Backup Documents 12/11-12/2012 Item #16D 3 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6n ,TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper.Attach to original document.Original documents should be hand delivered to the Board Office.The completed routing slip and original
documents are to be forwarded to the Board Office only after the Board has taken action on the item.)
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 Minutes&Records(line#5).
Route to Addressee(s) Office Initials Date
(List in routing order)
1. Kim Grant,Interim Director Housing,Human,Veterans Services t
Department '' • 12412--
2. Jennifer B.White,ACA Office located within Housing,Human,
Veterans Services Department C -13 CAD olla
3. County Attorney's Office County Attorney's Office
4. BCC Office Board of County Commissioners `1�J 1,Q,1�
5. Minutes and Records Clerk of Court's Office (/9 113
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
summary.Primary contact information is needed in the event one of the addressees above,including Sue Filson, the executive
g ikon,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 Wendy Klopf-Operations Coordinator Phone Number 239-252-2901
Contact
Agenda Date Item was 12/11/12 Agenda Item Number 16.D.3
Approved by the BCC
Type of Document ESG Acceptance of Funds 4- 1 page documents 4
Attached
INSTRUCTIONS&CHECKLIST
Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is appropriate. Yes N/A(Not
(Initial) Applicable)
1. Original document has been signed/initialed for legal sufficiency.(All documents to be signed by the
Chairman,with the exception of most letters,must be reviewed and signed by the Office of the
County Attorney.This includes signature pages from ordinances,resolutions,etc.signed by the WK
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 Office and WK
all other parties except the BCC Chairman and the Clerk to the Board
3. The Chairman's signature line date has been entered as the date of BCC approval of the document or WK
the final negotiated contract date whichever is applicable.
4. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's signature and WK
initials are required.
5. In most cases(some contracts are an exception),the original document and this routing slip should be 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 _12/1U12 and all changes made during the WK
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 224.05
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16fl3
MEMORANDUM
Date: January 10, 2013
To: Wendy Klopf, Operations Coordinator
Housing & Human Services
From: Teresa Cannon, Deputy Clerk
Minutes & Records Department
Re: ESG Acceptance of Funds — Grant #E-11-UC-12-002E
Attached are the three (3) originals referenced above, (Item #16D3) approved by Board
of County Commissioners on Tuesday, December 11, 2012.
An original has been kept in the Minutes & Records Department, as part of the
Board's Official Records.
If you should have any questions, please contact me at 252-8411.
Thank you.
Grant Agreement U.S.Department of Housing and Lifl3ent
Subtitle B of Title IV of the McKinney-Vento Office of Community Planning and Development
Homeless Assistance Act,42 USC 11371 et seq. Emergency Solutions Grants Program
Grant Number: E-11-UC-12-002E
1. Name of Grantee(as shown in item 5 of Standard Form 424) 2.Grantee's 9-digit Tax ID Number
Collier County 59-6000558
3. Grantee's DUNS Number:
076997790
4. Grantee's Complete Address(as shown in item 5 of Standard Form 424)
3299 E.Tamiami Trail
Naples,FL 34112-5361
Grant Agreement:This Grant Agreement between the Department of Housing and Urban Development(HUD)and the above named Grantee is
made pursuant to the authority of Subtitle B of Title IV of the McKinney-Vento Homeless Assistance Act(42 U.S.C. 11371 et seq.). The Grantee's
submissions under 24 CFR Part 91 that pertain to this Grant,the HUD regulations at 24 CFR Part 576(as now in effect and as may be amended from
time to time),section 100261 of the Moving Ahead for Progress in the 21st Century Act(Public Law 112-141),and any special conditions attached to
this Grant Agreement constitute part of this Grant Agreement.Subject to the provisions of this Grant Agreement,HUD will make the Grant available
to the Grantee upon execution of the Grant Agreement by the Grantee and HUD.The Grant may be used to pay costs incurred after the date specified
in item 8 below,provided the activities to which the costs are related are carried out in compliance with all applicable requirements.The Grantee
agrees to assume all of the responsibilities with respect to environmental review,decision making,and action required under the HUD regulations at 24 CFR
Part 58. The Grantee shall also comply with the Office of Management and Budget requirements for Universal Identifier and Central Contractor
Registration and Reporting Subaward and Executive Compensation Information at 2 CFR Part 25,Appendix A to Part 25-Award Term,and 2 CFR
Part 170,Appendix A to Part 170-Award Term..
5.Special Conditions(check one): 0 None ❑Attached
6a.Date HUD Received Grantee's Annual Submission under 24 CFR Part 91 6b.Date Grantee Notified:(mm/dd/yyyy)
5/15/2012
7.Date of Start of Grantee's Program Year(mm/dd/yyyy) 8.Date Use of Funds May Begin(the later of the date in 6a and the date in 7)
10/1/2011 7/27/2012
9.Funding Approval(check one): ❑ Original Amendment
10. Amount of Emergency Shelter Grant/Emergency
Solutions Grant: $
10a.Funds Reserved for this Grantee $
10b.Funds Now Being Approved $53,219
10c. Reservation to be Cancelled(10a minus 10b) $
11.Name and Complete Address of Department Designated to Administer the Grant
Housing and Human Services Department
3339 East Tamiami Trail, Suite 211 Naples,FL 34112-5361
11a.Name of Authorized Official
Kimberley Grant
11 b.Title 11c.Signa re 11d.Date(m /dd/yyyy)
Interim Director ( ,-1 t`�1
lie.Phone Number 11f.Fax Number 11g.E-mail Address
(239)252-2273 (239)252-2213 kimberleygrant(a,colliergov.net.
12.U.S.Department of Housing and Urban Development 13.Grantee Name
Community Planning and Development Division Collier County
12a.Name of Authorized Official 13a.Name of Authorized Official
Maria R.Ortiz-Hill Honorable Fred W.Coyle
12b.Title 13b.Title
Direct. Chair,Board of County Commissioners
12c.Si. - /
AP 2d.Date 13d.Date mm/dd/yyyy)
08/28/2012 ?I`r I D1 `12
- Appcoved as to form & legal Sufficiency
T TE$T g`. Ef O • �
DWI: 'T E•" I�IrI
stant County Attorney
lgnatlflr'e *a.4.