Backup Documents 04/09/2019 Item #16D 8 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 1 6 D 8
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 routin.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. Don Luciano Community and Human DL 04/04/19
Services
2. County Attorney Office County Attorney Office c+-C°3
►o
119
3. BCC Office Board of County
Commissioners \( f zs\Vo\e
4. Minutes and Records Clerk of Court's Office
.1' (-1i oily 311 Cp, ev,
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 Don Luciano,Grants Coordinator, Phone Number 239-252-2509
Contact/ Department Community and Human Services
Agenda Date Item was April 9,2019 Agenda Item Number 16 D
Approved by the BCC
Type of Document SHIP Construction Assistance Sponsor Number of Original 6 — 3 aAc,?,.,
Attached Amendments. Documents Attached
PO number or account
number if document is N/A
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? 5 0 LC DL
2. Does the document need to be sent to another agency for additional signatures? If yes, DL
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 DL
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 DL
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 DL
document or the fmal negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's DL
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip DL
should be provided to the County Attorney Office at the time the item is input into SIRE.
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 04/09/19 and all changes made during (L, o
the meeting have been incorporated in the attached document. The County `' _ m
Attorney's Office has reviewed the changes,if applicable.
9. Initials of attorney verifying that the attached document is the version approved by the 0_, _ .
'3-V11-*"BCC,all changes directed by the BCC have been made,and the document is ready for the .J V1
Chairman's signature.
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
Instructions
160 8
1) There are 6 original Contracts. Please return four Chairman signed Contracts to:
Don Luciano
Grants Coordinator
Collier County Government Community and Human Services
3339 E. Tamiami Trail, Bldg. H, Suite 211
Naples, FL 34112
1: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 a 8
MEMORANDUM
Date: April 11, 2019
To: Don Luciano, Grants Coordinator
Housing, Human & Veteran Services
From: Ann Jennejohn, Deputy Clerk
Minutes & Records Department
Re: Amendment #3 to agreements with LeeCorp Homes Inc. and
Prestige Home Centers, Inc. for the administration of the State
Housing Initiatives Partnership Demolition and/or Replacement
of Manufactured Housing Program
Attached, please find two copies of each of the amendments referenced above,
approved by the Board of County Commissioners (Item #16D8) April 9, 2019.
The third original set of documents has been held for the Official Record in the
Board's Minutes & Records Department.
If you have any questions please call me at 252-8406.
Thank you
Attachments (4)
160
Grant -SHIP LHAP FY: 2016-2017,
2017-2018 and 2018-2019
Activity: - Homeownership
Project: Demo/Replacement of
Manufactured Homes
SPONSOR: LeeCorp Homes Inc.
DUNS #:054188622
FETI#: 59-2306425
CSFA#: 40.901
Agreement#: SHIP DR-001
Monitoring End Date: 9/2020
THIRD AMENDMENT TO
AGREEMENT BETWEEN COLLIER COUNTY, FLORIDA
AND
LEECORP HOMES INC.
This THIRD AMENDMENT TO AGREEMENT is made and entered into as of this 9th
day of April, 2019, by and between Collier County, a political subdivision of the State of Florida
(the "COUNTY" or "Grantee") and LeeCorp Homes Inc., existing under the laws of the State of
Florida ("SPONSOR").
WITNESSETH
WHEREAS, on May 8, 2018, Agenda Item 16.D.8,the County entered into an Agreement
with LeeCorp Homes, Inc. to administer the State Housing Initiatives Partnership (SHIP)
Demolition and Replacement Manufactured of Home Program;
WHEREAS, on August 14, 2018, Agenda Item 16.D.7, the County approved the First
Agreement Amendment;
WHEREAS, on October 23, 2018, Agenda Item 16.D.5, the County approved the Second
Agreement Amendment;
WHEREAS, the Parties desire to amend the Agreement to allow partial payments for
eligible activities associated with the manufactured home replacement;
WHEREAS, the Parties desire to amend the Agreement to include an additional model of
manufactured homes (Exhibit I);
WHEREAS, the Parties desire to amend the Agreement to correct the period of Financial
and Compliance Reporting; and add additional language as stated below.
