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Agenda 01/27/2009 Item #16D 4 Agenda Item No. 16D4 January 27. 2009 Page 1 of 20 EXECUTIVE SUMMARY Recommendation that the Board of County Commissioners approves, and authorizes the Chairman to sign, an Agreement providing for a $250,000 State Housing Initiative Partnership (SHIP) grant to Habitat for Humanity of Collier County, Inc. for the acquisition and/or rehabilitation of at least five (5) residential dwelling units to benefit households earning less than 120% ofthe Area Median Income. OBJECTIVE: That the Board of County Commissioners (Board) approves, and authorizes the Chairman to sign, the attached Agreement with Habitat for Humanity of Collier County, Inc. for the acquisition and/or rehabilitation of at least five (5) residential dwelling units to benefit households earning less than 120% of the Area Median Income. CONSIDERA TlONS: On July 7, 1992, the William E. Sadowski Affordable Housing Act was signed into law to provide additional funding to local communities, through a documentary stamp tax on real estate transactions, to promote affordable bousing. Under the SHIP program, Collier County and the City of Naples receive funds from the State of Florida to provide initiatives to expand affordable housing opportunities. On July 22, 2008 the Board of County Commissioners adopted Resolution No. 2008-212 approving an amendment to the Local Housing Assistance Plan (LHAP) to provide funding for Acquisition-Rehabilitation/New Construction. The grant of $250,000 to Habitat for Humanity of Collier County, Inc. will assist with the acquisition and/or rehabilitation of at least five (5) existing residential dwelling units to benefit households earning less than 120% of the Area Median Income. To fund this activity, SHIP monies will be reallocated from the Purchase Assistance strategy to the Acquisition-Rehabilitation/New Construction strategy. For SHIP FYOS/09, $270,000 had been budgeted for the Acquisition-Rehabilitation/New Construction strategy. In order to fund this amended activity, an additional $130,000 shall be reallocated from Purchase Assistance bringing the total SHIP FYOS/09 Acquisition-Rehabilitation/New Constructions strategy budget to $400,000. The reallocation of funding will allow Collier County to assist sponsors in acquiring existing units at competitive prices, as well as acknowledge the decrease in applications for Purchase Assistance at this time. FISCAL IMPACT: Approval of this Agreement will provide a SHIP grant in the amount of $250,000 to Habitat for Humanity of Collier County, Inc. No general funds shall be utilized for this project. GROWTH MANAGEMENT IMPACT: None. LEGAL CONSIDERATIONS: This item has been reviewed and approved by the County Attorney's Office. This item is not quasi judicial, and as such ex parte disclosure is not _ required. This item requires majority vote only. This item is legally sufficient for Board approval. - CMG STAFF RECOMMENDATION: That the Board approves and authorizes the Chairman to sign the attached Agreement with Habitat for Humanity of Collier County, Inc. for the Agenda Item No. 16D4 January 27, 2009 Page 2 of 20 acqUlSl110n and/or rehabilitation of at least five (5) residential dwelling units to benefit households earning less than 120% of the Area Median Income. PREPARED BY: Frank Ramsey, Housing Manager, Housing and Human Services Page I of 1 Agenda Item No. 1604 January 27,2009 Page 3 of 20 COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS Item Number: Item Summary: 16D4 Recommendation that the Board of County Commissioners approves, and authorizes the Chairman to sign, an Agreement providing for a $250,000 State Housing Initiative Partnership (SHIP) grant to Habitat for Humanity of Collier County, Inc. for the acquisition and/or rehabilitation of at least five (5) residential dwelling units to benefIt households earning less than 120% of the Area Median Income. Meeting Date: 1/27/2009900:00 AM Prepared By Frank Ramsey SHIP Program Coordinator Date Public Services Housing and Human Services 1/5/20091:19:49 PM Approved By Marcy Krumbine Director Date Public Services Housing & Human Services 1/9/200910:20 AM Approved By Colleen Greene Assistant County Attorner Date County Attorney County Attorney Office 1/9/200912:19 PM Approved By Jeff Klatzkow Assistant County Attorney Date County Attorney County Attorney Office 1/9/20092:33 PM Approved By Lyn Wood Purchasing Agent Date Administrative Services Purchasing 1112/20094:06 PM Approved By Marla Ramsey Public Services Administrator Date Public Services Public Services Admin. 