Backup Documents 05/11/2010 Item #16D5ORIGINAL DOCUMENTS CHECKLIST & ROUTING SL
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TOT6D 5
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 routine lines #I through #4. complete the checklist and forward to Ian Mitchell
Route to Addressee(s)
(List in routing order)
Office
Initials
Date
1.Colleen Greene
County Attorney
(Initial)
S,1Z.IU
5.Ian Mitchell, Supervisor BCC Office
Board of County Commissioners
Agenda Item Number
�PI3 to
3. Minutes and Records-
Clerk of Court's Office
4.
DCF- Challenge Grant Amendment #2
Number of Original
3
5.
resolutions, etc. signed by the County Attorney's Office and signature pages from
Documents Attached
6.
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 Sue Filson, need 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
Wendy Klopf, Operations Coordinator
Phone Number
252 -2901
Contact
a ro riate.
(Initial)
Applicable)
Agenda Date Item was
May 11, 2010
Agenda Item Number
16D5
Approved by the BCC
signed by the Chairman, with the exception of most letters, must be reviewed and signed
Type of Document
DCF- Challenge Grant Amendment #2
Number of Original
3
Attached I
resolutions, etc. signed by the County Attorney's Office and signature pages from
Documents Attached
INSTRUCTIONS & CHF,CKLIViT
1: 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
a ro riate.
(Initial)
Applicable)
1.
Original document has been signed/initialed for legal sufficiency. (All documents to be
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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,
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
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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
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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
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signature and initials are required.
5.
In most cases (some contracts are an exception), the original document and this routing slip
NA
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 of your deadlines!
6.
The document was approved by the BCC on May 11, 2010(enter date) and all changes
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made during the meeting have been incorporated in the 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 2.24.05
16D5
MEMORANDUM
Date: May 14, 2010
To: Wendy Klopf, Operations Coordinator
Housing & Human Services
From: Ann Jennejohn, Deputy Clerk
Minutes & Records Department
Re: Amendment to Florida's Department of Children &
Families Challenge Grant, changing the administration
of the Homeless Management Information System
Attached are three (3) original copies of the amendment document
referenced above, (Item #16D5) approved by Board of County
Commissioners on May 11, 2010.
After forwarding to the State of Florida for signature, we would
request that an original please be returned to the Minutes and
Records Department for the Board's Official Record.
If you have any questions, please contact me at 252 -8406.
Thank you.
Attachment
16D5
STATE OF FLORIDA
DEPARTMENT OF CHILDREN AND FAMILIES
Amendment #0002
This amendment, entered into between the State of Florida, Department of Children and
Families, hereinafter referred to as °Department', and Collier County Board of County
Commissioners, hereinafter referred to as the "Grantee ", amends Grant # HFZ03 to:
• Amend Grant Language
Challenge Grant Agreement, Page 1, Paragraph 2. is hereby amended as follows:
2. Grantee hereby agrees to perform the tasks and to provide the services described
in the application as described in Attachment I with the following exceptions:
A. With or prior to requesting the first draw, a copy of the Grantee's executed sub -
recipient agreements will be provided to the Department.
B. Beginning May 01, 2010, the Grantee will operate and manage the Homeless
Management Information System (HMIS) as reflected In the Lead Agencies
Continuum of Care. The Grantee will be responsible for all financial obligations to
the Collier County Hunger and Homeless Coalition, Inc. pursuant to this grant up to
and including April 30, 2010 as it relates to HMIS activities performed before May
01, 2010. Any remaining funds subject to this grant for HMIS activities will be used
by the Grantee to manage and operate HMIS.
This amendment shall begin on April 15, 2010, or the date which the amendment has
been signed by both parties, whichever is later.
All provisions in the contract 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 specked in the contract.
This amendment and all of its attachments are hereby made a part of this grant.
IN WITNESS THEREOF, the parties hereto have caused this 1 -page amendment to
be executed by their officials thereunto duly authorized.
PROVIDER: COLLIER COUNTY
BOARD OF COUNTY
COMMIISSIONE7�tk.
SIGNED BY.
PRINT NAME: Fred W. Coyle
PRINT TITLE: Chairman
STATE OF FLORIDA
DEPARTMENT OF CHILDREN AND
FAMILIES
IGNED BY:
PRINT NAME: Harriet A. Coleman
PRINT TITLE: Circuit Administrator
Item # ' (40 57
Agenda
Date
Date
Recd
DATE: 05/11/2010 DATE:
Provider FEID #: 598000558
Page 1 Amendment 0002
Grant # HFZ03
Approved as to form & legal sufficiency
Colleen Greene,
Assistant County Attorney
K ..
`T
A7FTEST
DWIGHT E :::OROOCIt, clerk; '
By: