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Backup Documents 02/28/2012 Item #16D 2 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 16 D THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE 2 ROUTING SLIP Complete routing lines#1 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 a line through routing lines#1 through#4,complete the checklist,and forward to Ian Mitchell. Route to Addressee(s) Office Initials Date JList in routing order) Lisa Oien HHVS Jennifer White CAO ��1.) 4 Z5\ Z Ian Mitchell, Executive Manager Board of County Commissioners Z} /2 Minutes and Records Clerk of Courts Office I PRIMARY CONTACT INFORMATION (The primary contact is the holder of the original document pending BCC approval.Normally the primary contact is the person who created/prepared the executive summary.Primary contact information is needed in the event one of the addressees above,including Ian Mitchell,needs 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 Lisa Oien Phone Number After recording call Contact 252-6141 HHVS for pick up of document for our records Agenda Date Item was 2/28/2012 Agenda Item Number 16D2 Approved by the BCC_ Type of Document 1 document in duplicate,subrecipient Number of Documents 2 Attached agreement amendment attached INSTRUCTIONS & CHECKLIST Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not appropriate. (Initial) Applicable) 1. Original document has been signed/initialed for legal sufficiency.(All documents to be LO 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 LO 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- LO 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 - LO signature and initials are required. 5. In most cases(some contracts are an exception),the original document and this routing slip LO should be provided to 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 4/10/2012(enter date)and all changes LO 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 1602 MEMORANDUM Date: April 30, 2012 To: Lisa Oien, Grants Coordinator Housing, Human & Veteran Services From: Teresa Polaski, Deputy Clerk Minutes & Records Department Re: Agreement Amendment #2/Contract #10-DB-D4-09-21-01-K09 Attached is an original referenced above, (Item #16D2) approved by the Board of County Commissioners on February 28, 2012. The Minutes and Record's Department will retain an original application for the Board's Official Record. If you have any questions please call me at 252-8411. Thank you. Attachment • 1602 Agreement Amendment#2 The School District of Collier County CDBG/DRX Contract#10-DB-D4-09-21-01-K09 DRUCDBG 2008 THIS AMENDMENT, to the June 22, 2010, Agreement is made and entered into this 2'3 day of t Li 4/2 2012, by and between the parties to the original Agreement The School District of Collier Count, existing under the laws of the State of Florida (to be referred to as "Subrecipient")and Collier County,a political subdivision of the State of Florida, (to be referred to as "County")and states as follows: RE: "The School District of Collier County" Catalog of Federal Domestic Assistance# 14.228 Emergency Rule 9BER09-2 CDBG/DRI Contract#1 0-DB-D4-09-21-01-K09 In order to continue the services provided for in the original Agreement document referenced above, the Subrecipient agrees to amend the Agreement as follows: Words Strode-Through are deleted; Words Underlined are added Dollar amounts have original underlines * * HI. TIME OF PERFORMANCE June 22, 2010 is the effective date of DCA Agreement #10-DB-D4-09-2101-K09 with Collier. The services of the SUBRECIPIENT shall be undertaken and completed in light of the purposes of DCA Agreement #10-DB-D4-09-2101-K09. Subrecipients are authorized to incur eligible expenses after that date and prior to execution of this Agreement subject to HHVS prior written approval. In any event, all services required hereunder shall be completed by the SUBRECIPIENT prior date to June 21,2012 December 21, 2012. Any funds not obligated by the expiration date of this Agreement shall automatically revert to the COUNTY. * * EXHIBIT"A" SCOPE OF SERVICES The School District of Collier County Generator Project * * * THE SUBRECIPIENT AGREES TO: * * * CDBG/DRI 2008 The School District of Collier County Contract Amendment tit Page 1 of 2 1602 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 7/2010 2/2011 Prepare Bid Documents 3/2011 5/20112/1i _ Procure Contractor 6/20117/2011 6/20449/22011 Permitting 6/20449/2011 44/24142/2012 Work Commencement 12/20111/2012 4240142/2012 Work Completion 12/20112/21 1/20123/- t 12 Final Ins.ections The above Project Work Plan details items to be completed and submitted by "Date End". Modifications to the above Work Plan require the approval of the Florida Department of Community Affairs and the Board of County-Commissioners. A Work Plan modification will be required if the listed activity exceeds the assigned end date by 90 days or greater. Any modification(s)will be made an integral component of this Agreement. * * * IN WITNESS WHEREOF, the Subrecipient and the County, have each, respectively, by an authorized person or agent, hereunder set their hands and seals on this 2.0 '4 day of Fes.( .rt ,20 /Z . ATTEST: BOARD OF COUNTY COMMISSIONERS D OHT E. EtROCK,,CLERI OF CO1;.LI R COUNTY, FLORIDA sS.cc�6- By: Deputy Clerk FRED W. COYLE,CHAI N 2/26/Zc/Z Da { ...14 J� #gniture(oft R Firs Witness: SCHOOL DISTRICT OF COLLIER COUNTY r1. /:// /-1_ _Signature By: Roy M.T BoadChai ers n ,yam f Type/print witness name Ne0.,91nApproved as to form and legal sufficiency: Signature '' ff is f(i Q U�C(51. 1,t tz. Type/print witness name Jennifer B. White Assistant County Attorney ,,-R7) CDBG/DRI 2008 The School District of Collier County Contract Amendment#2 Page 2 of 2