1/13/20095:32 PM Approved By Steve Carnell Purchasing/General Svcs Director Date Administrative Services Purchasing 1/13/20099:07 PM Approved By OMS Coordinator OMB Coordinator Date County Manager's Office Office of Management & Budget 1/14/200911 :04 AM Approved By Sherry Pryor Management & Budget Analyst Date County Manager's Office Office of Management & Budget 1/15/200911:26 AM Approved By James V. Mudd County Manager Date Board of County County Manager's Office 1/15/20096:52 PM Commissioners file://C:\Agenda Test\Export\ I 22-January%2027 ,%202009\ 16. %20CONSENT%20AGEND... 1/21/2009 Agenda Item No. 16D4 January 27,2009 Page 4 of 20 AGREEMENT BETWEEN COLLIER COUNTY AND HABITAT FOR HUMANITY OF COLLIER COUNTY, INC. SHIP ACOUlSITION-REHABILITATION/NEW CONSTRUCTION 2q-t'f\ This Agreement ("Agreement"), effective this Hth day of January, 2009, is made by and between Collier County, a political subdivision of the State of Florida, hereinafter referred to as "COUNTY," and Habitat for Humanity of Collier County, Inc., a private not-for-profit corporation, existing under the laws of the State of Florida, having its principal office at 11145 Tamiami Trail East, Naples, Florida, 34113, hereinafter referred to as "SPONSOR." RECITALS: WHEREAS, the COUNTY is a participant in the State Housing Initiatives Partnership (SHIP) Program; and WHEREAS, pursuant to the SHIP Program, the COUNTY is undertaking certain activities to primarily benefit housing for very low - low - and moderate income persons and neighborhoods; and WHEREAS, the Local Housing Assistance Plan (LHAP) Fiscal Year 2007-2010 was adopted on April 24, 2007 through Resolution No. 2007-96; and WHEREAS, through Resolution No. 2008-212 the Board of County Commissioners ("Board") adopted a revision to the three-year LHAP amending a strategy that outlines the intended use of SHIP funds for fiscal years 2007-2008, 2008-2009 and 2009-201 0; and WHEREAS, the Board finds that the activities undertaken in connection with this Agreement constitute valid and worthwhile County purposes, and as such, that SPONSOR should be duly funded or reimbursed for the expenses as set forth herein. WITNESSETH: NOW, THEREFORE, in consideration of the mutual promises and covenants herein contained, it is agreed by the Parties as follows: 1. All of the Recitals are true and correct and are hereby expressly incorporated herein by reference as if set forth fully below. Page I of 17 Agenda Item No. 1604 January 27,2009 Page 5 of 20 II. DEFINITIONS (I) "COUNTY" means Collier County, and where applicable, its authorized representative(s ). (2) "SHIP" means the State Housing Initiatives Partnership Program of Collier County, S 420.907-.9079, Florida Statutes. (3) "SPONSOR" means Habitat for Humanity of Collier County, Inc. (4) "Very low - low - and moderate income persons" means the definition set by S 420.9071, Florida Statutes. (5) "Project" means the work contemplated to be performed as set forth in Exhibit "A." (6) "Florida Housing Finance Corporation" means the agency governing the SHIP Program. II. SCOPE OF SERVICES The SPONSOR shall, in a satisfactory and proper manner, as determined by COUNTY, perform the tasks necessary to conduct the program outlined in Exhibit "A," and shall submit each request for advancement and/or reimbursement of funds using Exhibit "B," all of which are attached hereto and made a part hereof. The SPONSOR may request advance funds for acquisition of eligible property with the required documentation. Payments for eligible work tasks and/or activities may be made directly to the provider of the service(s), as approved by HOUSING AND HUMAN SERVICES, at SPONSOR'S written request. IV. TIME OF PERFORMANCE The effective date of this Agreement is written above, and the services of the SPONSOR shall be undertaken and completed within twelve (12) months from date of executed Agreement. V. CONSIDERATION AND LIMITATION OF COSTS The SPONSOR shall be paid by the COUNTY for allowable costs, using SHIP funds, determined by COUNTY, in an amount not to exceed TWO HUNDRED FIFTY THOUSAND AND 00/100 DOLLARS ($250,000.00) for the services described in Exhibit "A." Funding shall not exceed fifty-thousand dollars per residential unit. All activities specified in Exhibit "A" shall be performed by SPONSOR employees, or shall be solicited under a procedure acceptable to the COUNTY. Contract administration