1' F i
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NOW, THEREFORE, in consideration of the mutual promises and covenants contained
herein,the parties hereto agree to amend the Agreement as set forth below.
Words Stiattek-Throagh are deleted; Words Underlined are added
* *
III. SPECIAL GRANT CONDITIONS
* *
C. Performance Deliverables
Program Deliverable Deliverable Supporting Submission Schedule
Documentation
Special Grant Condition Policies as stated in this Within sixty(60) days of
Policies (Section B) agreement agreement execution
Insurance Insurance Certificate Within 30 days of agreement
execution and Annually
within thirty(30) days of
renewal
Detailed project Schedule Project Schedule Within thirty(30) days of
agreement execution
Project Plans and Site Plans and Specifications Prior to Construction Start for
Specifications each housing unit
Submission of Quarterly Exhibit F 10 days following the end of
Progress Report the quarter and a fmal close
out report upon project
completion
Financial and Compliance Exhibit G - • • . - .
Audit Reporting Single Audit OR one One
hundred eighty(180)days
after FY end
D. Payment Deliverables
Payment Deliverable Payment Supporting Documentation Submission
Schedule
Project Component 1: Submission of supporting documents Submission of
A manufactured housing unit must be provided as backup as invoice upon
and associated costs per outlined in Exhibit B. completion of a
Exhibit I housing unit
Project Component 2: (A) Submission of invoice,proof of Any time prior to or
Any allowable ancillary payment(if activity was completed by after completion and
activity associated with third party), and proof of inspection payment of the
building site and required Lf required) associated housing
h<N,
1 6 D 8
improvements necessary as unit
required by FEMA,HOA.,
County,any regulation,or to
replace the amenities of the
existing home that is not part
of the normal delivery, set-up
or housing unit costs.
(B) Any upgrades outside
those specified in(A)above,
shall be paid by the
homeowner.
* * *
V. AGREEMENT AMOUNT
It is expressly agreed and understood that the total amount to be disbursed by the COUNTY
for the use by the SPONSOR during the term of the Agreement shall not exceed Nine
Hundred Seventy-Six Thousand Five Hundred dollars ($976,500.00) pursuant to the
quoted price offered by the Sponsor in response to the SHIP application dated December
04, 2017, and the price methodology as defined below.
UNIT COST MANUFACTURED HOME SHIP Funds
Project Component 1: One Manufactured Housing Unit Up to $150,000 per
and associated costs in accordance with Exhibit I. and household. $75,000 for
associated building site and required improvements housing unit,per cost sheet
.. . _ _ _ e . (Exhibit I),plus $75,000 for
regulation. Any upgrades outside the per unit price building site and
-- . . • - • - -. improvements.
Project Component 2: (A) Any allowable ancillary * Partial payments are
activity associated with building site and required permitted for allowable
improvements necessary as required by FEMA, HOA, activities.
County, any regulation,or to replace the amenities of
the existing home, that is not part of the normal
delivery, set-up or housing unit costs.
(B) Any upgrades outside those specified in(A) above,
shall be paid by the homeowner. _—
TOTAL $976,500.00
1.iSk=N�
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EXHIBIT B
PROGRAM NARRATIVE
DEMOLITION AND/OR REPLACEMENT MANUFACTURED HOUSING
* * *
C. PAYMENT DOCUMENTS
Completed unit:
1. Copy of executed homeowner agreement for Collier County funded activities.
2. Copies of all required permits.
3. Change Orders, if applicable and documentation of approval.
4. Before and after pictures of work completed.
5. Certificate of occupancy.
6. Signature of homeowner confirming satisfaction of work completed. In case of a
refusal of signature on behalf of the homeowner, a letter from the SUBRECIPIENT is
required stating completion and reason for homeowner refusal.
