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Backup Documents 09/15/2009 Item #16D17 ORIGlNAL DOCUMENTS CHECKLIST & ROUTING SLIP16 TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO D I? THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Print on pink pap<:r. Attach tll origil.al document. Original doeum<:nts should be hand del1\'ercd ttl tl1<: Iloard Officc. Th<: completed routing slip and original doeu1l1ents arc to be t,)[\\ankd to the Board Office only afll'r th<: II, lard has taken action on the item) ROUTING SLIP Complete routing lines # I through !i4 as appropriate for additional signatures, dates, and/or int,][mation needed. If the document is already complete with the exception of the Chairman's signatllfe, draw a line through routing lines # I through #4, complete the checklist. and forward to Sue Filson (line #5) Route to Addressee(s) Office Initials Date (List in routing order) ---- ---- l.Sandra Marrero Housing and Human Services ~ 09/15/09 2. Chairman Donna Fiala BCC 3. 4. I 5. Ian Mitchell, Executive Manager Board of County Commissioners ( ~/I I /V'-- ( ~ Ib') 6. Minutes and Records Clerk of Court's Office PRIMARY CONTACT INFORMATION (The primary contact is the holder of the original document pending BCC approval. 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, including Sue Filson, need to contact staff for additional or missing information. All original documents needing the BCe Chairman's signature are to be delivered to the BeC office only after the Bee has acted to approve the item.) Name of Primary Staff Margo Castorena, Manager Phone Number 252-2912 Contact Agenda Date ltem was 09/15/2009 Agenda Item Number 16D-17 Approved by the BCC Type of Document Amendment Number of Original I Attached Documents Attached INSTRUCTIONS & CHECKLIST Initial the Yes column or mark "N/A" in the Not Applicable column, whichever is Yes I N/A (Not appropriate. (Initial) Applicable) I. Original document has been signed/initialed for legal sufficiency. (All documents to be X signed by the Chairman, with the exception of most letters, must be reviewed and signed by the Office of the County Attorney. This includes signature pages from ordinances, resolutions, etc. signed by the County Attorney's Office and signature pages from contracts, agreements, etc. that have been fully executed by all parties except the BCC Chainnan and Clerk to the Board and possiblv State Officials.) 2. All handwritten strike-through and revisions have been initialed by the County Attorney's X Office and all other parries except the BCC Chainnan and the Clerk to the Board 3. The Chairman's signature line date has been entered as the date of BCC approval ofthe X document or the final negotiated contract date whichever is applicable. 4. "Sign here" tabs are placed on the appropriate pages indicating where the Chairman's X signature and initials are required. 5. In most cases (some contracts are an exception), the original document and this routing slip X should be provided to Ian Mitchell in the Bee office within 24 hours of Bee approval. Some documents are time sensitive and require forwarding to Tallahassee within a certain time frame or the BCe's actions are nullified. Be aware ofvour deadlines! 6. The document was approved by the BCC on 07/15/2009 and all changes made during X the meeting have been incorporated in the attached document. The County Attorney's Office has reviewed the changes, if applicable. I: Forms/ County Forms/BCC Form,/ Original Documents Routing Slip WWS Original 9.03.04, Revised 1.26.05, Revis~d 2.24.05 16D17 MEMORANDUM Date: September 17, 2009 To: Margo Castorena HUD Federal Grants Manager From: Teresa Polaski, Deputy Clerk Minutes & Records Department Re: Amendment #1 to "The Shelter for Abused Women & Children" Enclosed please one (1) copy original of the document referenced above (Agenda Item #16DI7) as approved by the Board of County Commissioners on Tuesday, September 15, 2009. If you have any questions, please call me at 774-8411. Thank you. Enclosures (1) 16D 17 EXHIBIT A-I Contract Amendment # I "The Shelter for Abused Women & Children Inc." ~ -1-'1-\. This amendment, dated I . 'P.J-t::~ he",., IS-, 2009 to the referenced agreement shall be by and between the parties to the original Agreement, The Shelter for Abused Women & Children Inc. (to be referred to as Sponsor) and Collier County, a political subdivision of the state of Florida, (to be referred to as "County"). Statement of Understanding RE: Contract # FL14870-6001 "The Shelter for Abused Women & Children Inc. Construction and Services." In order to continue the services provided for in the original Agreement document referenced above, the Sub- Recipient agrees to amend the above referenced Agreement as follows: Note: Words struek threl:lgh have been deleted; words underlined have been added. AMEND ARTICLE THREE: TIME OF PERFORMANCE Delete: IR any eveRt, all services reql:lired herel:lflder shall be I:lRdertakeR by the SUBRECIPIENT prior te ,A.priI30, 2009. Add: In any event, all services required hereunder shall be undertaken by the SUBRECIPIENT prior to September 9, 2009. AMEND ARTICLE FIVE: PA YMENTSINOTICES: Delete: HHS shall not be respoRsible fer payrneRt of any charges, elaims, or dema-Rds of the SUBRECIPIENT reeeiyed after May 15, 2009. Add: HHS shall not be responsible for payment