Backup Documents 09/14/2010 Item #16D10ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP16 D 10
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. It the document is already complete with the
eendon of the Chairman's sienaure. draw a line throueh routine lines #1 throueh #4. complete the checklist, and forward to Sue Filson (line #5).
Route to Addressee(s)
(List in routing order
Office
Initials
Date
1. Terri Daniels
Housing, Human and Veterans
Services
(Initial)
9/17/10
2.
September 14, 2010
Agenda Item Number
16D 10
3.
signed by the Chairman, with the exception of most letters, must be reviewed and signed
4. Ian Mitchell, Manager
Board of County Commissioners
Number of Original
/l
5. Minutes and Records
Clerk of Court's Office
Documents Attached
PRIMARY CONTACT INFORMATION
(The primary contact is the holder of the original document pending BCC approval. Normally the pri mary 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 B('(" Chairman's signatma 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)
Applica ble
Agenda Date Item was
September 14, 2010
Agenda Item Number
16D 10
Approved by the BCC
signed by the Chairman, with the exception of most letters, must be reviewed and signed
Type of Document
OAA 2010 Agreement— Amendment 41
Number of Original
3
Attached
resolutions, etc. signed by the County Attorney's Office and signature pages from
Documents Attached
INSTRUCTIONS & CHECKLIST
1: Forma/ 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)
Applica ble
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,
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 awa I e of your deadlines!
6.
The document was approved by the BCC on (enter date) and all changes
made during the meeting have been incorpor#W tW the attached document. The
County Attorney's Office has reviewed the cha es, if applicable.
1: Forma/ County Forms/ BCC Forms/ Original Documents Routing Slip W WS Original 9.03.04, Revised 1.26.05, Revised 2 24.05
16D 10
MEMORANDUM
Date: September 23, 2010
To: Terri Daniels, Grants Supervisor
Human Services Department
From: Martha Vergara, Deputy Clerk
Minutes & Records Department
Re: OAA 2010 Agreement — Amendment #1
Attached, please find one (3) original as referenced above (Agenda
Item #16D10), approved by the Board of County Commissioners on
Tuesday, September 14, 2010.
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
16 D 14
Amendment 1 OAA 203.10 Page
STANDARD CONTRACT
AREA AGENCY ON AGING
Collier County Board of Commissioners
This AMENDMENT, entered into by Area Agency on Aging for Southwest Florida. Inc.,
hereinafter referred to as the "Agency," and Collier County Board of County Commissioners,
hereinafter referred to as the "recipient," amends contract OAA 203.10.
The purpose of this amendment is to: (1) amend Paragraph 4 of the Standard Contract due to the
transfer of funds; (2) introduce Paragraph 2.7.4 of Attachment I; (3) amend Paragraph 3.3 of
Attachment I; (4) revise and replace Attachment III, Exhibit I; (5) revise and replace Attachment
V, Certification for Debarment; and (6) revise and replace Attachment VII, Budget Summary.
(1) Paragraph 4 of the Standard Contract is hereby amended to read:
(4) Contract Amount
The agency agrees to pay for contracted services according to the terns and conditions of
this contract in an amount not to exceed $951,138.00 , or the rate schedule, subject to the
availability of funds. Any costs or services paid for under any other contract or from any
other source are not eligible for payment under this contract.
(2) Paragraph 2.7.4 of Attachment I is hereby introduced to read:
2.7.4 Remedies - Nonconforming Services
The recipient shall ensure that all participants served under this agreement are eligible for
the program, and that all monthly and/or quarterly performance reports and financial
records are maintained for each reporting period and submitted as stipulated in 1.4 — 1.4.2
and 2.1 — 2.1.4.1
Any nonconforming program services, performance reports or financial records not
meeting the aforementioned requirements shall not be eligible for reimbursement under
this program. The costs associated with enrolling, training, reporting and/or managing
the program shall be borne solely by the recipient. The agency requires immediate notice
of any significant and /or systemic infractions that compromise the recipient's ability to
provide participant services, to achieve programmatic performance or to provide sound
financial management of the program.
(3) Paragraph 3.3 of Attachment I is hereby amended to read:
3.3 Invoice Submittal and Requests for Payment
All requests for payment and expenditure reports submitted to support requests for payment
shall be on DOEA forms 106A, revised 11/09 (ATTACHMENT IX), and 105AS, revised
11/09 (ATTACHMENT X).
(4) ATTACHMENT III, Exhibit -1 is hereby replaced with the revised ATTACHMENT Ill,
Exhibit -1 and attached hereto.
16D 10
Amendment 1 OAA 203.10 Page 2
(5) ATTACHMENT V, Certification Regarding Debarment is hereby replaced with the
revised ATTACHMENT V, Certification Regarding Debarment and attached hereto.
(6) ATTACHMENT VII, Budget Summary is hereby replaced with the revised
ATTACHMENT VII, Budget Summary and attached hereto.
This amendment shall be effective August 12, 2010.
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 5 page amendment to be executed
by their officials there unto duly authorized.
