Backup Documents 04/27/2010 Item #16D 6T
ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 16 D b
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 sumanne. draw a Iin, thrnu rh r-Am. li a "I n..,.,,..�, un ..,..... 1i .h _,__1.n-. __ I . _ ,. . -. ,.. .._.
Route to Addressee(s)
List in routing order
Office
Initials
Date
1. Terri Daniels
Housing and Human Services
Dept.
Initial)
4/28/2010
2.
April 27, 2010
Agenda Item Number
16D6
3.
signed by the Chairman, with the exception of most letters, must be reviewed and signed
4.
Agreement — Community Care for the
Number of Original
3
5. Ian Mitchell, Manager BCC
Board of County Commissioners
Documents Attached
%
9' ►2$(,0
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 /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
Terri Daniels
Phone Number
252 -2689
Contact
appropriate.
Initial)
Applicable)
Agenda Date Item was
April 27, 2010
Agenda Item Number
16D6
Approved by the BCC
signed by the Chairman, with the exception of most letters, must be reviewed and signed
Type of Document
Agreement — Community Care for the
Number of Original
3
Attached
Elderly..- CCE.203.09 Amend #2
Documents Attached
INSTRIWTIONC R. (-ARr'kt 1QT
1: 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)
Applicable)
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,
CW
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.
7
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. Bea ar of your deadlines!
6.
The document was approved by the BCC on L 0 (enter date) and all changes
made during the meeting have been incorporat 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 W WS Original 9.03.04, Revised 1.26.05, Revised 2.24.05
160 6
MEMORANDUM
Date: April 28, 2010
To: Terri Daniels, Grants Supervisor
Human Services Department
From: Martha Vergara, Deputy Clerk
Minutes & Records Department
Re: Contract # #HCE 203.09 Amendment #2
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 #002 Contract HCE 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 Court v Board of Commissioners hereinafter
referred to as the "recipient ", amends agreement #HCE 203.09.
The purpose of this amendment is to:
1. Increase Subsidies by $5,000, 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.
Collier County Housing
RECIPIENT: and Human Services AGENCY: Area Agency on Aging for
By: Board of County
.Commissioners of Collier Southwest Florida, Inc.
C nt y, $tjorda)
SIGNED BY:' SIGNED BY:
NAME: Fred Coyle
TITLE: Chairman
DATE: April 27, 2010
FEDERAL ID NUMBER: 59- 6000558
FISCAL YEAR -END DATE: 9/30
Approved as to form & legal sufficiency
CyPPv�_ 2p-r o__
Colleen Greenc,
Assistant. County t�ttorney
ATTEST`.
DWIGIJTT}E..� �SROOGK Chili
419"Um on -to
NAME: Naomi Manning
TITLE: Board President
DATE: _ April 9, 2010
Pi
16D 6
Amendment #002 Contract HCE 203.09
ATTACHMENT III
EXHIBIT 1
1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS AGREEMENT
CONSIST OF THE FOLLOWING:
E RAM TITLE FUNDING SOURCE CFDA AMOUNT ERAL 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:
MATCHING RESOURCES FOR FEDERAL PROGRAMS
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL STATE AWARD
STATE FINANCIAL ASCrcTAn1ry clturcrm m. o__
PROGRAM TITLE
FUNDING SOURCE
CFDA
AMOUNT
Home Care for the Elderly
Pro ram - Collier
General Revenue
65001
$90,066.00
TOTAL AWARD
$90,066.00
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO
THIS AGREEMENT ARE AS FOLLOWS:
2
Amendment #002
160 6
Contract HCE 203.09
ATTACHMENT VII
HOME CARE FOR THE ELDERLY PROGRAM
BUDGET SUMMARY
Collier County Services for Seniors
I. HCE Subsidies $83,493.00
2. HCE Case Management $ 6,573.00
3. Total $90,066.00
16D 6
Attestation Statement
Agreement/Contract Number —ACE 203.09
Amendment Number 2
I, Fred Co 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.
an
Signature of Recipient/Contractor representative
Approved as to form and
Legal sufficiency
Assistant Co my Attorney
Revised April 2010
04/27/10
Date
,ATTEST:
OW16HT E. SROCi<,
By:
West of to
l