Backup Documents 11/08/2011 Item #16J4 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP .:
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(line#6).
Route to Addressee(s) Office Initials Date
(List in routing order)
1.
2.
3.
4.
5. Ian Mitchell, Executive Manager Board of County Commissioners (I () 100
to the BCC
J-
6. Minutes and Records Clerk of Court's Office
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/pitred the executive
summary.Primary contact information is needed in the event one of the ad resse above,inclpdin Sue Filson,need to contact staff for additional or missing
information.All original documents neediriallacg Chairm delive ' CC offr (tq,fnpp ye the
.tem) (146 �� —• C:.::
ante of Primary Staff �,5-- Ora(a SN'- SVe_c((�''^S ,.�Llr'^,L--
ontact �� �,( T'� UJTI
agenda Date Item vill `\\it\k\ alltalMEM (A
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1. Original do egal suffflilMiliPMEMIN
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, \1 '
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.)
Is the Chairman's original signature required? , .., .;
3 All handwritten strike-throughs and revisions have been initialed by the County Attorney's f
Office and all other parties except the BCC Chairman and the Clerk to the Board. CrJ6
4. The Chairman's signature line date has been entered as the date of BCC approves ,��\
document or the final negotiated contract date,whichever is applicable.
5. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's
signature and initials are required.
6. In most cases(some contracts are an exception),the original document and alEiniMIN
should be provided to Ian Mithchell in the BCC office within 24 hours o pproval�
Some documents are time sensitive and require forwarding to Tallahas ace
time frame or the BCC's actions are nullified. Be await of your deadlines.
7. The document was approved by the BCC on ' \�j \\, (enter date)ar�
legingi
made during the meeting have been incorporated in he attached document. ThQ E71 iiii.i
i County Attorney's Office has reviewed the changes,if applicable.
l: Forms/County Forms/BCC Forms/Original Documents Routing Slip,Revised 6-15-2011
16j4
MEMORANDUM
Date: November 10, 2011
To: Lori Sams,
Collier County Sheriff's Office
From: Teresa Polaski, Deputy Clerk
Minutes & Records Department
Re: Equitable Sharing Agreement and Certification
Attached for further processing is the original document referenced above
(Agenda Item #16J4) approved by the Board of County Commissioners on
Tuesday, November 8, 2011.
If you have any questions, please call me at 252-8411.
Thank you.
Attachment
16J4
OMB Number 1123-0011
�--c.STOFry, Expires9-30-2014
Equitable Sharing 7-
_ Agreement and•
Certification
1789--
0 Police Department Oi Sheriffs Office 0 Task Force(Complete Table A,page2)
0 Prosecutor's Office 0 Other(specify)
Agency Name:Collier County Sheriffs Office
NCIC/ORI/Tracking Number: F L 0 1 1 0 0 0 0
Street Address:3319 E. Tamiami Trail
City: Naples State:FL Zip: 34112
Contact: Title: Ms. First:Lori Last: Sams
Contact:Phone:239-252-0842 E-mail: Lori.Sams @colliersheriff.org
Same as Preparer:First: Lori Last:Sams
.0v.,Contact Preparer: Phone: 239-252-0842 E-mail: Lori.Sams @colliersheriff.org
Last Fiscal Year End: 09/30/2011 Agency Current Fiscal Year Budget: $131,973,300.00
O New Participant: Read the Equitable Sharing Agreement(page-1)and sign the Affidavit(page-1)
Complete the Annual Certification Report,read the Equitable Sharing Agreement(page
Existing Participant: -1),and sign the Affidavit(page-1)
O Amended Form: Revise the Annual Certification Report,read the Equitable Sharing Agreement(page-1),
and sign the Affidavit(page-1).
Annual Certification Report
Summary of Equitable Sharing Activity Justice Funds' Treasury Funds'
1 Beginning Equitable Sharing Fund Balance(must match
Ending Equitable Sharing Fund Balance from prior FY) $434,641.99 $289,738.28
2 Federal Sharing Funds Received $52,228.39 $0.00
3 Federal Sharing Funds Received from Other Law Enforcement
Agencies and Task Forces(complete Table B,page-1) $19,850.62 $0.00
4 Other Income $0.00 $0.00
5 Interest Income Accrued Non-Interest Bearing 0
Interest Bearing $1,169.26 $722.25
6 Total Equitable Sharing Funds(total of lines 1 -5) $507,890.26 $290,460.53
7 Federal Sharing Funds Spent(total of lines a-m below) $0.00 $24,300.00
8 Ending Balance(difference between line 7 and line 6) $507,890.26 $266,160.53
Justice Agencies are:FBI,DEA,ATF,USPIS,USDA,DCIS,DSS,and FDA.
