Backup Documents 09/28/2010 Item #16D 5ORIGINAL DOCUMENTS IGIN DOCUMENTS SENT TO
1605
TO ACCOMPANY
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
1' h h "- lines #1 throu h #4 co ]etc the checklist, and forward to Sue Filson line #5).
exception of the Chairman s si ature, draw a met rou
Route to Addressee(s)
ro
Office
Initials
Date
(List in routing order)
1. Terri Daniels
Housing and Human Services
(Initial)
10 /1 /10
2.
September 28, 2010
Agenda Item Number
16D5
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
t ID/
(
Attached 1
1 2009
1 Documents Attached
' O
5. 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
I LGI11.)
Name of Primary Staff
Terri Daniels
Phone Number
252 -2689
Contact
appropriate.
(Initial)
Applicable)
Agenda Date Item was
September 28, 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
Choose Life License Plate reports 2005-
Number of Original
5
Attached 1
1 2009
1 Documents Attached
INSTRUCTIONS & CHECKLIST
I: 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
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,
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.
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Office and all other parties except the BCC Chairman and the Clerk to the Board
3.
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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
si nature 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_a&a of your deadlines!
6.
The document was approved by the BCC on (enter date) and all changes .,
made during the meeting have been incorporate Til the attached document. The
County Attorne 's Office has reviewed the changes, if applicable.
I: 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: October 5, 2010
To: Terri Daniels, Grants Supervisor
Housing, Human & Veteran Services
From: Ann Jennejohn, Deputy Clerk
Minutes & Records Department
Re: Florida's Department of Highway Safety & Motor
Vehicles 2005 -2009 Annual Reports for the
"Choose Life" Specialty License Plate
Attached are the original documents referenced above (Item #16D5),
approved by the Board of County Commissioners September 28, 2010.
Copies of the reports will be on file in the Minutes and Record's Department
with the Board's Official Records.
If you have any questions, please feel free to call me at 252 -8406.
Thank you.
Attachment
1605
ANNUAL CHOOSE LIFE SPECIALTY LICENSE PLATE AFFIDAVIT TO DHSMV BY COUNTY
County COLLIER
Fiscal Year Ending
County Prior Year Ending Balance
Annual Plate Fees Received From State
Interest Earned on Fees
Total Available for Distribution by the County
Annual Plate Fees Distributed to Agencies
Amount Retained by Agency from Previous Year
Total Available for Agency Expenditures
Primary:
Women
Infants
Total
Clothing
300.00
300.00
Housing
3,744.00
3,744.00
Medical Care
21.00
21.00
Food
645.00
645.00
Utilities
150.00
150.00
Transportation
143.04
143.04
Other Material Needs
0.00
Total Primary Expenditures
$ 5,003.04
Total Primary and Secondary Expenditures
Primary expenses as a % of total Expenditures
Secondary expenses as a % of total Expenditures
Percentage of Distributed Fees Utilized
Amount Returned By Agency (if any) to County
Amount Retained by Agency (if any)
County Fiscal Year Ending Balance
2008
$ 0.00
$ 0.00
$ 1,144.00
$ 1,144.00
$ 24,616.56
$ 24,616.56
Secondary:
Women
Infants
Total
Counseling
2,698.00
2,698.00
Training
0.00
Advertising
0.00
Adoption
0.00
Total Secondary Expenditures
$ 2,698.00
$ 7,701.04
65 %
35 %
31 %
$ 16,915.52
$ 0.00
$ 18,059.52
We certify that all recipient agencies and the County have complied with Florida Statutes, 320.08056 and
320.08058(30).
