Backup Documents 09/14/2010 Item #16D 5ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 160
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print oil pink documents are to paper Attach to original
Boa d Office only after documents Should taken hand delivered to the
)Board Office. The completed routing slip attd original
ROUTING SLIP
Complete routing lines NI through 14 as appropriate for additional signatures, dates, and/or information needed. If the document is already complete with the
exception of the Chairman's si afire, draw a line throu h routin lines 91 throw h 44, complete the checklist, and forward to Ian Mitchell Date )
Route to Addressee(s)
Office Initials
(List in routin order)
County Attorney
1. Jennifer White Q J
2.Ian Mitchell, Executive Manager Board of County Commissioners
3. Minutes and Records Clerk of Corn is Office
4. —
5.
6. _
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 tam Mitchell, need to contact smtF for additional or missing
information. All original documents needing the BCC Chairman's signature are to be delivered to the 13CC office only after the BCC has acted to approve the
item.
_. _�.....___. e..,tr candra Marrero. Grants Coordinator Phone Number 252 -239
3a Date Item was
rved by the BCC
of Document
September 14, 2010
Contract
or
Item
Number
& CHECK-LISI
column, whichever is Yes N/A (Not
a to JllmUr.
1. Original document signed initialed for legal sufficiency. (All documents to e
signed by the Chth the exception of most letters, must be reviewed and signedby the Office of t Attorney. This includes signature pages from ordinances, resolutions, etc. he County Attorney's Office and signature pages from contracts, agreemthat have been fully executed by all parties except the BCC Chairman and CBoard and ossibly State Officials.)
2. All handwritten strike - through and revisions have been initialed by the County Attomey
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 titc date of BCC approval of the
document or the final negotiated contract date whichever is applicable.
t a yes indicating where the Chairman's
NA
4. "Sign here" tabs are placed on the approprta e p b
si afire and in are re tired.
Tsome cases (some contracts are an exception), the o riginal document and this routing slip Ne provided to Sue Filson in the BCC office within 24 hours of BCC approval.
ocuments are time sensitive and require forwarding to Tallahassee within a certain
me or the BCC's actions are nullified. Be aware of our deadlines! cument was approved by the BCC on September 14, 2010(enter date) and all SM
s made during the meeting have been incorporated in the attached document.
....... Attnrnev'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
16D
MEMORANDUM
Date: September 24, 2010
To: Sandra Marrero, Grants Coordinator
Human Services Department
From: Martha Vergara, Deputy Clerk
Minutes and Records Department
Re: Contract Amendment
"David Lawrence Mental Health Center Inc."
Attached is an original agreement, referenced above (Agenda Item #16D5)
approved by the Board of County Commissioners on September 14, 2010.
The Minutes and Records Department has kept the original as part of
the Board's Official Records.
If you should have any questions, you may contact me at 252 -7240.
Thank you.
Attachment (1)
16D
EXHIBIT A -1 Contract Amendment # I
"David Lawrence Mental Health Center, Inc."
This Amendment, dated �o��_�rr� �r /Y , 2010 to the referenced Agreement shall
be by and between the parties t6 the original Agreement, David Lawrence Mental Health Center, Inc.
(hereafter referred to as "Sub- Recipient ") and Collier County, a political subdivision of the State of
Florida, (to be referred to as "County ").
Statement of Understanding
RE: Contract # CD09 -05 "David Lawrence Mental Health Center, Inc."
In order to continue the services provided for in the original Agreement document referenced above,
the Sub - Recipient agrees to amend the above referenced Agreement as follows:
Note: Words true�a gn have been deleted; words underlined have been added.
AMENDMENT TO: III. TIME OF PERFORMANCE
The effective date of the Agreement between HUD and Collier County shall be July 1, 2009.
Subrecipients are authorized to incur eligible expenses after that date and prior to execution of this
Agreement subject to HHS prior written approval. The services of the SUBRECIPIENT shall be
undertaken and completed in light of the purposes of this Agreement. In any event, all services
required hereunder shall be completed by the SUBRECIPIENT prior to june 15, 2010 December 31,
2010. Any funds not obligated by the expiration date of this Agreement shall automatically revert to
the COUNTY, as set forth in Section XI below.