7. Final invoice Invoice.
8. Pay Request Form(Exhibit E)
9. Copy of the executed mortgage, if any.
Partial Payment:
1.Invoice
2.Pay Request Form (Exhibit E)
3.Proof of payment(if applicable)
4.Proof of completion as evidenced by County inspection, certificate of completion,third
party inspection or photographs of completed work.
160 8
EXHIBIT D
REPORTING REQUIREMENTS
Type of Report Period Covered/Supporting Documents Date Due
1. Quarterly By the 10th of the following
Progress Report • Exhibit"F"- Quarterly Progress Report month.
2. Financial & • Copy of Corporate Tax Returns 4-20180 days after end of fiscal
Compliance • Exhibit"G"-Annual Audit Monitoring Report year, until monitoring end date
AuditReporting
3. Insurance • Liability and Office and Director Annually within 30 days of
• Workers Comp expiration
• Automobile Liability
4. Invoice Exhibit "E"-Request for Payment Upon delivery of unit completion
of any allowable activity
associated with the program.
EXHIBIT "I"
COST SHEET
SINGLEWIDE MANUFACTURED HOMES***
Total cost includes demo and estimated fill,but does not include additional fill,carport,or High Set. Those costs
are enumerated below.
* * *
Model Name: IMLTSWW-4685
Size: 16'x68' — Singlewide — 3 Bed/2Bath
Total Cost: ... ... ... ... ... ... ... ... ... ... $75,900.00
REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
1608
IN WITNESS WHEREOF, the SPONSOR and the COUNTY, have each respectively,
by authorized person or agent, hereunder set their hands and seals on the date first written above.
ATTEST: BOARD OF COUNTY COMMISSIONERS
CRYSTAL K. KINZEL, CLERK OF COURTS COLLIER; ORIDA
4°
44.
By: - -i� ., - ��q-� - By: _...%'-=. .mow.
•x:-, ,, w , DEPUTY CLERK ,' LLIAM L. McDANIEL, R.
Qst as fo C� an% CHAIRMAN
sxiiatafe only.
Approved as to form and legality:
tom.
Jenna er A. Belpedi i 0‘
Assistant County Attorney �,�Q
LEECORP HOMES INC.
By: r`
Christopher Lee,President
Item# 1
Agenda t _L1
Date
Date -t9
Rec'd
Deputy Cfer 4 4
(R)
1608
Grant- SHIP LHAP FY: 2016-2017,
2017-2018 and 2018-2019
Activity: -Homeownership
Project: Demo/Replacement of
Manufactured Homes
SPONSOR: Prestige Home Centers, Inc.
DUNS#:618971857
FETI#: 59-3015570
CSFA#: 40.901
Agreement#: SHIP DR-002
Monitoring End Date: 9/2020
THIRD AMENDMENT TO
AGREEMENT BETWEEN COLLIER COUNTY,FLORIDA
AND
PRESTIGE HOME CENTERS,INC.
This THIRD AMENDMENT TO AGREEMENT is made and entered into as of this 9th
day of April,2019, by and between Collier County, a political subdivision of the State of Florida
(the "COUNTY" or "Grantee") and Prestige Home Centers, Inc., existing under the laws of the
State of Florida("SPONSOR").
WITNESSETH
WHEREAS, on May 8, 2018,Agenda Item 16.D.8, the County entered into an Agreement
with Prestige Home Centers, Inc. to administer the State Housing Initiatives Partnership (SHIP)
Demolition and Replacement Manufactured of Home Program;
WHEREAS, on August 14, 2018, Agenda Item 16.D.7, the County approved the First
Agreement Amendment;
WHEREAS, on October 23, 2018, Agenda Item 16.D.5,the County approved the Second
Agreement Amendment;
WHEREAS, the Parties desire to amend the Agreement to allow partial payments for
eligible activities associated with the manufactured home replacement;
WHEREAS,the Parties desire to amend the Agreement to include price increases(effective
for units assigned after February 1, 2019) for the manufactured homes (Exhibit I);
WHEREAS, the Parties desire to amend the Agreement to correct the period of Financial
and Compliance Reporting; and add additional language as stated below. MAR 20'19 RCV0
•
i bD 8
NOW, THEREFORE, in consideration of the mutual promises and covenants contained
herein,the parties hereto agree to amend the Agreement as set forth below.
Words Struck-Through are deleted; Words Underlined are added
* * *
III. SPECIAL GRANT CONDITIONS
C. Performance Deliverables
Program Deliverable Deliverable Supporting Submission Schedule
Documentation
Special Grant Condition Policies as stated in this Within sixty(60)days of
Policies(Section B) agreement agreement execution
Insurance Insurance Certificate Within 30 days of agreement
execution and Annually
within thirty(30)days of
renewal
Detailed project Schedule Project Schedule Within thirty(30) days of
agreement execution
Project Plans and Site Plans and Specifications Prior to Construction Start for
Specifications each housing unit
Submission of Quarterly Exhibit F 10 days following the end of
Progress Report the quarter and a final close
out report upon project
completion
Financial and Compliance Exhibit G Annually,nine (9)months for
Audit Reporting Single Audit OR one One
hundred eighty(180) days
after FY end
D. Payment Deliverables
Payment Deliverable Payment Supporting Documentation Submission
Schedule
Project Component 1: Submission of supporting documents Submission of
A manufactured housing unit must be provided as backup as invoice upon
and associated costs per outlined in Exhibit B. completion of a
Exhibit I housing unit
Project Component 2: (A) Submission of invoice,proof of Any time prior to or
Any allowable ancillary payment (if activity was completed by after completion and
activity associated with third party), and proof of inspection payment of the
building site and required (if required) associated housing
A
1608
improvements necessary as unit
required by FEMA,HOA,
County, any regulation, or to
replace the amenities of the
existing home that is not part
of the normal delivery, set-up
or housing unit costs.
(B)Any upgrades outside
those specified in(A) above,
shall be paid by the
homeowner.
*
V. AGREEMENT AMOUNT
It is expressly agreed and understood that the total amount to be disbursed by the COUNTY
for the use by the SPONSOR during the term of the Agreement shall not exceed Nine
Hundred Seventy-Six Thousand Five Hundred dollars ($976,500.00) pursuant to the
quoted price offered by the Sponsor in response to the SHIP application dated December
04, 2017, and the price methodology as defined below.
UNIT COST MANUFACTURED HOME SHIP Funds
Project Component 1: One Manufactured Housing Unit Up to $150,000 per
and associated costs in accordance with Exhibit I.and household. $75,000 for
associated building site and required improvements housing unit,per cost sheet
necessary as required by FEMA,HOA,County or any (Exhibit I),plus$75,000 for
regulation. Any upgrades outside the per unit price building site and
. - . . - - . - . •. . improvements.
Project Component 2: (A)Any allowable ancillary * Partial payments are
activity associated with building site and required permitted for allowable
improvements necessary as required by FEMA,HOA, activities.
County,any regulation, or to replace the amenities of
the existing home, that is not part of the normal
delivery. set-up or housing unit costs.
(B) Any upgrades outside those specified in(A)above,
shall be paid by the homeowner.
TOTAL $976,500.00
* * *
r k
1608
EXHIBIT B
PROGRAM NARRATIVE
DEMOLITION AND/OR REPLACEMENT MANUFACTURED HOUSING
C. PAYMENT DOCUMENTS
Completed unit:
1. Copy of executed homeowner agreement for Collier County funded activities.
2. Copies of all required permits.
3, Change Orders, if applicable and documentation of approval.
4.Before and after pictures of work completed.
5, Certificate of occupancy.
6. Signature of homeowner confirming satisfaction of work completed. In case of a
refusal of signature on behalf of the homeowner, a letter from the SUBRECIPIENT is
required stating completion and reason for homeowner refusal.
7. Final invoice Invoice.
8. Pay Request Form(Exhibit E)
9. Copy of the executed mortgage, if any.
Partial Payment:
1.Invoice
2.Pay Request Form(Exhibit E)
3.Proof of payment(if applicable)
4.Proof of completion as evidenced by County inspection, certificate of completion,third
party inspection or photographs of completed work.