ATTEST:
DWIGHT E. BROCK, Clerk
By:
Deputy Clerk
A� Gott__--4- to C1+� ire 1
w1J�7 MM +
Approved as to form and
legal sufficiency
BOARD OF COUNTY COMMISSIONERS
COLLIER COUNTY, FLORIDA
By:
Fred W. Coyle, Chairman
Date: RI11two
September 14, 2010
AREA AGENCY ON AGING FOR
SOUTHWEST FLORIDA
By:
Assistant ounty Attorney
Leigh Anna Nowak, Board President
Date:
Federal Tax ID: 59- 6000558
Fiscal Year Ending 9/30
16010
Amendment I OAA 203.10 Page 3
ATTACHMENT III
EXHIBIT -1
1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS
CONSIST OF THE FOLLOWING:
COLLIER COUNTY
Program Title
Year
Funding Source
CFDA /CSFA
Amount
Older Americans Act Title IIIB
2010
U.S. Health and Human
93.044
CA /CM /SCAS /INSC
Services
$ 35,000.00
Transportation
$ 70,000.00
Support Services
$ 256,666.00
Total IIIB
$361,666.00
Title III C1 Congregate Meals
2010
U.S. Health and Human
93.045
Spending Authority
Services
$182,001.00
Title III C2 Home Delivered Meals
2010
U.S. Health and Human
93.045
- Spending Authority
Services
$341,454.00
Older Americans Act Title IIIE
2010
U.S. Health and Human
93.052
$45,513.00
Supplement Services
Services
$ 18,489.00
Grandparent Services
$ 2,015.00
Total IIIE
$66,017.00
TOTAL FEDERAL AWARD:
$951,138.00
16010
Amendment I OAA 203.10 Page 4
ATTACHMENT V
CERTIFICATION REGARDING DEBARMENT, SUSPENSION, INELIGIBILITY AND
VOLUNTARY EXCLUSION FOR LOWER TIER COVERED TRANSACTIONS
(1) The prospective contractor certifies, by signing this certification, neither it nor its principals is presently debarred,
suspended, proposed for debarment, declared ineligible, or voluntarily excluded from participation in this transaction by any
federal department or agency.
(2) Where the prospective contractor is unable to certify to any of the statements in this certification, such prospective
participant shall attach an explanation to this certification.
'^-� September 14, 2010
Signature (— Date
Fred W. Coyle, Chairman Collier County Board of Commissioners
Name /Title Agency /Organization
(Certification signature should be same as Contract signature.)
Instructions for Certification
1. The terms "covered transaction," " debarred," " suspended," " ineligible, "lower tier covered transaction, "person,"
"primary covered transaction," and "voluntarily excluded," as used herein, have the meanings set out in the sections of rules
implementing Executive Order 12549. (2 CFR 180.5- 180.1020, as supplemented by 2 CFR 376.10 - 376.995). You may contact
the Contract Manager for assistance in obtaining a copy of those regulations.
2. This certification is a material representation of facts upon which reliance was placed when the parties entered
into this transaction. If it is later determined that the recipient knowingly rendered an erroneous certification, in addition to
other remedies available to the federal government the Agency may pursue available remedies, including suspension and /or
debarment.
3. The recipient will provide immediate written notice to the Contract Manager if at any time the recipient learns that its
certification was erroneous when submitted or has become erroneous by reason of changed circumstances. The recipient may
decide the method and frequency by which it determines the eligibility of its principals. Each participant to a lower tier covered
transaction may, but is not required to, check the Excluded Parties List System (EPLS).
4. The recipient will include a "Certification Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion -
'Lower Tier Covered Transaction" in all its lower tier covered transactions and in all solicitations for lower tier covered
transactions.
5. The recipient agrees that it shall not knowingly enter into any lower tier covered transaction with a person who is
debarred, suspended, determined ineligible or voluntarily excluded from participation, unless otherwise authorized by the
federal government.
6. If the recipient knowingly enters into a lower tier covered transaction with a person who is suspended, debarred,
ineligible, or voluntarily excluded from participation in this transaction, in addition to other remedies available to the federal
government, the Agency may pursue available remedies, including suspension, and /or debarment.
7. The recipient may rely upon a certification of a prospective participant in a lower tier covered transaction, that is not
debarred, suspended, ineligible, or voluntarily excluded from the covered transaction, unless it knows that the certification is
erroneous.
ATTEST:
DWIGHT E. BROCK, CLERK
DeputyCled
;A6list ii b, pNtt`NY1 '{
3�Y�11iiM'� /AbN
Approved as to form and
legal sufficiency
Assistant County Attorney
Amendment 1
OAA 203.10
OAA BUDGET SUMMARY
RECIPIENT: Collier County Board of Commissioners
16D 10
Page 5
ATTACHMENT Vll
1. Title III B Support Services
$ 361,666.00
2. Title III Cl Congregate Meals
$ 182,001.00
3. Title III C2 Home Delivered Meals
$ 341,454.00
4. Title III E Services
$ 66,017.00
TOTAL
$951,138.00
1b010
Attestation Statement
Agreement/Contract Number OAA 203.10
Amendment Number I
I, Fred W. Coyle, Chairman 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.
1,,J
Signature of Recipient/Contractor rep e entative
Approved as to form and
legal sufficiency
AssistaR County Attorney
September 14, 2010
Date
ATTEST:
DWIGHT E. BROCK, CLERK
Revised April 2010 ' � "M-`"V'"
DeputyCler'
Att&st at to ChajrjM I