Backup Documents 01/22/2019 Item #16E4 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 1 6 E a
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 CMG 1/22//19
4. BCC Office Board of County
Commissioners 2_4-\\),'Qk
r of Court's Office o
5. Minutes and Records Clerk qa-t-tIn 3 3
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 Amy Lyberg,Hum Resources Phone Number 252-8460
Contact/Department
Agenda Date Item was 1/22/19 Agenda Item Number 16-E-4
Approved by the BCC
Type of Document Extension—Service Learning 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,whichever is Yes N/A(Not
appropriate. (Initial) Applicable)
1. Does the document require the chairman's original signature STAMP OK CMG
2. Does the document need to be sent to another agency for additional signatures? If yes, CMG
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 CMG
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 CMG
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 CMG
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 CMG
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this CMG
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 1/22/19 and all changes made during the CMG N/A is not
meeting have been incorporated in the attached document. The County Attorney's an option for
Office has reviewed the changes,if applicable. this line.
9. Initials of attorney verifying that the attached document is the version approved by t - /A is not
BCC,all changes directed by the BCC have been made,and the document is ready fi th . . option for
Chairman's signature. - _ is line,
[04-COA-01081/1344830/111: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 E 4
MEMORANDUM
Date: January 24, 2019
To: Amy Lyberg, Director
Human Resources Department
From: Teresa Cannon, Deputy Clerk
Minutes & Records Department
Re: Extension to Service Learning Agreement w/Florida Gulf Coast
University Board of trustees
Attached for your records is a scanned copy of the agreement referenced above
(Item #16E4) approved by the Board of County Commissioners on Tuesday,
January 22, 2019.
The Board's Minutes and Records Department is holding the original document
for the Board's official record.
If you have any questions, please feel free to call me at 252-8411.
Thank you.
Attachment
1 6 E 4
Extension Agreement
between Florida Gulf Coast University Board of Trustees
and the Collier County Board of County Commissioners
2oick
This Extension Agreement, dated=r:,x-wc,` 7,241-5., to shall be by and between Florida Gulf
Coast University Board of Trustees ("FGCU/Contractor") and the Collier County Board of County
Commissioners ("Community Service Agency"), Parties to the Service Learning Agreement dated
January 24,2017.
Statement of Understanding
RE: Service Learning Agreement dated January 24,2017
In order to continue the services provided for in the Service Learning Agreement referenced above, the
Parties agree to extend the Agreement as follows:
I. The Agreement is hereby extended through and including January 24,2020.
2. All other terms and conditions of the Agreement shall remain in full force and effect.
IN WITNESS WHEREOF,the parties have each,respectively,by an authorized person or agent,have
executed this Amendment on the date(s)indicated below.
Accepted:__..c��.xs..R....\ - ,2-0-14
Crystal K.Kinzel,Clerk OWNER:
BOARD * I I Y COM 10 '
OF O 1' ,FLORIDA
Mr, I
b 11i*Clerk +'
{4t.�s� S to ��1N By:
signature on y. /, . L. McDaniel,Jr.,
Chairman
toilov d orm and legali
istant County Attorney
FLORIDA GULF COAST UNIVERSITY
BOARD OF TRUS ES
a
Mitchell L.Cordova,Ph.D.
Vice President,Student Success and Enrollment Management
Appro0 as t• fo nyegality:
day,/it e
"'avid M. reenbaum
Assistant General Counsel
(04-HUM-01048/1446674/1J
GC372946 2
C