure(s) or the maximum
amount of coverage available through the National Flood Insurance Program (NFIP), whichever is
greater. The policy will show Collier County as a Loss Payee A.T.I.M.A. This policy will be provided
as such time that he buildings' walls and roof exist.
OPERATION /MANAGEMENT PHASE (IF APPLICABLE)
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16D1
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. Public Liability coverage in an amount not less than $1,000,000 per occurrence for
combined Bodily Injury and Property damage. Collier County must be shown as an additional insured
with respect to this coverage.
8. 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 A.T.I.M.A.
9. 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.
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16 n 1
EXHIBIT "C"
ADDITIONAL CoC -SHP S +C GRANT REQUIREMENTS
Enter additional requirements here, IF NONE EXIST, state "There are no additional grant
requirements."
1. The Subrecipient will be responsible for providing all reporting data to Collier County upon
request regarding the Federal Funding Accountability and Transparency Act (FFATA).
2010 -CoC Shelter Plus Care
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Page 24 of 30
2010 -CoC Shelter Plus Care
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EXHIBIT "D"
REQUIRED SUBMITTALS
D -1 Request for Payment
D -la Release and Affidavit Form
D -2 CoGSHP S +C Monthly Progress Report
Page 25 of 30
16D1
1601
SCHEDULE "D -1"
COLLIER COUNTY HOUSING, HUMAN AND VETERAN SERVICES
REQUEST FOR PAYMENT
SECTION I: REQUEST FOR PAYMENT
Sponsor Name: Collier County Housing Authority
Sponsor Address: 1800 Farmworkers Way, Immokalee, FL 34142
Project Name: NEW Shelter Plus Care (S +C)
Project No: FL0394C4DO6100 Payment Request #
Dollar Amount Requested: $
SECTION II: STATUS OF FUNDS
1. Grant Amount Awarded $ $81,840
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)
E1
E.9
I certify that this request for payment has been drawn in accordance with the terms and
conditions of the Agreement between the COUNTY and us, as the SPONSOR. I also certify that the
amount of the Request for Payment is not in excess of current needs.
Signature
Title
Authorizing Grant Coordinator
Supervisor.
Dept Director
2010 -CoC Shelter Plus Care
FL0394C4DO61000
CCHA
Date
(approval authority under $14,999)
(approval required $15,000 and above)
Page 26 of 30
16D1
SCHEDULE "D -Ia"
RELEASE AND AFFIDAVIT FORM
The SPONSOR certifies for itself and its subcontractors, material -men, 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 SPONSOR's (monthly /final)
Request for Payment.
SPONSOR
Witness:
C'
Print name and title
STATE OF
COUNTY OF
:•
ITS: President
DATE:
The foregoing instrument was acknowledged before me this day of ,
2011, 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) Notary Public, State of:
2010 -CoC Shelter Plus Care
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Page 27 of 30
Commission No.:
•1
SCHEDULE 46D -2"
CoC -SHP S +C MONTHLY PROGRESS REPORT
Complete form for past month and submit to Housing, Human and Veteran Service's staff by
the 10`h of the following month.
Status Report for Month of
Submittal Date:
Project Name FL -606 NEW Shelter Plus Care (S +C)
Project Number FL0394C4DO6100 Activity Number
SPONSOR: Collier County Housing Authority, Inc.
Contact Person Angela Edison
Telephone: 239 - 657 -3649 Fax: 239 - 657 -7232
E -mail: Edisoncchanaol.com
1. Activity Status/Milestones (describe any action taken, relating to this project, during
the past month):
2. What events /actions are scheduled for the next two months?
3. Describe any affirmative marketing you have implemented regarding this project.
Please list and attach any recent media coverage of your organization relating to this project.
4. List any additional data relevant to the outcome measures listed on the application
for this project.
5. Identify any potential issues that may cause delay.
6. Progress on Completion of the Grant Activity (s):
For each funded activity, provide a concise written narrative that compares work accomplished to date versus planned
timeframes for completion of the activity as outlined in your application.
Provide detailed explanations for any delays in carrying out a grant activity, its cause, and steps being taken to assure
completion of the activity or use by December 13, 2013.
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Should any activity be identified as facing the likelihood of NOT BEING COMPLETED BY December 13, 2015.
Report on the activity, the cause, and corrective actions.
7. For projects that serve a particular clientele, please complete the following
information by entering the appropriate number in the blank spaces and in the chart below. Complete
the below chart for NEW clients served this month. DO NOT DUPLICATE clients served in
previous months. You may provide data by either households or persons served. However, if one
person received TWO services this counts as TWO SERVICE UNITS:
TOTAL BENEFICIARIES
This project benefits households or persons. Please circle one category (either
"households" or "persons "). Enter the number of beneficiaries in the blank space and in Box 1. "
INCOME
Of the households or persons assisted, are extremely low - income income (0 -30 %) of the
current Median Family Income (MFI). Enter this number in Box "2. "
Of the households or persons assisted, - are very low - income (31 -50 %) of the current
Median Family Income (MFI). Enter this number in Box "3. "
Of these households or persons assisted, are low- income (51 -80 %) of the current Median
Family Income (MFI). Enter this number in Box "4. "
NOTE. The total of Boxes 2,3 and 4 should equal the number in Box].
FEMALE HEAD OF HOUSEHOLD
This project assisted Female Head of Households REGARDLESS of income. Enter this
number in box "5 " below.
BOX 1
BOX 2
BOX 3
BOX 4
BOX 5
Total Number of
Extremely
Very
Low Income
Female Head of
Households or
Low Income
Low Income
(51 -80 %)
Household
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1601
Persons Assisted (0 -30 %) (31 -50 %)
SPONSOR's must indicate total beneficiaries for Race AND Ethnicity
Definitions of Race:
White: A person having origins in any of the original peoples of Europe, the Middle East, or North
Africa.
Black or African - American: A person having origins in any of the black racial groups of Africa.
Asian: A person having origins in any of the original peoples of the Far East, Southeast Asia, or
the Indian subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia,
Pakistan, the Philippine Islands, Thailand, and Vietnam.
American Indian or Alaska Native: A person having origins in any of the original peoples of North
and South America (including Central America), and who maintains tribal affiliation or community
attachment.
Native Hawaiian or Other Pacific Islander: A person having origins in any of the original people of
Hawaii, Guam, Samoa, or other Pacific Islands.
Definitions of Ethnicity:
Hispanic or Latino: A person of Cuban, Mexican, Puerto Rican, South or Central American, or
other Spanish culture or origin, regardless of race.
Tabulation Table of Race and Ethnicity Beneficiaries
Race
# Total
# Hispanic
White
Black or African American
Asian
American Indian or Alaskan Native
Native Hawaiian or Other Pacific Islander
American Indian/Alaska Native and White
Asian and White
Black/African American and White
American Indian/Alaskan Native and Black/African American
Other Multi- Racial
TOTAL:
2010 -CoC Shelter Plus Care
FL0394C413061000
CCHA
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