Q/28!10
Chair, Board of County Commissi rs Date
Ap s to form and legal sufficiency:
Revised January 2010 ' -
Jeffre Klatzkow
County torney
AWHTE.8R6QK# T:
CLERK
�aAl
Dep Cle
#;tut
1605
ANNUAL CHOOSE LIFE SPECIALTY LICENSE PLATE AFFIDAVIT TO DHSMV BY COUNTY
County COLLIER
Fiscal Year Ending
County Prior Year Ending Balance
Annual Plate Fees Received From State
Interest Earned on Fees
Total Available for Distribution by the County
Annual Plate Fees Distributed to Agencies
Amount Retained by Agency from Previous Year
Total Available for Agency Expenditures
Zdmay;
Women
Infants
Total
Clothing
600.00
600.00
Housing
5,006.74
5,006.74
Medical Care
7,990.16
7,990.16
Food
900.00
900.00
Utilities
426.36
426.36
Transportation
395.18
395.18
Other Material Needs
0.00
Total Primary Expenditures 1
$ 15,318.44
Total Primary and Secondary Expenditures
Primary expenses as a % of total Expenditures
Secondary expenses as a % of total Expenditures
Percentage of Distributed Fees Utilized
Amount Returned By Agency (if any) to County
2007
$ 26,326.00
$ 0.00
$ 1,132.00
$ 27,458.00
$ 27,458.00
$ 16,251.00
$ 43,709.00
Secondary:
Women
Infants
Total
Counseling
3,774.00
3,774.00
Training
0.00
Advertising
0.00
Adoption
0.00
Total Secondary Expenditures
$ 3,774.00
$ 19,092.44
80 %
20 %
44 %
/o
Amount Retained by Agency (if any) $ 24,616.56
County Fiscal Year Ending Balance $ 0.00
We certify that all recipient agencies and the County have complied with Florida Statutes, 320.08056 and
320.08058(30).
Y s
9/28/10
Chair, Board of County Commissioners Date
ATf EU:
Revised January 2010 Appr s to form and legal sufficiency: D ..1 0TE..BR0CK, CA,`.F' K
Jeffre A. latzkow
v4 .-44wo
County A rney Deputkcler4
�et«c u a tn� s
16D5
ANNUAL CHOOSE LIFE SPECIALTY LICENSE PLATE AFFIDAVIT TO DHSMV BY COUNTY
County Prior Year Ending Balance
Annual Plate Fees Received From State
Interest Earned on Fees
Total Available for Distribution by the County
Annual Plate Fees Distributed to Agencies
Amount Retained by Agency from Previous Year
Total Available for Agency Expenditures
County COLLIER
Fiscal Year Ending
2005
Infants
$
61,007.00
1,964.00
$
21,329.00
Housing
$
980.00
$
83,316.00
$
50,007.00
$
0.00
$
50,007.00
Wmuyu
Women
Infants
Total
Clothing
1,964.00
1,964.00
Housing
15,445.00
15,445.00
Medical Care
14,687.00
14,687.00
Food
3,797.00
3,797.00
Utilities
1,063.00
1,063.00
Transportation
501.00
501.00
Other Material Needs
0.00
Total Primary Expenditures
$ 37,457.00
Total Primary and Secondary Expenditures
Primary expenses as a % of total Expenditures
Secondary expenses as a % of total Expenditures
Percentage of Distributed Fees Utilized
Amount Returned By Agency (if any) to County
Amount Retained by Agency (if any)
County Fiscal Year Ending Balance
Secondary:
Women
Infants
Total
Counseling
2,081.00
2,081.00
Training
0.00
Advertising
0.00
Adoption
6,572.00
6,572.00
Total Secondary Expenditures
$ 8,653.00
$ 46,110.00
81.2 %
18.8
92.2 %
$ 0.00
$ 3,897.00
$ 33,309.00
We certify that all recipient agencies and the County have complied with Florida Statutes, 320.08056 and
320.08058(30).
L! 9/28/10
Fred Coyle, Chair, Board of County Comrrlissioners Date
Revised January 2010 AppNyjAjj=fonn and legal sufficiency:
dqwx
JeffreyApatzkow
County Mtomey
Mmff1 :80O' CK, CLERK.