shall be handled by the SPONSOR and monitored by the COUNTY, which shall have access to all records and documents related to the project. Payments for eligible work tasks and/or activities Page 2 ofl7 may be made directly to the provider of the service(s), as HUMAN SERVICES, at SPONSOR'S written request. Agenda Item No. 16D4 January 27, 2009 Page 6 of 20 approved by HOUSING AND VI. NOTICES All notices required to be given under this Agreement shall be sufficient when delivered to COUNTY at its office, presently located at 3301 E Tamiami Trail, Suite 211, Naples, FL 34112, and to the SPONSOR when delivered to its office at the address listed on page one (I) of this Agreement. VII. SPECIAL CONDITIONS The SPONSOR agrees to comply with the requirements of the SHIP Program as described in the S 420.907 through 420.9079, Florida Statutes, and Chapter 67.37 of the Florida Administration Code. All work performed by SPONSOR, any contractor(s) and their subcontractor(s), must conform to the requirements of the following: I. 2005 Environmental Health & Safety 2. 2004 Florida Building Code (includes Energy Efficient Code) 3. 2004 Florida Building Code/Fuel Gas 4. 2004 Florida Building Code/Mechanical 5. 2004 Florida Building Code/Plumbing 6. 2004 Florida Building Code/Americans with Disabilities 7. 2005 National Electric Code 8. 2002-01 Building Construction Administrative Code VIII. GENERAL CONDITIONS A. IMPLEMENTATION OF PROJECT ACCORDING TO REQUIRED PROCEDURES The SPONSOR shall implement this Agreement in accordance with applicablc Federal, State, and County laws, ordinances and codes. No payments will be made until approved by COUNTY. B. AMENDMENTS This Agreement, along with all exhibits and attachments, may be amended only by written agreement executed by the governing boards of both parties, except that COUNTY representative may approve adjustments between linc item amounts, scope clarifications, or an extension of time and schedule provided in Exhibit "A" that do not Page 3 of 17 Agenda Item No. 16D4 January 27, 2009 Page 7 of 20 change the project, or exceed the amount funded by the COUNTY, as stated herein. Any modifications to this contract shall be in compliance with the County Purchasing Policy and Administrative Procedures in effect at the time such modifications are authorized. C. INDEMNIFICATION To the maximum extent permitted by Florida law, the SPONSOR shall indemnify and hold harmless Collier County, its officers and employees from any and all liabilities, damages, losses and costs, including, but not limited to, reasonable attorneys' fees and paralegals' fees, to the extent caused by the negligence, recklessness, or intentionally wrongful conduct of the SPONSOR or anyone employed or utilized by the SPONSOR in the performance of this Agreement. This indemnification obligation shall not be construed to negate, abridge or reduce any other rights or remedies which otherwise may be available to an indemnified party or person described in this paragraph. This section does not pertain to any incident arising from the sole negligence of Collier County. The foregoing indemnification shall not constitute a waiver of sovereign immunity beyond the limits set forth in 9 768.28, Florida Statutes. D. TERMINATION In event of termination for any of the following reasons, all finished or unfinished documents, data studies, surveys, drawings, maps, models, photographs, reports prepared, and capital equipment secured by the SPONSOR with funds under this Agreement shall be returned to HOUSING AND HUMAN SERVICES or the COUNTY. In the event of termination, the SPONSOR shall not be relieved of liability to the COUNTY for damages sustained by the COUNTY by virtue of any breach of the Contract by the SPONSOR, and the COUNTY may withhold any payment to the SPONSOR for set-off purposes until such time as the exact amount of damages due to the COUNTY from the SPONSOR is determined. 1. TERMINATION FOR CAUSE Should the SPONSOR be found to have failed to perform in a manner satisfactory to the COUNTY as per this Agreement, the COUNTY may terminate said agreement immediately for cause; further the COUNTY may terminate this Agreement for convenience with a seven (7) day written notice. The COUNTY shall be sole judge of non-performance. 2. TERMINATION FOR CONVENIENCE Page 4 of 17 Agenda Item No. 1604 January 27,2009 Page 8 of 20 At any time during the term of this Agreement, either par1y may, at its option and for any reason, terminate this Agreement upon ten (10) working days written notice to the other party. Upon termination, the COUNTY shall pay the SPONSOR for services rendered pursuant to this Agreement through and including the date of termination. E. INSURANCE. The SPONSOR or Contractor, if applicable, shall provide insurance as follows: Commercial General Liabilitv: Coverage shall have minimum limits of $300,000 Per Occurrence, Combined Single Limit for Bodily Injury Liability and Property Damage Liability. This shall include Premises and Operations; Independent Contractors; Products and Completed Operations and Contractual Liability. Workers' Compensation: Insurance covering all employees meeting Statutory Limits of Chapter 440, Florida Statutes, and all Federal Government Statutory Limits and Requirements. Special Requirements: Collier County shall be listed as the Certificate Holder and included as an Additional Insured on the Comprehensive General Liability Policy. Current, valid insurance policies meeting the requirement herein identified shaH be maintained by SPONSOR or Contractor, if applicable, during the duration of this Agreement. Renewal certificates shall be sent to the COUNTY thirty (30) days prior to any expiration date, There shall be a thirty (30) day notification to the COUNTY in the event of cancellation or modification of any stipulated insurance coverage. SPONSOR or Contractor, if applicable, shall insure that all subcontractors comply with the same insurance requirements that he is required to meet. The SPONSOR or same Contractor, if applicable, shaH provide COUNTY with certificates of insurance meeting the required insurance provisions. F. INDEPENDENT AGENT AND EMPLOYEES The SPONSOR agrees that, in all matters relating to this Agreement, it will be acting as an independent agent and that its employees are not Collier County employees and are not subject to the COUNTY provisions of the law applicable to COUNTY employees relative to employment, hours of work, rates of compensation, leave, unemployment compensation and employee benefits, IX. ADMINISTRATIVE REOUlREMENTS A. DOCUMENT A TION AND RECORD KEEPING Page 5 of 17 Agenda Item No. 1604 January 27,2009 Page 9 of 20 I. The SPONSOR shall maintain all records required by the COUNTY and SHIP Regulations. 2. All invoices, plans, surveys, information, documents, maps, and other data procedures developed, prepared, assembled, or completed by the SPONSOR for the purpose of this Agreement shall be made available to the COUNTY by the SPONSOR at any time upon request by the COUNTY. Upon completion of all work contemplated under this Agreement copies of all documents and records relating to this Agreement shall be surrendered to COUNTY if requested. B. PURCHASING All purchasing for services and goods, including capital equipment, shall be made by purchase order or by a written contract and in conformity with the procedures prescribed by the Collier County Purchasing Policy, which are incorporated herein by reference. C. REPORTS, AUDITS, AND EV ALUA TIONS I. Payments and/or reimbursement will be contingent on the timely receipt of complete and accurate Request for Payment, attached herein as Exhibit "B," required by COUNTY, and on the resolution of monitoring or audit findings identified pursuant to this Agreement. 2. At any time during normal business hours and as often as the COUNTY or the Florida Housing Finance Corporation may deem necessary, there shall be made available by the SPONSOR for examination all its records with respect to all matters covered by this Agreement. 3. The SPONSOR, if applicable, agrees to comply with the requirements of the Florida Single Audit Act as defined in 9 215.97, Florida Statutes. D. ADDITIONAL COUNTY AND SHIP REOUIREMENTS COUNTY shall have the right under this Agreement to suspend or terminate payments and reimbursement until the SPONSOR complies with any additional conditions that may be imposed by the COUNTY or SHIP at any time. Funds are subject to the recapture provisions of 9 420.9075(5)(g), Florida Statutes from eligible persons or eligible sponsors who default on the terms of a grant award or loan award. Page 6 of 17 X. OTHER PROGRAM REOUIREMENTS A. PROGRAM BENEFICIARIES Agenda Item No. 16D4 January 27,2009 Page 10 of 20 One Hundred percent (100%) of the beneficiaries of the project funded through this Agreement must be very low - low - or moderate income persons as required by 9 420.9071(10), Florida Statutes. All prospective home buyers of subject property, as listed