Backup Documents 05/14/2019 Item #16D 3 1603
cork
Public Services Division
Community&Human Services
Memorandum
To: Clerks Recording (1).(.444.4d df -lt ,
CC:
From: Wendy Klopf, Grant Coordinator, Services for Seniors
Date: 05.16.19
Subject: Executed Amendments with Area Agency on Aging of SWFIa (AAA)
CHS is providing executed Amendments from Area Agency on Aging of SWFIa (AAA) that was approved
on the Consent Agenda on 5.14.19
• 16D3-ADI 203.18.002
• 16D3-ADI 203.18.003
• 16D3-CCE 203.18.002
Enclosed are the copies for Minutes and Records since they did not require the BCC signature due to
Resolution 2010-122, designating the Public Service Administrator authority to sign the amendments.
Let me know if you need anything.
,,t6A-OL I I 4#1/
Thanks
Wendy Klopf
Grant Coordinator-Services for Seniors
252-2901
Coder County
1603
July 2018—June 2019 ADI 203.18.002
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC.
ALZHEIMER'S DISEASE INITIATIVE PROGRAM
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
THIS AMENDMENT is entered into between the Area Agency on Aging for Southwest Florida,Inc. ("Agency")and Collier
County Board of County Commissioners,("Contractor"),amends agreement ADI 203.18.
The purpose of this amendment is to amend 4. Contract Amount,increase allocation for Collier County by$3,970.02,and
revise ATTACHMENT II-Exhibit 2 and ATTACHMENT X-Annual Budget Summary.
4. Contract Amount:
The Agency agrees to pay for contracted services according to the terms and conditions of this contract in an amount not to
exceed $406,970.02 subject to the availability of funds. Any costs or services paid for under any other contract or from
any other source are not eligible for payment under this contract.
All provisions in the contract and any attachments thereto in conflict with this Amendment shall be and are hereby changed to
conform to this Amendment.
All provisions not in conflict with this Amendment are still in effect and are to be performed at the level specified in the contract.
This Amendment and all its attachments are hereby made part of the contract.
IN WITNESS THEREOF,the Parties hereto have caused this amendment,to be executed by their undersigned officials as duly
authorized; and agree to abide by the terms, conditions and provisions of this ADI contract as amended. This Amendment is
effective on the last date the Amendment has been signed by both Parties.
Contractor: COLLIER COUNTY BOARD AREA AGENCY ON AGING FOR
OF COUNTY a MMISSIONERS SOUTHWEST FLORIDA,INC.
SIGNED BY: it / SIGNED BY: %'rnIl..UO • O r1l tnt�
NAME: STEPHEN Y CARNELL NAME: MARIANNE G LORINI
TITLE:PUBLIC SERVICES DEPARTMENT HEAD TITLE: PRESIDENT/CEO
DATE: /12//9 DATE: '/l p/!
Federal Tax ID: 59-6000588
Fiscal Year Ending Date: 09/30
DUNS: 076997790 Approved as to form and legality
1. 2
•ristant County • ncY ck+ tItG\
1
1603
ADI 203.18.002
July 2018–June 2019
ATTACHMENT II-EXHIBIT 2
FUNDING SUMMARY
Note: Title 2 CFR,as revised,and Section 215.97,F.S.require that the information about Federal Programs and State
Projects included in Attachment II,Exhibit 1 be provided to the recipient.Information contained herein is a prediction of
funding sources and related amounts based on the contract budget.
1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS CONTRACT
CONSIST OF THE FOLLOWING:
GRANT AWARD(FAIN#): FEDERAL AWARD DATE:
DUNS NUMBER: 076997790
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL FEDERAL AWARD
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED
PURSUANT TO THIS CONTRACT ARE AS FOLLOWS:
FEDERAL FUNDS:
2 CFR Part 200–Uniform Administrative Requirements,Cost Principles,and Audit Requirements for Federal Awards.
OMB Circular A-133–Audits of States,Local Governments, and Non-Profit Organizations
2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS CONTRACT CONSIST OF
THE FOLLOWING:
MATCHING RESOURCES FOR FEDERAL PROGRAMS
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL STATE AWARD
STATE FINANCIAL ASSISTANCE SUBJECT TO SECTION 215.97, F.S.
PROGRAM TITLE FUNDING SOURCE CSFA AMOUNT
Alzheimer's Disease Initiative General Revenue—TSTF-Collier 65004 $ 406,970.02
TOTAL AWARD S 406,970.02
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT
TO THIS CONTRACT ARE AS FOLLOWS:
STATE FINANCIAL ASSISTANCE
Sections 215.97&215.971,F.S.,Chapter 69I-5,F.A.C,State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws,rules and regulations
2
1603
ADI 203.18.002
July 2018—June 2019
ATTACHMENT X
ANNUAL BUDGET SUMMARY
ALZHEIMER'S DISEASE INITIATIVE PROGRAM
For
Collier County Board of County Commissioners
Collier
ALLOCATION TOTAL $ 406,970.02
CPs
3 `'..
1603
Revised August 2007
Attestation Statement
Agreement/Contract Number ADI 203.18
Amendment Number QQ ,
I,STEPHEN Y CARNELL ,attest that no changes or revisions have been made to the
(Recipient/Contractor representative)
content of the above referenced agreement/contract or amendment between the Area Agency on Aging for
Southwest Florida and
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
(Recipient/Contractor name)
The only exception to this statement would be for changes in page formatting,due to the differences in
electronic data processing media,which has no affect on the agreement/contract content.
*it 4
e. /9
Signature o Recipient/ ontractor representative Da e
Approved as to form and legality
Assistant Corm Home
`t\g\\°1
Revised August 2007
i
16033
July 2018—June 2019 ADI 203.18.003
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC.
ALZHEIMER'S DISEASE INITIATIVE PROGRAM
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
THIS AMENDMENT is entered into between the Area Agency on Aging for Southwest Florida, Inc. ("Agency")and Collier
County Board of County Commissioners, ("Contractor"), amends agreement ADI 203.18.
The purpose of this amendment is to amend 4. Contract Amount, increase allocation for Collier County by$60,000.00, and
revise ATTACHMENT II-Exhibit 2 and ATTACHMENT X-Annual Budget Summary.
4. Contract Amount:
The Agency agrees to pay for contracted services according to the terms and conditions of this contract in an amount not to
exceed$466,970.02 subject to the availability of funds. Any costs or services paid for under any other contract or from
any other source are not eligible for payment under this contract.
All provisions in the contract and any attachments thereto in conflict with this Amendment shall be and are hereby changed to
conform to this Amendment.
All provisions not in conflict with this Amendment are still in effect and are to be performed at the level specified in the contract.
This Amendment and all its attachments are hereby made part of the contract.
IN WITNESS THEREOF,the Parties hereto have caused this amendment,to be executed by their undersigned officials as duly
authorized; and agree to abide by the terms, conditions and provisions of this ADI contract as amended. This Amendment is
effective on the last date the Amendment has been signed by both Parties.
Contractor: COLLIER COUNTY BOARD AREA AGENCY ON AGING FOR
OF COUNTY COMMISSIONERS
SOUTHWEST FLORIDA,INC.
n J/�, �L SIGNED BY:
SIGNED BY:"t lC����-�� /` '�'u'��{
NAME: STEPHEN Y CARNELL NAME: MARIANNE G LORINI
TITLE: PUBLIC SERVICES DEPARTMENT HEAD TITLE: PRESIDENT/CEO
DATE: Z.// DATE: `s///
Federal Tax ID: 59-6000588
Fiscal Year Ending Date: 09/30 Approved as to form and legality
DUNS: 076997790
Assistant County Au rney J
413O (el
1
ADI 203.18.0.16 El 3
July 2018–June 2019
ATTACHMENT II-EXHIBIT 2
FUNDING SUMMARY
Note: Title 2 CFR, as revised, and Section 215.97,F.S. require that the information about Federal Programs and State
Projects included in Attachment II,Exhibit 1 be provided to the recipient. Information contained herein is a prediction of
funding sources and related amounts based on the contract budget.
1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS CONTRACT
CONSIST OF THE FOLLOWING:
GRANT AWARD (FAIN#): FEDERAL AWARD DATE:
DUNS NUMBER: 076997790
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL FEDERAL AWARD
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED
PURSUANT TO THIS CONTRACT ARE AS FOLLOWS:
FEDERAL FUNDS:
2 CFR Part 200–Uniform Administrative Requirements, Cost Principles,and Audit Requirements for Federal Awards.
OMB Circular A-133 –Audits of States, Local Governments, and Non-Profit Organizations
2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS CONTRACT CONSIST OF
THE FOLLOWING:
MATCHING RESOURCES FOR FEDERAL PROGRAMS
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL STATE AWARD
STATE FINANCIAL ASSISTANCE SUBJECT TO SECTION 215.97,F.S.
PROGRAM TITLE FUNDING SOURCE CSFA AMOUNT
Alzheimer's Disease Initiative General Revenue—TSTF-Collier 65004 $ 466,970.02
TOTAL AWARD $ 466,970.02
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT
TO THIS CONTRACT ARE AS FOLLOWS:
STATE FINANCIAL ASSISTANCE
Sections 215.97&215.971,F.S.,Chapter 69I-5,F.A.C, State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws,rules and regulations
2
ADI 203July 2018—June 2019
.6 0 3
ATTACHMENT X
ANNUAL BUDGET SUMMARY
ALZHEIMER'S DISEASE INITIATIVE PROGRAM
For
Collier County Board of County Commissioners
Collier
ALLOCATION TOTAL $ 466,970.02
3 0
1603
Revised August 2007
Attestation Statement
Agreement/Contract Number ADI.203.18
Amendment Number .003
I,STEPHEN Y CARNELL ,attest that no changes or revisions have been made to the
(Recipient/Contractor representative)
content of the above referenced agreement/contract or amendment between the Area Agency on Aging for
Southwest Florida and
COLIER COUNTY BOARD OF COMMISSIONERS .
(Recipient/Contractor name)
The only exception to this statement would be for changes in page formatting,due to the differences in
electronic data processing media,which has no affect on the agreement/contract content.
1 r
14130
Signature of Recipien'Contractor representative Date
Approved as to form and legality
c1J
Assistant Count Att r r
Y Y
101
Revised August 2007
S
1603
July 2018—June 2019 CCE 203.18.002
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC.
COMMUNITY CARE FOR THE ELDERLY PROGRAM
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
THIS AMENDMENT is entered into between the Area Agency on Aging for Southwest Florida, Inc. ("Agency") and
Collier County Board of County Commissioners,("Contractor"), amends agreement CCE 203.18.
The purpose of this amendment is to amend 4. Contract Amount, increase allocation for Collier County by$3,133.00,
and revise ATTACHMENT II-Exhibit 2 and ATTACHMENT VIII-Annual Budget Summary.
4. Contract Amount:
The Agency agrees to pay for contracted services according to the terms and conditions of this contract in an amount
not to exceed$881,648.00 subject to the availability of funds. Any costs or services paid for under any other contract
or from any other source are not eligible for payment under this contract.
All provisions in the contract and any attachments thereto in conflict with this Amendment shall be and are hereby changed to
conform to this Amendment.
All provisions not in conflict with this Amendment are still in effect and are to be performed at the level specified in the
contract.
This Amendment and all its attachments are hereby made part of the contract.
IN WITNESS THEREOF, the Parties hereto have caused this amendment,to be executed by their undersigned officials as
duly authorized; and agree to abide by the terms, conditions and provisions of this CCE contract as amended. This
Amendment is effective on the last date the Amendment has been signed by both Parties.
Contractor: COLLIER COUNTY BOARD AREA AGENCY ON AGING FOR
OF COUNTY COMMISSIONERS �j� SOUTHWEST FLORIDA,4NC. y
SIGNED BY: '�fJlj '���- �% SIGNED BY: Ltri 0+t- fltXLA/tl`'
NAME: STEPHEN Y CARNELL NAME: MARIANNE G LORINI
TITLE: PUBLIC SERVICES DEPARTMENT HEAD TITLE: PRESIDENT/CEO
DATE: LA I 1 2,1 C/ DATE: LI/19//
Federal Tax ID: 59-6000588
Fiscal Year Ending Date: 09/30 Approved as to form and legality
DUNS: 076997790
2,
Assistant County Attv1y\�1
1603
July 2018—June 2019 CCE 203.18.002
ATTACHMENT II-EXHIBIT 2
FUNDING SUMMARY
Note: Title 2 CFR&2 CFR Part 200, as revised,and Section 215.97(5),F.S.require that the information about
Federal Programs and State Projects included in Exhibit 1 be provided to the recipient.Information contained herein
is a prediction of funding sources and related amounts based on the contract budget.
1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS
CONTRACT CONSIST OF THE FOLLOWING:
GRANT AWARD(FAIN#): FEDERAL AWARD DATE:
DUNS NUMBER: 076997790
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL FEDERAL AWARD
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED
PURSUANT TO THIS CONTRACT ARE AS FOLLOWS:
FEDERAL FUNDS:
2 CFR Part 200—Uniform Administrative Requirements,Cost Principles,and Audit Requirements for Federal
Awards. OMB Circular A-133—Audits of States,Local Governments,and Non-Profit Organizations
2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS CONTRACT CONSIST
OF THE FOLLOWING:
MATCHING RESOURCES FOR FEDERAL PROGRAMS
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
•
TOTAL STATE AWARD
STATE FINANCIAL ASSISTANCE SUBJECT TO Sec.215.97,F.S.
PROGRAM TITLE FUNDING SOURCE CSFA AMOUNT
Community Care for the Elderly General Revenue-Collier 65.010 $ 881,648.00
TOTAL AWARD $ 881,648.00
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO
THIS CONTRACT ARE AS FOLLOWS:
STATE FINANCIAL ASSISTANCE
Section 215.97,F.S.,Chapter 691-5,F.A.C, State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws,rules and regulations
2
f�l )
16133
July 2018—June 2019 CCE 203.18.002
ATTACHMENT VIII
ANNUAL BUDGET SUMMARY
COMMUNITY CARE FOR THE ELDERLY PROGRAM
for
Collier County Board of County Commissioners
Collier
CCE Services Allocations $ 881,648.00
•
3
160 3
Revised August 2007
Attestation Statement
Agreement/Contract Number CCE 203.18
Amendment Number Qja
I,STEPHEN Y CARNELL ,attest that no changes or revisions have been made to the
(Recipient/Contractor representative)
content of the above referenced agreement/contract or amendment between the Area Agency on Aging for
Southwest Florida and
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
(Recipient/Contractor name)
The only exception to this statement would be for changes in page formatting,due to the differences in
electronic data processing media,which has no affect on the agreement/contract content.
1, -�G (2
Signature of Recipien ontractor representative to
Approved as to form and legality
•
A sistunt County tirney `$,\�
Revised August 2007