The URL can be used to link to this page

Backup Documents 05/25/2010 Item #16D11ORIGINAL DOCUMENTS CHECKLIST & ROUTING SL I� iT TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO L� 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 Sue Filson pine #5). Route to Addressee(s) List in routing order Office Initials Date 1. Terri Daniels Housing and Human Services Dept. Agenda Item Number 6/8/2010 2. Ian Mitchell, Manager BCC Board of County Commissioners /9I,o 3. Minutes and Records Clerk of Court's Office Number of Original (6) 3 copies for each 4. Amend #4 Documents Attached agreement PRIMARY CONTACT INFORMATION (The primary contact is the holder of the original document pending BCC approval. Normally the primary contact is the person who crunted/prepared the executive summary. Primary contact information is needed in the event one of the addressees above, including Ian Mitchell, need to contact staff for additional or missing information. All original documerts needing the BCC Chun man's signature are to be delivered to the BCC. office only after the BCC has acted to approve the item.) Name of Primary Staff Contact Terri Daniels Phone Number 252 -2689 Agenda Date Item was May 25, 2010 Agenda Item Number 16DI I Approved by the BCC Original document has been signed/initialed for legal sufficiency. (All documents to be Type of Document Community Care for the Elderly CCE.203.09 Number of Original (6) 3 copies for each Attached Amend #4 Documents Attached agreement Home Care for the Elderly HCE 203.09 Amend #3 2. Alzheimer's Disease Initiative 203.09 Amend #2 INSTRUCTIONS & CHECKLIST 1: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip WWS Original 9.03.04, Revised 1.26.05, Revised 224.05 Initial the Yes column or mark "N /A" in the Not Applicable column, whichever is Yes N/A (Not appropriate. (Initial) Applic able 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, I�t^ 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 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 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 signature and initials are required. 5. In most cases (some contracts are an exception), the original document and this routing slip should be provided to Sue Filson 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 f our deadlines! 6. The document was approved by the BCC on (enter date) and all changes made during the meeting have been incorporaTeil in t e attached document. The County Attorney's Office has reviewed the changes, if applicable. 1: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip WWS Original 9.03.04, Revised 1.26.05, Revised 224.05 16011 MEMORANDUM Date: June 9, 2010 To: Terri Daniels, Grants Supervisor Human Services Department From: Martha Vergara, Deputy Clerk Minutes & Records Department Re: Contract: HCE 203.09 - Amendment #4, HCE #203.09 - Amendment #3, Alzheimer's Diease Initiative 203.09 — Amendment #2 Attached, please find three originals as referenced above (Agenda Item #161311), approved by the Board of County Commissioners on Tuesday, May 25, 2010. Please return a fully executed copy once all signatures have been obtained for the Board's permanent records. If you should have any questions, please call 252 -7240. Thank you. Amendment #003 STANDARD CONTRACT AREA AGENCY ON AGING Collier County Board of Commissioners 16011 Contract HCE 203.09 This AMENDMENT, entered into by the Area Agency on Aging for Southwest Florida, Inc., hereinafter referred to as the "agency ", and Collier County Board of Commissioners, hereinafter referred to as the "recipient', amends agreement # HCE 203.09. The purpose of this amendment is to extend this contract for 90 days or until a new contract is executed, whichever comes first. The 2010 -2011 allocation is shown below. Program Title Funding Source CFDA/CSFA # 2010 -2011 Fund Amounts Home Care for the Elderly - General Revenue / 65001 $78,493.00 Subsidies TSTF Home Care for the Elderly — General Revenue / 65001 $6,573.00 Case Management TSTF TOTAL FUNDS CONTAINED IN $85,066.00 THIS CONTRACT- COLLIER: This amendment shall be effective on July 1, 2010. All provisions in the agreement and any attachments thereto in conflict with this amendment shall be and are hereby changed to conform with this amendment. All provisions not in conflict with this amendment are still in effect and are to be performed at the level specified in the agreement. This amendment and all of its attachments are hereby made a part of this agreement. Amendment #003 16D 11 Contract HCE 203.09 IN WITNESS WHEREOF, the parties hereto have caused this 2 page amendment to be executed by their officials there unto duly authorized. ATTEST: DWIGHT EE�BRO1CK, Clerk By; U vH.x�iM k- DeputlC i . ' Attlyt u W 4tg04twe Approved as to form and legal sufficiency Cam, -4A� Assistant County Attorney Federal Tax ID: 59- 6000558 Fiscal Year Ending: 09/30 BOARD OF COUNTY COMMISSIONERS COLLIER COUNTY, FLORIDA By: FRED COYLE, CHAIRMAN Date: May 25, 2010 AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA By: NAOMI E. MANNING, BOARD PRESIDENT Date: 16011 lttestation Statement Agreement/Contract Number HCE 203.09 Amendment Number 3 1, Fred Coyle attest that no changes or revisions have been made to (Recipient/Contractor representative) the content of the above referenced agreement/contract or amendment between the Area Agency on Aging for Southwest Florida, Inc. and Collier County Board of Commissioners (Recipient/Contractor name) The only exception to this statement would be for changes in page formatting, due to the differences in electronic data processing media, which has no affect on the agreement/contract content. Fred Coyle, Chairman Signature of Recipient/Contractor representative Approved as to form and legal sufficiency C OW4 a — Assistant County Attorney May 25.2010 Date _.3 i71 Mi•!I Amendment #004 STANDARD CONTRACT AREA AGENCY ON AGING Collier County Board of Commissioners 16D1� Contract CCE 203.09 This AMENDMENT, entered into by the Area Agency on Aging for Southwest Florida, Inc., hereinafter referred to as the "agency ", and Collier County Board of Commissioners, hereinafter referred to as the "recipient', amends agreement # CCE 203.09. The purpose of this amendment is to extend this contract for 90 days or until a new contract is executed, whichever comes first. The 2010 -2011 allocation is shown below. Program Title Funding Source CFDA/CSFA # 2010 -2011 Fund Amounts Community Care for the Elderly General Revenue / 65010 $443,156.00 — Spending Authority TSTF Community Care for the Elderly General Revenue / 65010 $114,000.00 — Lead Agency Services TSTF Community Care for the Elderly General Revenue / 65010 $98,322.00 — Lead Agency Operations TSTF TOTAL FUNDS CONTAINED IN $655,478.00 THIS CONTRACT- COLLIER: This amendment shall be effective on July 1, 2010. All provisions in the agreement and any attachments thereto in conflict with this amendment shall be and are hereby changed to conform with this amendment. All provisions not in conflict with this amendment are still in effect and are to be performed at the level specified in the agreement. This amendment and all of its attachments are hereby made a part of this agreement. Amendment 9004 16D11 Contract CCE 203.09 IN WITNESS WHEREOF, the parties hereto have caused this 2 page amendment to be executed by their officials there unto duly authorized. ATTEST: DWIGHT E BROCK, Clerk B} Deputy Clerk khed at. U. Mi s ;fp atwe ds t r Approved as to form and legal sufficiency Assistant County Attorney Federal Tax ID: 59- 6000558 Fiscal Year Ending: 09/30 2 BOARD OF COUNTY COMMISSIONERS COLLIER COUNTY, FLORIDA By: * j— L'). FRED COYLE, CHAIRMAN Date: May 25, 2010 AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA By: NAOMI E. MANNING, BOARD PRESIDENT Date: 16D II Attestation Statement Agreement/Contract Number _CCE 203.09 Amendment Number 4 1, Fred Covle attest that no changes or revisions have been made to ( Recipient /Contractor representative) the content of the above referenced agreement/contract or amendment between the Area Agency on Aging for Southwest Florida, Inc. and Collier County Board of Commissioners (Recipient/Contractor name) The only exception to this statement would be for changes in page formatting, due to the differences in electronic data processing media, which has no affect on the agreement/contract content. Fred Coyle, Chairman Signature of Recipient /Contractor representative Approved as to form and legal sufficiency M p Assistant Cou ty Attorney Revised April 2010 May 25, 2010 Date ?T TEST` ;)WIGHT E. BROCK, Clerk iYgplfiyry M� � Amendment #002 STANDARD CONTRACT AREA AGENCY ON AGING Collier County Board of Commissioners 16011 Contract ADI 203.09 This AMENDMENT, entered into by the Area Agency on Aging for Southwest Florida, Inc., hereinafter referred to as the "agency ", and Collier County Board of Commissioners, hereinafter referred to as the "recipient ", amends agreement # ADI 203.09. The purpose of this amendment is to extend this contract for 90 days or until a new contract is executed, whichever comes first. The 2010 -2011 allocation is shown below. Program Title Funding Source CFDA/CSFA # 2010 -2011 Fund Amounts Alzheimer's Disease General Revenue / 65004 $95,290.00 Initiative - Respite Services TSTF Alzheimer's Disease General Revenue / 65004 $200.00 Initiative — Case TSTF Management TOTAL FUNDS CONTAINED IN $95,490.00 THIS CONTRACT- COLLIER: This amendment shall be effective on July 1, 2010. All provisions in the agreement and any attachments thereto in conflict with this amendment shall be and are hereby changed to conform with this amendment. All provisions not in conflict with this amendment are still in effect and are to be performed at the level specified in the agreement. This amendment and all of its attachments are hereby made a part of this agreement. Amendment #002 16x11 Contract AD] 203.09 IN WITNESS WHEREOF, the parties hereto have caused this 2 page amendment to be executed by their officials there unto duly authorized. ATTEST: DWIGHT E BROCK, Clerk By: Approved as to form and legal sufficiency �' l ODj-t 7f& OOc�Q_ Assistant County Attorney Federal Tax ID: 59- 6000558 Fiscal Year Ending: 09/30 2 BOARD OF COUNTY COMMISSIONERS COLLIER COUNTY, FLORIDA By: �kxl W, l� FRED COYLE, CHAIRMAN) Date: May 25 2010 AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA By: NAOMI E. MANNING, BOARD PRESIDENT Date: 16D11 Attestation Statement Agreement/Contract Number ADI 203.09 Amendment Number 2 I, Fred Co Ie attest that no changes or revisions have been made to (Recipient/Contractor representative) the content of the above referenced agreement/contract or amendment between the Area Agency on Aging for Southwest Florida, Inc. and Collier County Board of Commissioners (Recipient/Contractor name) The only exception to this statement would be for changes in page formatting, due to the differences in electronic data processing media, which has no affect on the agreement/contract content. ``�ck w. (�7' Fred Coyle, Chairman Signature of Recipient/Contractor representative Approved as to form and legal sufficiency Assistant Co my Attorney Revised April 2010 May 25, 2010 Date ATTEST, , DWIGHT E. BROCK Dark By�-��= AtUtt si !� � i t'p11�tYry OA t. �