on Exhibit "A," shall be qualified by COUNTY staff prior to transfer of title from SPONSOR to new owner. B. EVALUATION AND MONITORING The SPONSOR agrees that COUNTY may carry out periodic monitoring and evaluation activities as determined necessary by COUNTY and that the continuation of this Agreement is dependent upon compliance with SHIP regulations. The SPONSOR shall, upon the request of COUNTY, submit information and status reports requested by the COUNTY. lbe SPONSOR shall allow COUNTY to monitor the SPONSOR on site. Such site visits may be scheduled or unscheduled as determined by COUNTY and Florida Housing Finance Corporation. C. CONFLICT OF INTEREST The SPONSOR covenants that no person who presently exercises any functions or responsibilities in connection with the Project, has any personal financial interest, direct or indirect, in the target areas or any parcels therein, which would conflict in any marmer or degree with the performance of this Agreement and that no person having any conflict of interest shall be employed by or subcontracted by the SPONSOR. Any possible conflict of interest on the part of the SPONSOR or its employees shall be disclosed in writing to COUNTY provided, however, that this paragraph shall be interpreted in such a manner so as not to unreasonably impede the statutory requirement that maximum opportunity be provided for employment of and participation of low and very low-income residents of the project target area. Xl. SEVERABILITY OF PROVISIONS If any provision of this Agreement is held invalid, the remainder of this Agreement shall not be affected thereby if such remainder would then continue to conform to the terms and requirements of applicable law. XII. ENTIRE UNDERSTANDING This Agreement and its provisions merge any prior agreements, if any, between the Page 7 of 17 Agenda Item No. 16D4 January 27, 2009 Page 11 of 20 parties hereto and constitutes the entire understanding. The parties hereby acknowledge that there have been and are no representations, warranties, covenants, or undertakings other than those expressly set forth herein. IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed by their appropriate officials, as of the date first above written. ATTEST: Dwight E. Brock, Clerk of Courts BOARD OF COUNTY COMMISSIONERS COLLIER COUNTY, FLORIDA By: , Deputy Clerk By: DONNA "f"lAL,A , CHAIRMAN By' _ Sam Durso, M.D., President Z:'i0,1"- Second Witn ss 1.1...; (!)rMsb1: Type/print witnes name Approved as to form and legal sufficiency: C~fY)~ Colleen M. Greene Assistant County Attorney l"~t~ cfn- EXHIBIT "A" SCOPE OF SERVICES HABITAT FOR HUMANITY OF COLLIER COUNTY, INC. Agenda Item No. 16D4 January 27,2009 Page 12 of 20 THE SPONSOR AGREES TO: 1. PROJECT SCOPE This project will provide safe, decent and affordable housing for very low - low - and moderate income persons in Collier County. This SHIP Program grant in the amount of Two Hundred Fifty Thousand and 0011 00 Dollars ($250.000.00) may be used to acquire and/or rehabilitate at least five (5) residential dwelling units in Collier County to benefit very low - low - or moderate income persons as defined by 9 420.9071, Florida Statutes. Funding shall not exceed fifty-thousand dollars per residential unit and may include acquisition and/or rehabilitation. a. Acquisition SPONSOR may use project funds to finance the acquisition of eligible housing. Pursuant to 9 420.9071(12), Florida Statutes, COUNTY may allocate SHIP funds to eligible sponsors to partially assist in the construction, rehabilitation, or financing of eli gible housing. Eligible housing is defined in 9 420.9071(S), Florida Statutes. b. Rehabilitation SPONSOR may use project funds to rehabilitate eligible housing. Pursuant to 9 420.9071(12), Florida Statutes, COUNTY may allocate SHIP funds to eligible sponsors to partially assist in the construction, rehabilitation, or financing of eligible housing. Eligible housing is defined in 9 420.9071(8), Florida Statutes. Eligible work shall be determined by a Bid Specification Form prepared by HOUSING AND HUMAN SERVICES. 2. BUDGET Total funds available under this Agreement shall not exceed Two Hundred Fiftv Thousand and 0011 00 Dollars ($250.000.00) and the maximum award per unit shall be limited to fifty-thousand dollars ($50,000.00). The maximum award per unit may be allocated between acquisition and rehabilitation. Page 9 of 17 Agenda Item No. 16D4 January 27,2009 Page 13 of 20 -NOTE: SPONSOR may elect to allocate maximum award per unit between acquisition and rehabilitation. The Bid Specification Form, when prepared and if applicable, will be attached and incorporated into this Agreement and used to itemize the Rehabilitation budget. 3. STAFFING SPONSOR to provide list of staff directly responsible for reporting a nd request for payment processing. 4. FORMER PROJECTS Failure to adequately maintain any former SHIP funded projects may result in the delay of processing reimbursement requests for ongoing activities or in the forfeiture of future SHIP funds. 5. WORK SCHEDULE a. Acquisition Eligible Activity I Start Date I Target Dates Identify Property January 2009 March 2009 Purchase Property March 2009 July 2009 Identify Buyer( s) July 2009 October 2009 Transfer Property October 2009 December 2009 b. Rehabilitation Eligible Activity Start Date Target Dates 1 Purchase Property January 2009 March 2009 Bid Specification March 2009 May 2009 Complete Rehabilitation May 2009 October 2009 Transfer Property October 2009 December 2009 NOTE: Target dates are in effectfor program monitoring requirements only, and as such, are used by HOUSING AND HUMAN SERVICES as general target goals rather than strict performance requirements. Page 10 of 17 6. REPORTS Agenda Item No. 16D4 January 27,2009 Page 14 of 20 The SPONSOR shall submit detailed monthly progress reports to HOUSING AND HUMAN SERVICES outlining the status of specific activities under the project. Each report must account for the total activity for which the SPONSOR is paid with SHIP funds, in part or in whole, and which is required in fulfillment of their obligations under this Agreement. The progress reports shall be submitted on the form Exhibit "C". The progress reports shall be used as an additional basis for COUNTY'S approval of invoices, etc for payment. 7. COMPENSATION The COUNTY shall reimburse the SPONSOR for the performance of this Agreement upon completion or partial completion of the work tasks as accepted and approved by HOUSING AND HUMAN SERVICES pursuant to the submittal of monthly progress reports, but not more frequently than once per month. Progress payments to SPONSOR, as approved by HOUSING AND HUMAN SERVICES, can be made for any eligible activity listed in this Agreement. Eligible work tasks and/or activities shall include, but not be limited to, acquisition of property, rehabilitation of the property and resale of the property to an eligible person. Payments for eligible work tasks and/or activities may be made directly to the provider of the service(s), as approved by HOUSING AND HUMAN SERVICES, at SPONSOR'S request. Payment will be made upon receipt of a proper invoice and in compliance with S 218.70, Florida Statutes, otherwise known as the "Local Government Prompt Payment Act". END EXHIBIT "A" Page 11 of 17 Agenda Item No. 16D4 January 27,2009 Page 15 of 20 EXHIBIT "B" COLLIER COUNTY HOUSING AND HUMAN SERVICES REQUEST FOR PAYMENT SECTION I: REOUEST FOR PAYMENT SPONSOR Name: Habitat for Humanitv of Collier Countv.lnc SPONSOR Address: 11145 Tamiami Trail East. Naples. Florida 34113 Unit#l: Project No: Payment Request # Dollar Amount Requested: $ SECTION II: STATUS OF FUNDS I certify that this request for payment has been drawn in accordance with the terms and conditions of the Agreement between the County and us as the SPONSOR. I also certifY that the amount of the Request for Payment is not in excess of current needs. Signature Date Title (approval authority under $14,999) (approval required $15,000 and above) Supervisor Dept Director Page 120fl7 EXHIBIT "B" Agenda Item No. 16D4 January 27,2009 Page 16 of 20 COLLIER COUNTY HOUSING AND HUMAN SERVICES REQUEST FOR PAYMENT SECTION I: REQUEST FOR PAYMENT SPONSOR Name: Habitat for Humanitv of Collier Countv, Inc SPONSOR Address: 11145 Tamiami Trail East. Naples, F]orida 34113 Unit #2: Project No: Payment Request # Dollar Amount Requested: $ SECTION II: STATUS OF FUNDS 1. Total Loan Amount Unit #2 $ $50,000.00 2. Sum of Past Claims Paid on this Account $ 3. Total Loan Amount Less Sum of Past Claims Paid on this Account $ 4. Amount of Previous Unpaid Requests $ 5. Amount of To day's Request $ 6. Current Loan Balance (Initial Loan Amount Awarded Less Sum of<!!LRequests) $ 7. If applicable amount held as retainage to date by the County, if not retained by the sub-recipient. $ I certify that this request for payment has been drawn in accordance with the terms and conditions of the Agreement between the County and us as the SPONSOR. I also certify that