2 Treasury Agencies are:IRS,ICE,CBP,USSS,and USCG.
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16J4
Summary of Shared Monies Spent Justice Funds Treasury Funds
a
Total spent on salaries for new,temporary,not-to-exceed
one year employees Refer to§VIII.A.2.a.3 of the Justice Guide $0.00 $0.00
b Total spent on overtime $0.00 $0.00
c Total spent on informants,"buy money,"and rewards $0.00 $0.00
d Total spent on travel and training $0.00 $0.00
e Total spent on communications and computers $0.00 $24,300.00
f Total spent on weapons and protective gear $0.00 $0.00
g Total spent on electronic surveillance equipment $0.00 $0.00
h Total spent on buildings and improvements $0.00 $0.00
Total transfers to other state and local law enforcement
agencies(complete Table C,page-1) $0.00 $0.00
Total spent on other law enforcement expenses(complete
Table D,page-1) $0.00 $0.00
k Total Expenditures in Support of Community-based Programs
(complete Table E,page-1) $0.00
l Total Windfall Transfers to Other Government Agencies
(complete Table F,page-1) $0.00 $0.00
m Total spent on matching grants(complete Table G,page-1) $0.00 $0.00
n Total $0.00 $24,300.00
o Did your agency receive non-cash assets? 0 Yes 0 No If yes,complete Table H,page-1.
Please fill out the following tables,if applicable.
Table A: Members of Task Force
Agency Name NCIC/ORI/Tracking Number
Table B: Equitable Sharing Funds Received from other Agencies
Total the amount transferred to each agency on separate lines
Transferring Agency Name,City,and State Justice Funds Treasury Funds
Agency Name: Broward County Sheriffs Office
$19,850.62 $0.00
NCIC/ORI/Tracking Number: F L 0 0 6 0 0 0 0
Table C: Equitable Sharing Funds Transferred to Other Agencies
Total the amount transferred to each agency on separate lines
Receiving Agency Name,City,and State Justice Funds Treasury Funds
Agency Name:
$0.00 $0.00
NCIC/ORI/Tracking Number:
Page of September 2011
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Table D: Other Law Enforcement Expenses 1 6 J 4
Description of Expense Justice Funds Treasury Funds
None $0.00 $0.00
Table E: Expenditures in Support of Community-based Programs
Refer to§VIII.A.1.m and Appendix C of the Justice Guide
Recipient Justice Funds
None $0.00
Table F: Windfall Transfers to Other Government Agencies
Refer to§VIII.A.1.n of the Justice Guide and pp.25-26 of the Treasury Guide
Recipient Justice Funds Treasury Funds
None $0.00 $0.00
Table G: Matching Grants
Refer to§VIII.A.1.h of the Justice Guide and p.22 of the Treasury Guide
Matching Grant Name Justice Funds Treasury Funds
None $0.00 $0.00
Table H: Other Non-Cash Assets Received
Source Description of Asset
Justice 0
Treasury 0
Table I: Civil Rights Cases
Name of Case Type of Discrimination Alleged
El Race Color National ❑ Gender
Origin
Disability 11 Age ❑ Other
Paperwork Reduction Act Notice
Under the Paperwork Reduction Act, a person is not required to respond to a collection of information
unless it displays a valid OMB control number. We try to create accurate and easily understood forms
that impose the least possible burden on you to complete. The estimated average time to complete this
form is 30 minutes. If you have comments regarding the accuracy of this estimate, or suggestions for
making this form simpler,please write to the Asset Forfeiture and Money Laundering Section,
Program Operations Unit, 1400 New York Avenue,N.W.,Tenth Floor,Washington, DC 20005.
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16J4 4
Equitable Sharing Agreement
This Federal Equitable Sharing Agreement,entered into among (1)the Federal Government,(2)the above-stated law
enforcement agency("Agency"),and (3)the governing body,sets forth the requirements for participation in the
federal equitable sharing program and the restrictions upon the use of federally forfeited cash, property,proceeds,
and any interest earned thereon,which are equitably shared with participating law enforcement agencies. By its
signatures,the Agency agrees that it will be bound by the statutes and guidelines that regulate shared assets and the
following requirements for participation in the federal equitable sharing program. Receipt of the signed Equitable
Sharing Agreement and Certification(this"Document") is a prerequisite to receiving any equitably shared cash,
property,or proceeds.
1.Submission. This Document must be submitted to aca.submit @usdoj.gov within 60 days of the end of the
Agency's fiscal year. This Document must be submitted electronically with the Affidavit/Signature page(page-1)
submitted by fax. This will constitute submission to the Department of Justice and the Department of Treasury.
2.Signatories. This agreement must be signed by the head of the Agency and the head of the governing body.
Examples of Agency heads include police chief,sheriff,director,commissioner,superintendent,administrator,
chairperson,secretary,city attorney,county attorney,district attorney, prosecuting attorney,state attorney,
commonwealth attorney,and attorney general. The governing body's head is the person who allocates funds or
approves the budget for the Agency. Examples of governing body heads include city manager, mayor,city council
chairperson,county executive,county council chairperson,director,secretary,administrator,commissioner,and
governor.
