Backup Documents 11/08/2011 Item #10JORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 10
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
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 pine #5).
Route to Addressee(s)
List in routing order
Office
Initials
Date
1. Ashlee Franco, Acctin . Supervisor
HRVS
Initial
11/29/11
2. Jeffrey Klatzkow, County Attomey
County Attome 's Office, 80 Fl.
Agenda Item Number
11/29/11
3. Ian Mitchell, Executive Manager
Board of County Commissioners
of this
!2 z 1
4. Clerk of Courts
Minutes and Records Dept., 4 Fl.
Number of
2 Agreement
5. Ashlee Franco, Acctin . Supervisor
HHVS
Documents Attached
contracts, agreements, etc. that have been fully executed by all parties except the BCC
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
Ashlee Franco / Housing, Human and
Phone Number.
252 -2689
Contact
Veteran Services
Initial
A licable
Agenda Date Item was
November 8, 2011
Agenda Item Number
16D 19 — PLAN j
Approved by the BCC
signed by the Chairman, with the exception of most letters, must be reviewed and signed
of this
A reement
Type of Document
Contract Agreement
Number of
2 Agreement
Attached
Stamp of Chairman's signature
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
Initial the Yes column or mark "N /A" in the Not Applicable column, whichever is
Yes
N/A (Not
appropriate.
Initial
A licable
1.
Original document has been signed/ initialed for legal sufficiency. (All documents to be
AF -part
signed by the Chairman, with the exception of most letters, must be reviewed and signed
of this
by the Office of the County Attorney. This includes signature pages from ordinances,
Routing
resolutions, etc. signed by the County Attorney's Office and signature pages from
Slip
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
AF
N/A
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
AF
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
AF
signature and initials are required.
5.
In most cases (some contracts are an exception), the original document and this routing slip
AF
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 11/8/2011 (enter date) and all changes
AF
N/A
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
10 1
MEMORANDUM
Date: December 5, 2011
To: Ashley Franco
Housing, Human and Veteran Services
From: Teresa Polaski, Deputy Clerk
Minutes & Records Department
Re: Extension Agreement w /PLAN
Attached for your records is an original of the document referenced above (Item
#10J) approved by the Collier County Board of County Commissioners on Tuesday,
November 8, 2011.
The Minutes & Records Department has retained an original to be kept in the
Board's Official Records.
If you have any questions, please feel free to contact me at 252 -8411.
Thank you.
10J
EXTENSION AGREEMENT
THIS EXTENSION AGREEMENT, made and entered into on this 8t' day of November
2011, by and between the Physicians Led Access Network of Collier County (PLAN), authorized
to do business in the State of Florida whose business address is 2500 Tamiami Trail N., Suite
#212, Naples, Florida 34103, hereinafter called the "Contractor" (or "Consultant ") and Collier
County, a political subdivision of the State of Florida, Collier County, Naples, hereinafter call
the "County ":
RECITALS:
WHEREAS, on February 24, 2009, the parties entered into an Agreement (hereinafter
referred to as the "Agreement ") wherein Contractor agreed to assist income eligible residents of
Collier County with access to medical services provided by physicians in PLAN's network; and
WHEREAS, the Agreement provided for two one -year renewals, which were duly
exercised; and
WHEREAS, the parties wish to continue their relationship on the same terms and
conditions set forth in the Agreement.
NOW, THEREFORE, in consideration of the foregoing Recitals, and other good and
valuable consideration, the receipt and sufficiency of which is hereby mutually acknowledged,
the Parties agree as follows:
1. The foregoing Recitals are true and correct and are incorporated by reference herein.
2. The Agreement is hereby extended for an additional term, to expire December 31,
2012. The County may, at its discretion and with the consent of the Contractor, renew the
Agreement under all of the terms and conditions contained in this Extension Agreement for two
(2) additional twelve (12) month periods. The County shall give the Contractor written notice of
the County's intention to extend the term not less than ten (10) days prior to the end of the term
then in effect.
3. Paragraph 3 of the Agreement is hereby replaced and superseded with the following:
NOTICES. All notices from the County to the Contractor shall be deemed duly
served if mailed or faxed to the Contractor at the following address:
Physician Led Access Network (PLAN)
of Collier County, Inc.
2500 Tamiami Trail N., Suite #212
Naples, Florida 34103
Margaret Eadington, Chair
Phone: (239) 434 -0008
Fax: (239) 417 -8900
10
All notices from the Contractor to the County shall be deemed duly served if mailed or faxed to
the County to:
Housing and Human Services Department
3339 Tamiami Trail East Bldg. H/211
Naples, Florida 34112
Attn: Kimberley Grant, Interim Director
Phone: 239 - 252 -2273
Fax: 239 - 252 -2638
The Contractor and the County may change the above mailing address at any time upon giving
the other party written notification. All notices under this Agreement must be in writing.
4. Excepting those matters set forth herein, all terms and conditions of the Agreement
remain in full force and effect. This Extension Agreement merges any prior written and oral
understanding and agreements, if any, between the parties with respect to the matters set forth
herein.
5. This renewal may be recorded by the County, at the expense of the County, in the
Official Records of Collier County, Florida, within sixty (60) days of approval by the Board of
County Commissioners.
IN WITNESS WHEREOF, the Parties have executed this Extension Agreement on the
date and yea .fiV9t al*e written.
Att est „5, BOARD OF COUNTY COMMISSIONERS
DWIi' 4'$RQK,'rk OF COLLIER COUNTY, FLORIDA
t— B
Aftts t as . to ' i r clerk FRED W. COYLE, CHAI N
•3 i Qn 4wre, 'oh v 4
First Witness
PHYSICAN LED ACCESS NETWORK OF
COLLIER COUNTY
Type /print witness name By:
Margaret Eadingidn, PLAN Chair
Second Witness
Type /print witness name
form
and
Jeffrey
County
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