* * *
1608
EXHIBIT D
REPORTING REQUIREMENTS
Type of Report Period Covered/Supporting Documents Date Due
1. Quarterly By the 10th of the following
Progress Report • Exhibit"F"- Quarterly Progress Report month.
2. Financial& • Copy of Corporate Tax Returns 120180 days after end of fiscal
Compliance • Exhibit"G"-Annual Audit Monitoring Report year,until monitoring end date
AuditReporting
3.Insurance • Liability and Office and Director Annually within 30 days of
• Workers Comp expiration
• Automobile Liability
4.Invoice Exhibit"E"-Request for Payment Upon delivery of unit completion
of any allowable activity
associated with the program.
REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
0'1;')
160 8 t
EXHIBIT "I"
COST SHEET
SINGLEWIDE MANUFACTURED HOMES***
Total cost includes demo and estimated fill,but does not include additional fill,carport, or High Set. Those costs
are enumerated below.
Model Name: Park Model 1 Bedroom Model #: 37-4B1A (3)
Size: 14 x 37.3 ft. - Singlewide
Total Cost... ... ... ... ... ... ... ... ... ...$62,765,92 66,369.92
Model Name: Vacation Cottage 1 Bedroom Model #: 37-4M1A (3)
Size: 16 x 37.3 ft. - Singlewide
Total Cost . ... ... ... ... $6 ,567.92 68,171 .92
Model Name: Hailey 2 Bedroom Model #: 54H2A
Size: 16 x 54 ft. - Singlewide
Total Cost... ... $ 1-92 72,252.92
Model Name: Super Saver 2 Bedroom Model #: 44B2H (1 )
Size: 14 x 44 ft. - Singlewide
Total Cost._ ... ... ... ... ,..$60,910.92 64,514.92
DOUBLEWIDE MANUFACTURED HOMES**
Total cost includes demo and estimated fill, but does not include additional fill or High Set. Those costs
are enumerated below.
Model Name: Mindi 1 Bedroom Model #: 36C2H (2)
A. Size: 24 x 36 ft. - Doublewide
Total Cost... ... ... $79,160.92 83,700.92
B. Size: 26 x 36 ft. - Doublewide
Total Cost.. ... ... ...$81,050.92 85,290.92
C. Size: 28 x 36 ft. - Doublewide
Total Cost... ... ... ... ... ... ... ... ... ... ... ...$82,322.92 86,562.92
Model Name: Gail 2 Bedroom Model #: 40C2H (15)
A. Size: 26 x 42 ft, - Doublewide
Total Cost ... ... ... ... ...$83,223.92 87,463.92
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B. Size: 28 x 42 ft. - Doublewide
Total Cost. ... .. ... ... ....$84,495.92 88,735.92
Model Name: Reed 2 Bedroom Model #: 40C2F (2)
A. Size: 26 x 44 ft. - Doublewide
Total ... ... ... .. .. ... ... ... ... .$89,901.92 94 141.92
B. Size: 28 x 44 ft. - Doublewide
Total Cost ... ... ....$90,113.92 94,353.92
Model Name: Liz 3 Bedroom Model #: 48E3A (3)
Size: 28 x 48 ft. - Doublewide
Total Cost ...$93,505.92 98,169.92
Model Name: Gail 3 Bedroom Model #: 40C3H (15)
A. Size: 26 x 48 ft. - Doublewide
Total Cost... ... ... ... ... ... ... .. ... ...$85,149.92 90 113.92
B. Size: 28 x 48 ft. - Doublewide
Total Cost. . . ... ... ... ...$86,721.92 91 ,385.92
Model Name: Miley 3 Bedroom Model #: 52E3H (18)
Size: 28 x 52 ft. - Doublewide
Total Cost... ...$92,233.92 96,897.92
Model Name: Scott 4 Bedroom Model #: 52E4D (1)
Size: 28 x 56 ft. - Doublewide
Total Cost $94,1159.92 99,123.92
Model Name: Wayne 4 Bedroom Model #: 60E4D (2)
Size: 28 x 60 ft. - Doublewide
Total Cost. $99/M1.92 105,059.92
Model Name: Peyton 3 Bedroom Model #: 48E3H (4)
Size: 28 x 48 ft. - Doublewide
Total Cost. .. ... ... ... $93,661.92 98,325.92
* * *
160 8
IN WITNESS WHEREOF, the SPONSOR and the COUNTY, have each respectively,
by authorized person or agent,hereunder set their hands and seals on the date first written above.
