Backup Documents 05/10/2011 Item #16J 3
MEMORANDUM
Date:
'May 12, 2011
To:
Bonnie Baer, Assistant General Operations Manager
Clerk's Finance & Accounting
From:
Teresa Polaski, Deputy Clerk
Minutes & Records Department
Re:
Application for Revenue Sharing for State Fiscal Year 2011-
2012
Attached please find the original of the document referenced above, (Agenda
Item #16J3), which was approved by the Board of County Commissioners on
Tuesday, May 10, 2011.
If you have any questions, please call me at 252-8411.
Thank you.
Enclosure
16J 3
Dwight E. Brock
Clerk of Courts
'Goijjify-of-Gil)~lier
.... ---
CLERK. OF THE CIlRCUIT COURT
COLLIER COUNTY qoUR~OUSE
3301 TAMIAMI T~ EA~T
P.O. BOX 4f~J)44 \
NAPLES, FLORIDA ~101-3d14
it J
16J 3
1
, l
\. (
~---;(/
Clerk of Courts
Accountant
Auditor
Custodian of County Funds
May 9, 2011
MEMORANDUM
To: Ian Mitchell, Supervisor, BCC Office Operations
From: Bonnie L Baer, Assistant General Operations Manag~,P
Clerk's Finance & Accounting ,
Subject: Application for Revenue Sharing for State Fiscal Year 2011-2012
Each year an application is prepared, reviewed by recipient departments and legal sufficiency approval
by the County Attorney with additional sign off by Dwight E. Brock, Clerk of the Circuit Court.
The application is then presented by executive summary for the Board's Approval. The executive
summary is scheduled for the 5/10/11 agenda, item 1GJ3, and I have attached the original application
for Chairman Coyle's signature.
Please notify me (ext. 5435 or bonnie.baer@collierclerk.com) so that I can pick-up the executed
application to be forwarded to the State prior to the deadline of June 3D, 2011.
Thank you in advance for your assistance.
~~
'1\\~ \\
Phone - (239) 732-2646
Website: www.clerk.collier.fl.us
Fax - (239) 775-2755
Email: colliercIerk@cIerk.collier.fl.us
16J 3
"
DH.....rnIl.I!:NT
or RrV[NI.)[
Application for Revenue Sharing 2011-2012 State Fiscal Year
(Chapter 218, Part II Florida Statutes)
DR-700218
R. 01/11
Application deadline is June 30, 2011
Mail completed original application to:
Department of Revenue
Revenue Accounting Subprocess
P.O. Box 6609
Tallahassee, FL 32314-6609
850-617-8586
REVENUEACCOUNTING@dor.state.fl.us
Please TYPE or PRINT
Name of County COLLIER
OR
Name of Municipality
County
Telephone Number 239.252,6299
Fax Telephone Number 239.252.2096
Mayor or Chairman of Governing Body Fred W. Coyle, Chairman, Collier Board of County Commissioners
Chief Fiscal Officer Dwight E. Brock, Clerk of the Circuit Court of Collier County
E-mail Address
Crystal.Kinzel@collierclerk.com
Official Mailing Address 3299 Tamiami Trail E" Suite 403, Naples, FL 34112
IXI Check here if the address represents a change from the previous application.
Federal Employer 1.0. Number
(required for new participants only),
Please complete the questions below to determine your eligibility to participate in Revenue Sharing for this fiscal
year.
1. Have you submitted your financial statements for fiscal year ending 09/30/09 to the Department of Financial Services
as required by s. 218.32, F.S.?
[Z] Yes
ONo
2. Have you made provisions for annual postaudits of your financial accounts as provided by
s. 11.45, F,S.?
~Yes
ONO
02/22/2011
09/30/2010
Date of Audit Report
Fiscal Year-End
3.
'DR-700218
R. 01/11
Have you reported on your most recent financial statement revenues equivalent to three mills calculated based on Page 2
your 1973 taxable values? This revenue should be net of debt service or special millages approved by the voters,
The revenue can be generated by a combination of ad valorem tax, utility tax, occupational license tax, or a payment
from the county as allowed by s. 125,01, Florida Statutes.
16J 3
~Yes
DNO
4. If you have a law enforcement department, answer the questions below: (If you have a contracted or strictly
volunteer department, skip to question 5)
(A) Have your law enforcement officers, as defined by s. 943.10(1}, F.S., met the qualifications for employment as
established by the Criminal Justice Standards and Training Commission, and do you compensate them at an
annual salary rate of six thousand dollars ($6,000) or more?
~Yes
DNo
(B) Does the salary structure and salary plans for law enforcement officers meet the requirements of
Chapter 943 F,S.?
~Yes
DNo
5. If you have a fire department, answer the questions below: (If you have a contracted or strictly volunteer
department, skip to question 6)
(A) Have your firefighters, as defined by s. 633.30(1}, F.S., met the requirements stated in s. 633.34, 633.35, and
633.382 F.S.
~Yes
DNO
(B) Does your fire department employ any full-time firefighters, who currently have either a bachelor's degree or
associate degree from a college or university which is applicable to fire department duties, if the degree is not a
requirement for their current position?
~Yes
DNO
(C) If so, are these firefighters currently receiving supplemental compensation for those degrees?
~Yes
DNO
6. Are dependent special districts budgeted separately from the general budget of your government? Do they meet the
provisions for annual postaudit of their financial accounts in as provided by s. 11.45(3), F.S.?
~Yes
DNO
D Does Not Apply
7. Have you met the requirements of s. 200.065, F.S., if applicable? (The annual certification must be within 30 days of
adoption of an ordinance or resolution establishing a final property tax levy or, if no property tax is levied, not later
than November 1.
~Yes
DNO
The portion of revenue sharing funds which, according to Part II, Chapter 218, F.S., would otherwise be distributed
to a unit of local government which has not certified compliance or has otherwise failed to meet the requirements
of s. 200.065, F.S., shall be deposited in the General Revenue Fund for the 12 months following a determination of
noncompliance by the department.)
16 J'7318
R.01/11
I certify that all information is accurate and true to the best of my knowledge. I further certify that I will promptly Page 3
report to the Department of Revenue any changes in the above information. I also realize that failure to provide timely
inforlJ1ation required, allows the Department to utilize the best information available, If no such information is available,
the Department will take necessary action including disqualification, either partial or entire, and you will waive your
right to challenge the determination of the Department to your share of funds, if any, beyond your minimum entitlement,
according to the privilege of receiving shared revenues from the Revenue Sharing Trust Funds.
Do you believe that you have complied with ALL eligibility requirements as listed above?
[ZJ Yes
DNO
If the answer to question above is (NO), please provide an attachment of the revenue necessary to meet your obligations
because of pledges or assignments or trusts entered into which obligated funds received from revenue sharing.
Date: ~-2S ~ I (
Dwight E. Brock, Collier County Clerk of the Circuit Court
Signed:
Signed:
Date: tJ / , ! <..:.~ ( ,
ody Fred W. Coyle, Chairman, Collier County Board of
County Commissioners
Mail completed original application to address shown below.
Florida Department of Revenue
Revenue Accounting Subprocess
PO Box 6609
Tallahassee, FL 32314-6609
850-617-8586
REVENUEACCOUNTING@dor.state.fl.us
and legal sufficiency: