Backup Documents 01/12/2010 Item #16D 2
ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 16 D 2
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
exceotion of the Chairman's sianature, draw a line throue:h routing lines #1 throul?h #4, corrmlete the checklist, and forward to Sue Filson line #5),
Route to Addressee(s) Office Initials Date
(List in routinQ: order)
1. Terri Daniels Housing and Human Services 1/15/10
2.
3.
4. Ian Mitchell, Manager Board of County Commissioners ./t^'-. '/'1.0 1
(0
5. Minutes and Records Clerk of Court's Office
PRIMARY CONTACT INFORMATION
(The primary contact is the holder afthe original document pending Bee approvaL Nonnally 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 Sue Filson, need to contact stat! for additional or missing
infonnation. All original documents needing the Bee Chairman's signature are to be delivered to the BeC office only aftcr the Bee has acted to approve the
item)
Name of Primary Staff Terri Daniels Phone Number 252-2689
Contacl
Agenda Date lIem was January 12, 2010 Agenda lIem Number 16D2
Approved bv the BCC
Type of Document Choose Life License Plale Annual Reports Nmnber of Original 2
Attached 2005 and 2006 Documents Attached
1.
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark "N/A" in the Not Applicable colwnn, whichever is
a ro nate.
Original docmnenl has been signed/initialed for lcgal sufficiency. (All documents to be
signed by the Chairman, with the exception of most letters, musl be reviewed and signed
by the Office of the County Attorney. This includes signature pages from ordinances,
resolutions, etc. signed by the Counly Attorney's Office and signalure pages from
contracls, agreements, etc. that have been fully executed by all parties excepl the BCC
Chairman and Clerk to the Board and ossibl State Officials.)
All handwritten strike-Ihrough and revisions havc been inilialed by Ihe County Attorney's
Office and all other arlies exc t the BCC Chairman and Ihe Clerk to the Board
The Chairman's signalure line date has been enlered as the date ofBCC approval of the
document or the final ne otialed contract date whichever is a licable.
"Sign here" tabs are placed on the appropriate pages indicating where the Chairman's
si nature and initials are re uired.
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 docwnents are time sensitive and require forwarding to Tallahassee within a certain
lime frame or the BCC's actions are nullified. Be e of our deadlines!
The document was approved by the BCC on (enter date) and all changes
made during the meeting have been incorporal d i the attached document. The
Coun Attorne's Office has reviewed tbe chan es, if a licable.
y,
. (\;
.,
"
L
2.
3.
4.
5.
6.
(l
\->
C'
~~
, .
1'~{ .
1,~
,
I: Fonns! County Forms! Bee Forms/ Original Documents Routing Slip WWS 01igina1 9.03.04, Revised 1.26.05, Revised 2.24.05
MEMORANDUM
Date:
January 20, 2010
To:
Terri Daniels, Grants Supervisor
Human Services Department
From:
Teresa Polaski, Deputy Clerk
Minutes & Records Department
Re:
Choose Life License Plate Annual Reports 2005-
2006
Attached, please find a copy of each as referenced above (Agenda
Item #16D2), approved by the Board of County Commissioners on
Tuesday, January 12, 2010.
The Minutes and Records Department has kept the originals as
part of the Board's permanent records.
If you should have any questions, please call 252-8411.
Thank you.
16D2
16D21
ANNUAL CHOOSE LIFE SPECIALTY LICENSE PLATE REPORT
TO DHSMV BY COUNTY
COUNTY: Collier
Fiscal Year Ending: 2005
Counly Prior Year Ending Balance $ 51,007
Annual Plate Fees Received From State $ 21,329
Interest Earned on Fees $ 980
Total Available for Dislrlbution by the County $ 73,316
Annual Fees Distributed to Agencies $ 40,000
Interest Earned by Agency on Fees $ 109
Total Available for Agency Expenditures $ 33,425
Annual Plate Fee Expenditure by Agencies
Primary: Women Infants Total
Clothing $ 1,964 $ 1,964
Housing $ 15,445 $ 15,445
Medical Care $ 14,687 $ 14,687
Food $ 3,797 $ 3,797
Utilities $ 1,063 $ 1,063
Transportation $ 501 $ 501
other Material Needs $ -
Total Primary Expenditures $ 37,457
Total Primary ~ Secondary Expendilures
Primary expenses as a % of total Expenditures
Secondary expenses as a % of total Expenditures
Percentage of Distributed Fees Utilized
Amounl Relurned by Agency (if any) to County
Amount Retained by Agency (if any)
County Fiscal Year Ending Balance
Secondary: Women Infants Total
Cau nseli ng $ 2,081 $ 2,081
Training
Advertising
Adoption $ 6,572 $ 6,572
Total Secondary Expenditures $ 8,653
$
46,110
81.2%
18.g%
115.3%
$
$
$
3,997
33,316
We certify thai all :/iient agencies and the County have complied with the Florida Statutes, 320.08056 and 320.08058.(29)
/, , i
1jJ. .-;-:1 fI Mil n A :-w-. I)" fin "
. "'(+/~~- <:::>I:-l~__Vt<. 1/12/2010 ~~f' I p~
Donna Fi~, ,chairman;" .~,~ Date Approved as to form and legal Sufficiency
'., " ':1,':.'
Board oftounty C<>rnlj1iS"sj~rs Assistant Caunly Attorney
.' ".,:~ . ';""
',/) '~.~,~~.
'.- ~. ! '.'} ...., . ',,',
~~
il onaturt on I '
'\
16D2
ANNUAL CHOOSE LIFE SPECIALTY LICENSE PLATE REPORT
TO DHSMV BY COUNTY
COUNTY: Collier
Fiscal Year Ending: 2006
County Prior Year Ending Balance S 33,316
Annual Plate Fees Received From State S 21,426
Interest Earned on Fees S 1.591
Total Available for Distribution by the County S 56,333
Annual Fees Distributed to Agencies S 30.000
Interest Earned by Agency on Fees S 10
Total Available for Agency Expenditures S 26,333
Annual Plate Fee Expenditure by Agencies
Primary: Women Infants Total
Clothing S 1,100 S 1,100
Housing S 9,265 S 9,265
Medical Care S 3,430 S 3,430
Food S 1,300 S 1,300
Utilities S 997 S 997
Transportation S 167 S 167
Other Material Needs S -
Total Primary Expenditures S 16,259
Total Primary and Secondary Expenditures
Primary expenses as a % of total Expenditures
Secondary expenses as a % cftotal Expenditures
Percentage of Distributed Fees Utilized
Amount Returned by Agency (if any) to County
Amount Retained by Agency (if any)
County Fiscal Year Ending Balance
Secondary: Women Infanls Total
Counseling S 1,387 $ 1,387
Training
Advertising
Adoption S - $ -
Total Secondary Expenditures $ 1,387
s
17,646
92.14%
7.86%
58.82%
s
s
16,361
26,333
We certify that all reciP"rf agencies and the c~unty have complied with the Florida 5talutes, 320.08056 and 320 08058.(29)
// /, i ... il
,I, ,~, .,; A' ~12/2010
Donna Fia~~,thairman ';.)". !." Date
~ _ . . ",~A,
Board of County' ~ommis~j,9.ne~"
~f~~
i lQ.Raturl/ .
~Q.0A.m ~@A^- 0
Approved as to form and Legal Sufficiency
Assistant County Attorney