ATTEST: . 1. , BOARD OF CO 1 TY COMMISSIONERS
CRYSTAL IC KOz-gL, CLERK OF COURTS COLLIER
�CO4 ' DA
e
B -�- By: !
Attest a5�Q rtta •an,S PUTY CLERK W LIAM L. McDANIEL, JR.
CHAIRMAN
sigriatur onty:
Approved as to form and legality:
A
Jena er A. Belpedio III t
Assistant County Attorney `go 0
PRESTIGE HOME CENTERS, INC.
, /By' ► d� tees,
Tom Trexler, Pr sident
Item# klcAl
A.gend
Date —141
Date LA „may
RRec'd� ,_1
a
Deputy Clerk '
'lli ria,
1608
FORM 8B MEMORANDUM OF VOTING CONFLICT FOR
COUNTY, MUNICIPAL, AND OTHER LOCAL PUBLIC OFFICERS
LAST NAME—FIRST NAME—MIDDLE NAME NAME OF BOARD,COUNCIL,COMMISSION,AUTHORITY,OR COMMITTEE
Andrew I. Solis Collier County Board of County Commissioners
MAILING ADDRESS THE BOARD,COUNCIL,COMMISSION,AUTHORITY OR COMMITTEE ON
3299 East Tamiami Trail, 3rd Floor WHICH I SERVE ISA UNIT OF:
CITY COUNTY ❑CITY dCOUNTY ❑OTHER LOCAL AGENCY
Naples Collier NAME OF POLITICAL SUBDIVISION:
DATE ON WHICH VOTE OCCURRED Collier County
April 9, 2019 MY POSITION IS: d ELECTIVE ❑ APPOINTIVE
WHO MUST FILE FORM 8B
This form is for use by any person serving at the county, city, or other local level of government on an appointed or elected board, council,
commission, authority, or committee. It applies to members of advisory and non-advisory bodies who are presented with a voting conflict of
interest under Section 112.3143, Florida Statutes.
Your responsibilities under the law when faced with voting on a measure in which you have a conflict of interest will vary greatly depending
on whether you hold an elective or appointive position. For this reason, please pay close attention to the instructions on this form before
completing and filing the form.
INSTRUCTIONS FOR COMPLIANCE WITH SECTION 112.3143, FLORIDA STATUTES
A person holding elective or appointive county, municipal, or other local public office MUST ABSTAIN from voting on a measure which
would inure to his or her special private gain or loss. Each elected or appointed local officer also MUST ABSTAIN from knowingly voting on
a measure which would inure to the special gain or loss of a principal (other than a government agency) by whom he or she is retained
(including the parent, subsidiary, or sibling organization of a principal by which he or she is retained); to the special private gain or loss of a
relative; or to the special private gain or loss of a business associate. Commissioners of community redevelopment agencies(CRAs) under
Sec. 163.356 or 163.357, F.S., and officers of independent special tax districts elected on a one-acre, one-vote basis are not prohibited
from voting in that capacity.
For purposes of this law, a "relative" includes only the officer's father, mother, son, daughter, husband, wife, brother, sister, father-in-law,
mother-in-law, son-in-law, and daughter-in-law. A"business associate" means any person or entity engaged in or carrying on a business
enterprise with the officer as a partner, joint venturer, coowner of property, or corporate shareholder (where the shares of the corporation
are not listed on any national or regional stock exchange).