the amount of the Request for Payment is not in excess of current needs. Signature Date Title (approval authority under $]4,999) (approval required $15,000 and above) Supervisor Dept Director Page 13 of ] 7 Agenda Item No. 16D4 January 27,2009 Page 17 of 20 EXHIBIT "B" COLLIER COUNTY HOUSING AND HUMAN SERVICES REQUEST FOR PAYMENT SECTION I: REQUEST FOR PAYMENT SPONSOR Name: Habitat for Humanitv of Collier County, Inc SPONSOR Address: 11145 Tamiami Trail East, Naples, Florida 34113 Unit #3: Project No: Dollar Amount Requested: $ Payment Request # SECTION II: STATUS OF FUNDS 1. Total Loan Amount Unit #3 $ $50.000.00 2. Sum of Past Claims Paid on this Account $ 3. Total Loan Amount Less Sum of Past Claims Paid on this Account $ 4. Amount of Previous Unpaid Requests $ 5. Amount of Today's Request $ 6. Current Loan Balance (Initial Loan Amount Awarded Less Sum of1!!.LRequests) $ 7. If applicable amount held as retainage to date by the County, if not retained by the sub-recipient. $ I certify that this request for payment has been drawn in accordance with the tcrms and conditions of the Agreement between the County and us as the SPONSOR. I also certify that the amount of the Request for Payment is not in excess of current needs. Signature Date Title (approval authority under $14,999) (approval required $15,000 and above) Supervisor Dept Director Page 140fl7 EXHIBIT "B" Agenda Item No. 16D4 January 27,2009 Page 18 of 20 COLLIER COUNTY HOUSING AND HUMAN SERVICES REQUEST FOR PAYMENT SECTION I: REQUEST FOR PAYMENT SPONSOR Name: Habitat for Humanitv of Collier Countv. Inc SPONSOR Address: 11145 Tamiami Trail East. Naples. Florida 341 13 Unit #4: Project No: Payment Request # Dollar Amount Requested: $ SECTION II: STATUS OF FUNDS I. Total Loan Amount Unit #4 $ $50.000.00 2. Sum of Past Claims Paid on this Account $ 3. Total Loan Amount Less Sum of Past Claims Paid on this Account $ 4. Amount of Previous Unpaid Requests $ 5. Amount of To day's Request $ 6. Current Loan Balance (Initial Loan Amount Awarded Less Sum of all Requests) $ 7. If applicable amount held as retainage to date by the County, if not retained by the sub-recipient. $ I certify that this request for payment has been drawn in accordance with the terms and conditions of the Agreement between the County and us as the SPONSOR. I also certify that the amount of the Request for Payment is not in excess of current needs. Signature Date Title Supervisor Dept Director (approval authority under $14,999) (approval required $15,000 and above) Page 15 of 17 Agenda Item No. 1604 January 27,2009 Page 19 of 20 EXHIBIT "B" COLLIER COUNTY HOUSING AND HUMAN SERVICES REQUEST FOR PAYMENT SECTION I: REOUEST FOR PAYMENT SPONSOR Name: Habitat for Humanitv of Collier Countv, Inc SPONSOR Address: 11145 Tamiami Trail East. Naples, Florida 34113 Unit #5: Project No: Payment Request # Dollar Amount Requested: $ SECTION II: STATUS OF FUNDS I. Total Loan Amount Unit #5 $ $50.000.00 2. Sum of Past Claims Paid on this Account $ 3. Total Loan Amount Less Sum of Past Claims Paid on this Account $ 4. Amount of Previous Unpaid Requests $ 5. Amount of Today's Request $ 6. Current Loan Balance (Initial Loan Amount Awarded Less Sum ofillLRequests) $ 7. If applicable amount held as retainage to date by the County, if not retained by the sub-recipient. $ I certify that this request for payment has been drawn in accordance with the terms and conditions of the Agreement between the County and us as the SPONSOR. I also certify that the amount of the Request for Payment is not in excess of current needs. Signature Date Title (approval authority under $14,999) (approval required $15,000 and above) Supervisor Dept Director Page 16 ofl7 Agenda Item No. 16D4 January 27,2009 Page 20 of 20 EXIDBIT "C" COLLIER COUNTY HOUSING AND HUMAN SERVICES SHIP MONTHLY PROGRESS REPORT Complete form for the past month and submit to Housing and Human Services staff by the 10th day of the following month. Status Report for Month of: Submittal Date: SPONSOR Name: Project Number: 1. Describe any action taken, relating to this project, during the past month. 2. What events/actions are scheduled for the next two months? 3. Describe any affirmative marketing you have implemented regarding this project. Please list and attached any recent media coverage of your organization relating to this project. 4. List any additional data relevant to the outcome measures listed in the Agreement. 5. Identity any potential issues that may cause delay. Page 17 of 17