Backup Documents 04/27/2010 Item #16D 2ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 Q 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
exception of the Chairman's simatu... drawn line th.nnnh rni,n "o limo— it IT, ., ..... h se 1. +k. ....
Route to Addressee(s)
List in routing order
___... .._._..., ., __.. ._._..._. ............... ....................
Office
w., I Hwkn
Initials
"un, n".
Date
1. Terri Daniels
Housing and Human Services
Dept.
Agenda Item Number
4/28/2010
2. Ian Mitchell, Manager BCC
Board of County Commissioners
41Zfl'�p
3. Minutes and Records
Clerk of Court's Office
Number of Original
(6) 3 copies for each
4.
Amend #3 m
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 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
Contact
Terri Daniels
Phone Number
252 -2689
Agenda Date Item was
April 27, 2010
Agenda Item Number
16D2
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 #3 m
Documents Attached
agreement
Home Care or the Elderly HCE 203.09
Amend #2
INSTRUCTIONS & CHF.CK1JRT
I: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip W WS 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
ApplicableL
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,
cjnG-
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 of our deadlines!
6.
The document was approved by the BCC on (enter date) and all changes
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 W WS Original 9.03.04, Revised 1.26.05, Revised 2.24.05
16D 2
MEMORANDUM
Date: April 28, 2010
To: Terri Daniels, Grants Supervisor
Human Services Department
From: Martha Vergara, Deputy Clerk
Minutes & Records Department
Re: Contract # #CCE. 203.09 Amendment #3
Attached, please find three originals as referenced above (Agenda
Item #16D2), approved by the Board of County Commissioners on
Tuesday, April 27, 2009.
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.
160
Amendment #003 Contract CCE 203.09
STANDARD CONTRACT
AREA AGENCY ON AGING
Collier County Board of Commissioners
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:
1. Increase the Spending Authority by $60,000, and
2. Revise the Attachment III, Exhibit -1 and Budget Summary, Attachment VII.
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
IN WITNESS WHEREOF, the parties hereto have caused this 3 page amendment to be executed
by their officials there unto duly authorized.
ATTEST:
DWIGHT E. BROCK,.Clerk
B`
•iout" go-to
Approved as to form and
legal sufficiency /
Assistant County Attorney
FEDERAL ID NUMBER: 59- 60000558
FISCAL YEAR -END DATE: 9/30
BOARD OF COUNTY COMMISSIONERS
COLLIER C UNTY, FLORIDA
By: __ fit_ 0 k i."J L, .
FRED COYLE, CHAIRMAN �—
Date: April 27, 2010
AREA AGENCY ON AGING FOR
SOUTHWEST FLORIDA
NAOMI MANNING, BOARD PRESIDENT
Date: April 27, 2010
2
Amendment #003
1w
Contract CCE 203.09
ATTACHMENT III
EXHIBIT 1
1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS
AGREEMENT CONSIST OF THE FOLLOWING:
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL FEDERAL AWARD
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED
PURSUANT TO THIS AGREEMENT ARE AS FOLLOWS:
2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS AGREEMENT
CONSIST OF THE FOLLOWING:
MIAs LHINU KESUUKCES FOR FEDERAL PROGRAMS
PROGRAM TITLE FUNDING SOURCE CFDA AM011NT
� TOTAL STATE AWARD
STATE FINANCIAL. A4NKTA WCR cnutvrm mn v.._ �.
PROGRAM TITLE
FUNDING SOURCE
CFDA
AMOUNT
Community Care for the
Elder) - Collier
General Revenue/TSTF
65010
$715,478.00
TOTAL AWARD
$715,478.00
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED
PURSUANT TO THIS AGREEMENT ARE AS FOLLOWS:
2
z
Amendment #003
160
Contract CCE 203.09
COMMUNITY CARE FOR THE ELDERLY PROGRAM
BUDGET SUMMARY
Collier County Housing and Human Services
1. CCE Spending Authority
2. Lead Agency Services - (CM, CA, Intake)
3. Lead Agency Operations
3. Total
I
ATTACHMENT VII
$503,156.00
$114,000.00
$98,322.00
$715,478.00
2
160 2
Attestation Statement
Agreement/Contract Number CCE 203.09
Amendment Number 3
I, Fred C" oy le 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.
'A "k ('.), (,-,
irman
Signature of Recipient/Contract r representative
Approved as to form and
Legal sufficiency
Assistant County Attorney
Revised April 2010
04/27/10
Date
_ „S r
BROM Cferk
16D 2
MEMORANDUM
Date: April 28, 2010
To: Terri Daniels, Grants Supervisor
Human Services Department
From: Martha Vergara, Deputy Clerk
Minutes & Records Department
Re: Contract # #CCE. 203.09 Amendment #2
Attached, please find three originals as referenced above (Agenda
Item #16136), approved by the Board of County Commissioners on
Tuesday, April 27, 2009.
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.
16D
Amendment #002
STANDARD CONTRACT Contract CCE 203.09
AREA AGENCY ON AGING
Collier County Board of Commissioners
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; (1) amend paragraph 3.2.4 of Attachment I; and (2) revise
and replace Attachment IX, Invoice Schedule.
The purpose of this amendment is to;
1. Revise Rate Summary, ATTACHMENT VIII effective July 1, 2009
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.
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. 1
Attest, ,D%u *4 s
4iVW,ry oR, a
Approved as to form and
legal sufficiency
fD QppU-}y1 Q9UC1 -t 0
Assistant County Attorney
FEDERAL ID NUMBER: 59- 60000558
FISCAL YEAR -END DATE: 9/30
COLLIER COUNTY HOUSING AND
HUMAN SERVICES
BY:
BOARD OF COUNTY COMMISSIONERS
COLLIER COUNTY, FLORIDA �}
By:
FRED COYLE, CHAIRMAN
Date: April 27, 2010
AREA AGENCY ON AGING FOR
SOUTHWEST FLORIDA
NAOMI MANNING, BOARD PRESIDENT
Date: April 27, 2010
2
16D
Amendment #002 Contract CCE 203.09
ATTACHMENT VIII
COMMUNITY CARE FOR THE ELDERLY PROGRAM
RATE SUMMARY
Collier County
Services
Total Rate
Reimbursement Rate
Case Management
$50.51
$45.45
Case Aide
$26.34
$23.70
C
Chore
$20.00
$18.00
Companion
$20.00
$18.00
EARS
$.83
$.75
EARS Plus
$1.11
$1.00
Enhanced Chore
$30.00
$27.00
Facility Respite (24 hours)
$138.90
$125.00
Homemaking
$20.00
$18.00
Personal Care
$22.22
$20.00
Respite — In Home
$20.00
$18.00
Skilled Nursing
$38.89
$35.00
Adult Day Care
$10.00
$9.00
Spec. Medical Equipment
100% Cost
90 % o Cost
2
2
160 2
Attestation Statement
Agreement/Contract Number CCE 203.09
Amendment Number 2
I, 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.
airman
Signature of Recipient/Contractor representative
Approved as to form and
Legal sufficiency
Assistant Count Attorney
Revised April 2010
04/27/10
Date
ATTEST.
DWIGHT E. 131RIOCK, fork
sy�
art u to am Nadi: