Backup Documents 11/13/2018 Item #16J1 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 J1
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office
at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later
than Monday preceding the Board meeting.
**NEW** ROUTING SLIP
Complete routing lines#1 through#2 as appropriate for additional signatures,dates,and/or information needed. If the document is already complete with the
exception of the Chairman's signature,draw a line through routing lines#1 through#2,complete the checklist,and forward to the County Attorney Office.
Route to Addressee(s) (List in routing order) Office Initials Date
1.
2.
3. County Attorney Office County Attorney Office JAK 11/13/18
4. BCC Office Board of County A�
Commissioners V 1 V‘,\k14\\S.
5. Minutes and Records Clerk of Court's Office it laIci3
PRIMARY CONTACT INFORMATION
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,may need to contact staff for additional or missing information.
Name of Primary Staff Lori Sams,Sheri s Department Phone Number 252-0842
Contact/Department
Agenda Date Item was 11/13/18 Agenda Item Number 16-J-1
Approved by the BCC
Type of Document Equitable Sharing Agreement Number of Original One
Attached Documents Attached
PO number or account n/a
number if document is
to be recorded
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A"in the Not Applicable column ever is Yes N/A(Not
appropriate. (Initial) Applicable)
1. Does the document require the chairman's original signa' - STAMP OK JAK
2. Does the document need to be sent to another agency for ional signatures? If yes, JAK
provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet.
3. Original document has been signed/initialed for legal sufficiency. (All documents to be JAK
signed by the Chairman,with the exception of most letters,must be reviewed and signed
by the Office of the County Attorney.
4. All handwritten strike-through and revisions have been initialed by the County Attorney's JAK
Office and all other parties except the BCC Chairman and the Clerk to the Board
5. The Chairman's signature line date has been entered as the date of BCC approval of the JAK
document or the final negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's JAK
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this ,ice
routing slip should be provided to the County Attorney Office at the time the item is
input into MinuteTraq. 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 your deadlines!
8. The document was approved by the BCC on 11/13/18 and all changes made during JAK N/A is not
the meeting have been incorporated in the attached document. The County an option for
Attorney's Office has reviewed the changes,if applicable. �,�
9. Initials of attorney verifying that the attached document is the version approved by Oe . /A's not
BCC,all changes directed by the BCC have been made,and the document is ready or e option for
Chairman's signature. thisline.
[04-COA-01081/1344830/I]I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05;
Revised 11/30/12
1 6 J 1
MEMORANDUM
Date: November 15, 2018
To: Lori Sams,
Collier County Sheriff's Office
From: Teresa Cannon, Senior Deputy Clerk
Board Minutes & Records Department
Re: Equitable Sharing Agreement and Certification
Attached for your reference is an original as referenced above, (Item #16J1)
approved by the Collier County Board of County Commissioners on Tuesday,
November 13, 2018.
If our office can be of any further assistance, feel free to call 239-252-8411.
Thank you.
Attachment
1 6 J1
OMB Number 1123-0011
Exp res January 31.2018.
. Equitable Sharing Agreement and Certification
ijt.
,•`7S4r
NCIC/ORI/Tracking Number: FLO110000
Agency Name:Collier County Sheriffs Office Type: Sheriffs Office
Mailing Address: 3319 E. Tamiami Trail
Naples, FL 34112
Finance Contact
Name: Sams, Lori
Phone:2392520842 Email:Lori.Sams@colliersheriff org
ESAC Preparer
Name: Sams, Lori
Phone:2392520842 Email:Lori.Sams@colliersheriff org
FY End Date: 09/30/2018 Agency FY 2019 Budget: $187,203,400.00
Annual Certification Report
Summary of Equitable Sharing Activity Justice Funds 1 Treasury Funds 2
1 Begining Equitable Sharing Fund Balance $292,800.55 $441,025.50
(Must match Ending Balance from prior FY)
2 Equitable Sharing Funds Received $0 00 $0 00
3 Equitable Sharing Funds Received from Other Law $0,00 $0 00
Enforcement Aaencies and Task Force(Complete Table Bi
4 Other Income $0.00 $0.00
5 Interest Income $2,254.30 $3,67327
6 Total Equitable Sharing Funds Received(total of lines 1-5) $295,054.85 $444,698.77
7 Equitable Sharing Funds Spent(total of lines a-n below) $44,265.17 $0.00
8 Ending Equitable Sharing Funds Balance $250,789.68 $444,698.77
(difference between line 7 and line 6)
1Department of Justice Asset Forfeiture Program participants are FBI DEA.ATF USPIS,USDA DCIS,DSS and FDA
2Department of the Treasury Asset Forfeiture Program participants are IRS ICE,CBP and USSS
Summary of Shared Funds Spent Justice Funds Treasury Funds
a Law enforcement operations and investigations $0.00 $0.00
b Training and education $0.00 $0.00
c Law enforcement, public safety and detention facilities $0.00 $0.00
d Law enforcement equipment $44,265.17 $0.00
e Joint law enforcement/public safety operations $0.00 $0.00
f Contracting for services $0.00 $0.00
g Law enforcement travel and per diem $0.00 $0.00
h Law enforcement awards and memorials $0.00 $0.00
i Drug, gang and other education or awareness programs $0.00 $0.00
j Matching grants (Complete Table C) $0.00 $0.00
k Transfers to other participating law enforcement $0.00 $0.00
aaencies(Complete Table Dr
I Support of community-based programs(complete Table E) $0.00
m Non-categorized expenditures(Complete Table F) $0.00 $0.00
n Salaries(Complete Table 0) $0.00 $0.00
Total $44,265 17 $0.00
Date Printed: 10/19/2018 Page 1 of 4 February 2016
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Table B:Equitable Sharing Funds Received From Other Agencies
Transferring Agency Name Justice Funds Treasury Funds
Table C: Matching Grants
Matching Grant Name Justice Funds Treasury Funds
Table D:Transfers to Other Participating Law Enforcement Agencies
Receiving Agency Name Justice Funds Treasury Funds
Table E: Support of Community-based Programs
Recipient Justice Funds
Table F: Non-categorized expenditures in(a)-(n)Above
Description Justice Funds Treasury Funds
Table G: Salaries
Salary Type Justice Funds ( Treasury Funds
Paperwork Reduction Act Notice
Under the Paperwork Reduction Act, a person is not required to respond to a collection of information unless it displays a valid
OMB control number. We try to create accurate and easily understood forms that impose the least possible burden on you to
complete.The estimated average time to complete this form is 30 minutes. If you have comments regarding the accuracy of
this estimate, or suggestions for making this form simpler, please write to the Asset Forfeiture and Money Laundering Section.
1400 New York Avenue, N.W., Washington, DC 20005.
Did your agency purchase any controlled equipment? 0 YES ® NO
Date Printed:10/19/201 t6 Page 2 of 4 February 2016
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Affidavit
Under penalty of perjury, the undersigned officials certify that they have read and understand their obligations under the
Equitable Sharing Agreement and that the information submitted in conjunction with this Document is an accurate
accounting of funds received and spent by the Agency under the Guide during the reporting period and that the recipient Agency
is compliant with the National Code of Professional Conduct for Asset Forfeiture.
The undersigned certify that the recipient Agency is in compliance with the applicable nondiscrimination requirements of the
following laws and their implementing regulations:Title VI of the Civil Rights Act of 1964 (42 U.S.C. § 2000d et seq.), Title IX of
the Education Amendments of 1972 (20 U.S.C. § 1681 et seq.), Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. §794),
and the Age Discrimination Act of 1975 (42 U.S.C. §6101 et seq.),which prohibit discrimination on the basis of race, color,
national origin, disability,or age in any federally assisted program or activity, or on the basis of sex in any federally assisted
education program or activity. The Agency agrees that it will comply with all federal statutes and regulations permitting federal
investigators access to records and any other sources of information as may be necessary to determine compliance with civil
rights and other applicable statutes and regulations.
Equitable Sharing Agreement
This Federal Equitable Sharing Agreement, entered into among (1)the Federal Government, (2)the above-stated law
enforcement agency ("Agency"), and (3)the governing body, sets forth the requirements for participation in the federal Equitable
Sharing Program and the restrictions upon the use of federally forfeited cash, property, proceeds,and any interest earned
thereon,which are equitably shared with participating law enforcement agencies. By submission of this form, the Agency
agrees that it will be bound by the statutes and guidelines that regulate shared assets and the following requirements for
participation in the Department of Justice and Department of the Treasury Equitable Sharing Programs. Receipt of the signed
Equitable Sharing Agreement and Certification(this"Document")is a prerequisite to receiving any equitably shared cash,
property, or proceeds.
1. Submission.This Document must be submitted within 60 days of the end of the Agency's fiscal year.This Document must
be signed and submitted electronically. Electronic submission constitutes submission to the Department of Justice and the
Department of the Treasury.
2.Signatories.This agreement must be signed by the head of the Agency and the head of the governing body. Examples of
Agency heads include police chief, sheriff, director, commissioner, superintendent, administrator, city attorney, county attorney,
district attorney,prosecuting attorney, state attorney, commonwealth attorney, and attorney general. The governing body's head
is the head of the agency that appropriates funding to the Agency. Examples of governing body heads include city manager,
mayor, city council chairperson,county executive, county council chairperson, administrator, commissioner, and governor. The
governing body head cannot be from the law enforcement agency and must be from a separate entity.