1 /1 i
16D5
ANNUAL CHOOSE LIFE SPECIALTY LICENSE PLATE AFFIDAVIT TO DHSMV BY COUNTY
County Prior Year Ending Balance
Annual Plate Fees Received From State
Interest Earned on Fees
Total Available for Distribution by the County
Annual Plate Fees Distributed to Agencies
Amount Retained by Agency from Previous Year
Total Available for Agency Expenditures
County COLLIER
Fiscal Year Ending 2006
$ 33,309.00
$ 21,426.00
$ 1,591.00
$ 56,326.00
$ 30,000.00
$ 3,897.00
$ 33,897.00
Primary:
Women
Infants
Total
Clothing
1,100.00
1,100.00
Housing
9,265.00
9,265.00
Medical Care
3,430.00
3,430.00
Food
1,300.00
1,300.00
Utilities
997.00
997.00
Transportation
167.00
167.00
Other Material Needs
0.00
Total Primary Expenditures
$ 16,259.00
Total Primary and Secondary Expenditures
Primary expenses as a % of total Expenditures
Secondary expenses as a % of total Expenditures
Percentage of Distributed Fees Utilized
Amount Returned By Agency (if any) to County
Amount Retained by Agency (if any)
County Fiscal Year Ending Balance
Secondary:
Women
Infants
Total
Counseling
1,387.00
1,387.00
Training
0.00
Advertising
0.00
Adoption
0.00
Total Secondary Expenditures
$ 1,387.00
$ 17,646.00
92.1 %
7.86 %
52.1
$ 16,251.00
$ 26,326.00
We certify that all recipient agencies and the County have complied with Florida Statutes, 320.08056 and
320.08058(30),,'— tt yy
9/28/10
Fred Coyle, Chair, Board of County Commis i ners Date
Revised January 2010 e
Appro to form and legal sufficiency:
Jeffrey 1k. Wratzkow
County Attorney
NOTE _
CROCK, CLERK
.,
S
wt 14 , I
flli�i M1'
16D5
ANNUAL CHOOSE LIFE SPECIALTY LICENSE PLATE AFFIDAVIT TO DHSMV BY COUNTY
County Prior Year Ending Balance
Annual Plate Fees Received From State
Interest Earned on Fees
Total Available for Distribution by the County
Annual Plate Fees Distributed to Agencies
Amount Retained by Agency from Previous Year
Total Available for Agency Expenditures
County COLLIER
Fiscal Year Ending 2009
$ 18,059.52
$ 0.00
$ 290.00
$ 18,349.52
$ 15,974.00
$ 0.00
$ 15,974.00
primary:
Women
Infants
Total
Clothing
600.00
600.00
Housing
5,196.99
5,196.99
Medical Care
4,726.08
4,726.08
Food
2,050.00
2,050.00
Utilities
380.54
380.54
Transportation
1,423.00
1,423.00
Other Material Needs
0.00
Total Primary Expenditures
$ 14,376.61
Total Primary and Secondary Expenditures
Primary expenses as a % of total Expenditures
Secondary expenses as a % of total Expenditures
Percentage of Distributed Fees Utilized
Amount Returned By Agency (if any) to County
Amount Retained by Agency (if any)
County Fiscal Year Ending Balance
Secondary:
Women
Infants
Total
Counseling
0.00
Training
0.00
Advertising
0.00
Adoption
0.00
Total Secondary Expenditures
$ 0.00
$ 14,376.61
100
0 %
90 %
/o
$ 1,597.39
$ 2,375.52
We certify that all recipient agencies and the County have complied with Florida Statutes, 320.08056 and
320.08058(30).,_
v)sz X28/19
o
Fred Coyle, Chair, Board of County Commiss ers Date
ATTEST',
1DWI9HT E. BROCK CLERK
J
D
Appray orm and legal sufficiency:
Revised January 2010
Jeffrey Wratzkow
County Attorney