ELECTED OFFICERS:
In addition to abstaining from voting in the situations described above, you must disclose the conflict:
PRIOR TO THE VOTE BEING TAKEN by publicly stating to the assembly the nature of your interest in the measure on which you are
abstaining from voting; and
WITHIN 15 DAYS AFTER THE VOTE OCCURS by completing and filing this form with the person responsible for recording the
minutes of the meeting,who should incorporate the form in the minutes.
APPOINTED OFFICERS:
Although you must abstain from voting in the situations described above, you are not prohibited by Section 112.3143 from otherwise
participating in these matters. However, you must disclose the nature of the conflict before making any attempt to influence the decision,
whether orally or in writing and whether made by you or at your direction.
IF YOU INTEND TO MAKE ANY ATTEMPT TO INFLUENCE THE DECISION PRIOR TO THE MEETING AT WHICH THE VOTE WILL BE
TAKEN:
• You must complete and file this form (before making any attempt to influence the decision)with the person responsible for recording the
minutes of the meeting,who will incorporate the form in the minutes. (Continued on page 2)
CE FORM 8B-EFF. 11/2013 PAGE 1
Adopted by reference in Rule 34-7.010(1)(f),F.A.C.
1608
APPOINTED OFFICERS (continued)
• A copy of the form must be provided immediately to the other members of the agency.
• The form must be read publicly at the next meeting after the form is filed.
IF YOU MAKE NO ATTEMPT TO INFLUENCE THE DECISION EXCEPT BY DISCUSSION AT THE MEETING:
• You must disclose orally the nature of your conflict in the measure before participating.
• You must complete the form and file it within 15 days after the vote occurs with the person responsible for recording the minutes of the
meeting, who must incorporate the form in the minutes.A copy of the form must be provided immediately to the other members of the
agency, and the form must be read publicly at the next meeting after the form is filed.
DISCLOSURE OF LOCAL OFFICER'S INTEREST
I Andrew I. Solis hereby disclose that on April 9, . 20 19
(a)A measure came or will come before my agency which (check one or more)
inured to my special private gain or loss;
inured to the special gain or loss of my business associate,
inured to the special gain or loss of my relative.
inured to the special gain or loss of a client of my law firm , by
whom I am retained; or
inured to the special gain or loss of . which
is the parent subsidiary, or sibling organization or subsidiary of a principal which has retained me.
(b)The measure before my agency and the nature of my conflicting interest in the measure is as follows:
On April 9, 2019, the Board of County Commissioners will consider Agenda Item 16-D-8, a recommendation to
approve the Third Amendment to agreements with LeeCorp Homes Inc., and Prestige Home Centers, Inc., for
the administration of the State Housing Initiatives Partnership Demolition and/or Replacement of Manufactured
Housing Program.
Prestige Home Centers, Inc., is a client of my law firm and in an abundance of caution, I will abstain from voting
pursuant to Section 286,012,Fla. Stat. to avoid any perceived prejudice or bias.
If disclosure of specific information would violate confidentiality or privilege pursuant to law or rules governing attorneys, a public officer,
who is also an attorney, may comply with the disclosure requirements of this section by disclosing the nature of the interest in such a way
as to provide the public with notice of the conflict.
April 9, 2019
�„-
Date Filed Sign ure
NOTICE: UNDER PROVISIONS OF FLORIDA STATUTES §112.317, A FAILURE TO MAKE ANY REQUIRED DISCLOSURE
CONSTITUTES GROUNDS FOR AND MAY BE PUNISHED BY ONE OR MORE OF THE FOLLOWING: IMPEACHMENT,
REMOVAL OR SUSPENSION FROM OFFICE OR EMPLOYMENT, DEMOTION, REDUCTION IN SALARY, REPRIMAND, OR A
CIVIL PENALTY NOT TO EXCEED$10,000.
CE FORM 8B-EFF. 11/2013 PAGE 2
Adopted by reference in Rule 34-7 010(1)(f).F.A.C.