3. Uses.Any shared asset shall be used for law enforcement purposes in accordance with the statutes and guidelines that
govern the Department of Justice and the Department of the Treasury Equitable Sharing Programs as set forth in the current
edition of the Guide to Equitable Sharing for Slate and Local Law Enforcement Agencies(Guide).
4.Transfers. Before the Agency transfers funds to other state or local law enforcement agencies, it must first verify with the
Department of Justice that the receiving agency is a compliant Equitable Sharing Program participant.Transfers of tangible
property are not permitted.
5.Internal Controls.The Agency agrees to account separately for federal equitable sharing funds received from the
Department of Justice and the Department of the Treasury. Funds from state and local forfeitures,joint law enforcement
operations funds, and other sources must not be commingled with federal equitable sharing funds.
The Agency certifies that funds are maintained by the jurisdiction maintaining appropriated funds and agrees that such
accounting will be subject to the standard accounting requirements and practices employed by the Agency's jurisdiction in
accordance with the requirements set forth in the current edition of the Guide, including the requirement to maintain relevant
documents and records for five years.
The misuse or misapplication of shared resources or supplantation of existing resources with shared assets is prohibited.The
Agency must follow its jurisdiction's procurement policies when expending shared funds. Failure to comply with any provision of
this agreement shall subject the recipient agency to the sanctions stipulated in the current edition of the Guide.
6.Audit Report.Audits will be conducted as provided by the Single Audit Act Amendments of 1996 and OMB Super Circular,
Date Printed:10/19/2018 Page 3 of 4 February 2016
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Uniform Administrative Requirements, Costs Principles, and Audit Requirements for Federal Awards. The Department of Justice
and the Department of the Treasury reserve the right to conduct periodic random audits or reviews.
7. Freedom of Information Act. Information provided in this Document is subject to the FOIA requirements of the Department
of Justice and the Department of the Treasury.
During the past fiscal year: (1) has any court or administrative agency issued any finding,
judgment, or determination that the Agency discriminated against any person or group in
violation of any of the federal civil rights statutes listed above; or(2) has the Agency entered into
any settlement agreement with respect to any complaint filed with a court or administrative
agency alleging that the Agency discriminated against any person or group in violation of any of
the federal civil rights statutes listed above?
❑ Yes ® No
Agency Head
Name:Rambosk, Kevin J.
Title: Sheriff
Email:hq@colliersheriff_net
.?C
Signature:
i Date: 7,7- `
To the best of myr ledge a d belief,the information provided on this form Is true and accurate and has been reviewed and authorized by the Law
Enforcement Agency Head whose name appears above Entry of the Agency Head name above indicates his/her acceptance of and agreement to abide
by the policies and procedures set forth In the Guide to Equitable Shanng for State and Local Law Enforcement Agencies,including ensuring
permissibility of expenditures and following all required procurement policies and procedures.Entry of the Agency Head name above also indicates
his/her acceptance of and agreement to abide by requirements set forth in this Equitable Sharing Agreement,and any policies or procedures issued by
the Department of Justice or the Department of the Treasury related to the Asset Forfeiture or Equitable Sharing programs The Law Enforcement Head
also certifies that no items on the Prohibited list,as detailed in"Recommendations Pursuant to Executive Order 13688",were purchased with equitable
sharing funds on or after October 1,2015.
Governing Body Head
Name: Solis,Andy
Title: Chairman
Email: Andy.Solis oilier ntyfl.gov
Signature 9 Date: \_
To the best of my knowledge and belief,the agency's current fiscal year budget reported on this form is true and accurate and the Governing Body Head
whose name appears above certifies that the agency's budget has not been supplanted as a result of receiving equitable sharing funds.Entry of the
Governing Body Head name above indicates his/her acceptance of and agreement to abide by the policies and procedures set forth in the Guide to
Equitable Sharing for State and Local Law Enforcement Agen es th's Equitable Sharing Agreement,and any policies or procedures Issued by the
Department of Justice or the Department of the Treasury related to the Asset Forfeiture or Equitable Sharing Programs.
123'1 certify that I am authorized to submit this form on behalf of the Agency Head and the Governing Body Head.
fATTEST: , ! {
CRY L K. KINZEL LERK Approved as toform and legality
to ;
_«! - l �as"ti uty Clerk
/'``` `" _,,• Jeffrey A. KlatzKow, County Attorney
Date Printed:10/19/2018 Page 4 of 4 February 2016
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