3.Uses. Any shared asset shall be used for law enforcement purposes in accordance with the statutes and guidelines
that govern the federal Equitable Sharing Program as set forth in the current edition of the Department of Justice's
Guide to Equitable Sharing for State and Local Law Enforcement(Justice Guide),and the Department of the Treasury's
Guide to Equitable Sharing for Foreign Countries and Federal,State,and Local Law Enforcement Agencies(Treasury Guide).
4.Transfers. Before the Agency transfers cash,property,or proceeds to other state or local law enforcement
agencies, it must first verify with the Department of Justice or the Department of Treasury,depending on the source
of the funds,that the receiving agency is a federal Equitable Sharing Program participant and has a current Equitable
Sharing Agreement and Certification on file.
5.Internal Controls. The Agency agrees to account separately for federal equitable sharing funds received from the
Department of Justice and the Department of the Treasury. Funds from state and local forfeitures and other sources
must not be commingled with federal equitable sharing funds. The Agency shall establish a separate revenue
account or accounting code for state,local,Department of Justice,and Department of the Treasury forfeiture funds.
Interest income generated must be accounted for in the appropriate federal forfeiture fund account.
The Agency agrees that such accounting will be subject to the standard accounting requirements and practices
employed for other public monies as supplemented by requirements set forth in the current edition of the Justice
Guide and the Treasury Guide, including the requirement in the Justice Guide to maintain relevant documents and
records for five years.
The misuse or misapplication of shared resources or the supplantation of existing resources with shared assets is
prohibited. Failure to comply with any provision of this agreement shall subject the recipient agency to the sanctions
stipulated in the current edition of the Justice or Treasury Guides,depending on the source of the funds/property.
6.Audit Report. Audits will be conducted as provided by the Single Audit Act Amendments of 1996 and OMB
Circular A-133. The Department of Justice and Department of the Treasury reserve the right to conduct periodic
random audits.
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Affidavit
Under penalty of perjury,the undersigned officials certify that they have read and understand their obligations under
the Equitable Sharing Agreement and that the information submitted in conjunction with this Document is an accurate
accounting of funds received and spent by the Agency under the Justice and/or Treasury Guides during the reporting
period and that the recipient Agency is in compliance with the National Code of Professional Conduct for Asset Forfeiture.
The undersigned certify that the recipient Agency is in compliance with the nondiscrimination requirements of the
following laws and their Department of Justice implementing regulations: Title VI of the Civil Rights Act of 1964(42 U.S.C.
§2000d et seq.),Title IX of the Education Amendments of 1972(20 U.S.C.§ 1681 et seq.),Section 504 of the Rehabilitation
Act of 1973(29 U.S.C.§794),and the Age Discrimination Act of 1975(42 U.S.C.§6101 et seq.),which prohibit
discrimination on the basis of race,color,national origin,disability,or age in any federally assisted program or activity,or
on the basis of sex in any federally assisted education program or activity. The Agency agrees that it will comply with all
federal statutes and regulations permitting federal investigators access to records and any other sources of information as
may be necessary to determine compliance with civil rights and other applicable statutes and regulations.
During the past fiscal year: (1)has any court or administrative agency issued any finding,
judgment,or determination that the Agency discriminated against any person or group in
violation of any of the federal civil rights statutes listed above;or(2)has the Agency entered
into any settlement agreement with respect to any complaint filed with a court or
administrative agency alleging that the Agency discriminated against any person or group in
violation of any of the federal civil rights statutes listed above? O Yes O No
If you answered yes to the above question,complete Table I
Agency Head Governing Body Head
See 11 2 on page See 1 2 on page
LAJ
CP-- 4.-
Signature: ell .. Signature:
Name: ' evin . Rambosk Name: Fred W. Coyle
Title: Sheriff Title: Chairman, Collier Co. Comm.
Date: 10/20/2011 Date: 11/08/2011
Subscribe to Equitable Sharing Wire: andrea.marsh @colliersheriff.org
The Equitable Sharing Wire is an electronic newsletter that
gives you important,substantive,information regarding lori.sams @colliersheriff.org
Equitable Sharing policies,practices,and procedures. derek.bell @colliersheriff.org
Final Instructions:
Step 1: Click to save for your records Step 3: E-mail the XML file to aca.submit @usdoj.gov
Step 2: Click to save in XML format Step 4: Fax THIS SIGNED PAGE ONLY to (202)616-1344
ECYUSEONLY tered on mil 1
o FY End: 09/x U/?,Q11
o NCIC;fL01'10000' .t ,g ncy:Collier County Sheriff's Office Phone:
State: FL.- Cvnta ;Lbr'i ams E-mail: Lori.Sams @colliersheriff.org
AST
DWI., T E.BROM,OLERK September 2011
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