AMENDMENT TO: VI. GENERAL CONDITIONS
Paragraph D. SUBCONTRACTS
Any work or services subcontracted by the SUBRECIPIENT shall be specifically by written contract
or agreement, and such subcontracts shall be subject to each provision of this Agreement and
applicable County, State, and Federal guidelines and regulations. Prior to exesution by th
My
This review also includes ensuring that all consultant contracts and fee schedules meet the minimum
standards as established by the Collier County Purchasing Department, Florida Statutes and HUD.
Reimbursements for such services will be made at SUBRECIPIENT cost. Tyne. -. Of a,e .vofk of
AMENDMENT TO: VII. ADMINISTRATIVE REQUIREMENTS
Paragraph E. PRIOR WRITTEN APPROVALS
Exhibit A -1 Contract Amendment NI [CD09 -051
David Lawrence Mental Health Center, Inc.
Page 2 of 3
160
to this A gre ment-
cvtTxiazig+ccxncixr
(24(n All capital equipment expenditures of $1,000 or more;
(-3-)M All out -of -town travel (travel shall be reimbursed in accordance with Chapter 112, Fla. Stat.
unless otherwise required by CD13G);
(4)(D All change orders;
0542 All requests to utilize uncommitted funds after the expiration of this agreement for programs
described in Exhibit "A'; and
(6)LD All rates of pay and pay increases paid out of CDBG funds, whether for merit or cost of living.
AMENDMENT TO: EXHIBIT "A" SCOPE OF SERVICES
Paragraph A. PROJECT SCOPE and Paragraph B. BUDGET
A. PROJECT SCOPE:
The David Lawrence Center proposes to expand their psychiatric services to uninsured low income
Collier County residents who have been diagnosed with mental illness. This funding will provide a
portion of salary and benefits (50 %) of psyehiatrist for multiple David Lawrence psychiatrist and /or
contracted services at contracted rate of $150/hour who will provide psychiatric evaluations /visits,
diagnosis and case management some of which will require follow -up visits to uninsured low income
individuals who have been diagnosed with mental illness. All clients are triaged to determine need
based on routine, urgent, and emergent services. Each of the clients will receive a psychiatric
evaluation from a qualified psychiatrist to determine the best ongoing course of treatment. All eligible
clients will be required to present documented proof of income in accordance with HUD guidelines.
Collier County Department of Housing and Human Services is funding NINETY THREE
THOUSAND DOLLARS ($93,000) with CDBG funds for this Public Services project.
B. BUDGET — Mental Health Counseling Services
Line Item: CDBG Funds
u... st $93,000.00
j0% of Salary and
l3eneftts
Psychiatrist
50% of Salary,
Benefits and /or contracted
Services at $150.00
Total $93,000.00
Any reference in CDBG agreement CD09 -05 which makes reference to Prior Written Approvals
for subcontractors.
All other terms and conditions of the agreement and previous Zero Dollar Change Modifications shall
remain in force.
160
Exhibit A -I Contract Amendment A [CD09 -05]
David Lawrence Mental Health Center, Inc.
Page 3 of 3
IN WITNESS WHEREOF, the Sub - Recipient and the Owner have each, respectively, by an
authorized person or agent, hereunder set their hands and seals on the date(s) indicated below.
A
Accepted this Iffdayfof, 2010.
ATTEST
DWIGHT E. BROCK,CLEaRK
r
t���Pk
First ttness:
Signature
Printed Name and Title
Witness:
Y1r:v� VtSc���
Printed Name and
BOARD OF COUNTY COMMISSIONERS
OF COLLIER COUNTY, FLO A
By:
FRED W. COYLE, CHAIR
DAVID LAWRENCE MENTAL
HEALTH CENTER, INC.
By:
David Schimmel
Chief Executive Officer
Approval for form and legal sufficiency:
Jennifer .W White
Assistant County Attorney
5