of any charges, claims or demands of the SUB RECIPIENT incurred after September 9,2009. AMEND: ENTIRE UNDERSTANDING Delete: IN WIHiESS THEREOF, the J:larties hereto have cal:lsed this 21 page agreemeRt to be exeeuted by their I:lRoersigned officials as dl:lly authorized effeeti'/e the I'" day of May, 2008. Add: IN WITHNESS THEREOF, the parties hereto have caused this 2.1 page agreement to be executed by their undersigned officials as duly authorized effective the 9th day of September, 2008. AMEND ARTICLE FOUR: Consideration and Limitation of Costs Letter C Delete: Match fundiRg of25% is required for Sl:lpportive Services and 20% is reql:lired fer OperatiBg Services as reql:lired by HUD. Add: Match funding of20% is required for Supportive Services and 25% is required for Operating Services as required by HUD. Exhibit A-I Contract Amendment #1 160 FL14B70-6001 17 Shelter for Abused Women & Children Inc. Page 2 of3 AMEND ARTICLE TEN: MONTHLY REPORTS, EVALUATIIONS, AUDITS AND INSPECTIONS Delete: SA WCC will be reql:lired to Sl:lBmit its Aflfll:lal Performaece Report (;WR) to HHS by JI:IRe I, 2909. Add: SA WCC will be required to submit its Annual Performance Report (APR) to HHS by September 30, 2009. AMEND "EXHIBIT A" REPORTS: Delete: S;\ WCC, IRe will be required to sl:lBmit its ARRl:lal Performance Rep8rt (.^.PR) t8 HHS ey JURe I, 2009. Add: SA WCC, Inc. will be required to submit its Annual Performance Report (APR) to HHS by September 30, 2009 AMEND "EXHIBIT A" letter "C" ONE YEAR BUDGET: Delete: SHflP8rti'lc Services ReS81:lfces $14, 125.00 (f.pplicant 25% Cash Match) Add: Supportive Services-Resources $14, 125.00 (Applicant 20% Cash Match) Delete: OperatiRg E){penses Resol:lfces $14, 125. 00 (ApplicaFlt 25% Cash Match) Add: Operating Expenses-Resources $18,833.25 (Applicant 25% Cash Match) $14,125.00 $18.833.25 Total Match Funds $32,958.25 AMEND "EXHIBIT A" ONE YEAR BUDGET: Less than 10% reallocation within line items. Shelter for Abused Women & Children Inc. Oriainal Line Item Oriainal Budaet New Line Item New Budget -Transitional Living Advocate, salary & benefits, 80% -Childcare Supervisor, salary & benefits. 80% -Childcare Advocate, Salary & benefits, Supportive Services-Transitional 80% Living Advocate, 1 FTE, salary, -Childcare Program Support, salary & benefits, and taxes $ 56,500.00 benefits, 50% $ 61,415.00 -Utilities, insurance, maintenance supplies, etc, 75% -Computers & printers for residents for employment training programs, 5@ Operations-Maintenance, repair, $800.00 each, 75% staff-Facility Manager, Utilities, -Playground equipment for childcare equipment, supplies, insurance, program, furnishings, supplies, staff furnishinas $ 56, 500.00 trainina, certification fees, etc., 75% $ 51,585.00 Total $113,000.00 Total $113,000.00 Exhibit A-I Contract Amendment #1 16D FL14B70-6001 17 Shelter for Abused Women & Children Inc. Page 3 of3 All other terms and conditions of the agreement shall remain in force. IN WITNESS WHEREOF, the Sub-Recipient and the Owner have each, respectively, by an authorized person or agent, hereunder set their hands and seals on the date(s) indicated below. ~ Accepted: Q/pt. 15 ,2009 ~1;'tESi: COUNTY: '#'.'.', " D~ight E.' B;t;.~.ck; perk ~...~~~ '" '<'; :~ ' " ~. ~ ' , ~ By: ,.' k " " , Att'st,.I" to 0.. frNw . Donna Fiala, Chairman , 't',' . , ,.s..t'WU.,.. CMII.. Sub- RecIpIent: The Shelter for Abused Women & Children Inc. /~L~ By: By: Linda Oberhaus, Executive Director WIT~~~S~TO SU~ -. /~~// / / ~:~/ '/??'o- / /. PS/f //t./~r~. Print Name and Title CONTRACT SPECIALIST, vtR By ~nl ~LJi ( Lyn Wood t Approved as to form and GRA~INATOR Legal Sufficiency: By: ~~c:JJ?~~~ ~,;~:~ Sandra Marrero CDl\eet\ M. 6Yeene.. Printed Name ftem# Lb12t+ ..- .161111 fpati g-/2//o7 CONTRACTIWORK ORDER MODIFICATION (fl') CHECKLIST FORM ~O( PROJECT NAME: SAWCC. INC. SUDDortive Services and ODeratina Costs PROJECT #: FL 14B70-6001 Ac::flA.\.lI\ V\ j PROJECT MANAGER: S. Marrero BID/RFP #: N/A MOD#: ---1...- PO#: 4500102367 WORK ORDER #: NIA DEPARTMENT: Housina and Human Services CONTRACTOR/FIRM NAME: Shelter for Abused Women & Children Inc. (SAWCC) Original Contract Amount: $ 113.000.00 (Starting Point) Current BCC Approved Amount: $ 113.000.00 (Last Total Amount Approved by the BCG) Current Contract Amount: $ 113.000.00 (Including All Changes Prior To This Modification) Change Amount: $ 0 Revised ContractIWork Order Amount: $ 113.000.00 (Including This Change Order) Cumulative Dollar Value of Changes to this ContractIWork Order: $ 0 Date of Last BCC Approval 9-9-08 Agenda Item # 10F2F Percentage of the change over/under current contract amount 0 % Formula: (Revised Amount 1 Last BCC approved amounl)-1 CURRENT COMPLETION DATE (S): ORIGINAL: 9-9-2009 CURRENT: 9-9-2009 Describe the change(s): -Updates to endina date of contract. match fundina. due date of reports and additional items to the scope. Specify the reasons for the change(s) r 1. Planned or Elective r 2. Unforeseen Conditions (~ 3. Quantity Adjustments I3l 4. Correction of Errors (Plans, Specifications or Scope of Work) r 5. Value Added r 6. Schedule Adjustments Note: One or more may be checked, depending on the nature of the change(s). Identify all negative impacts to the project if this change order were not processed: The proiect would not be able to be completed. This change was requested by: 0 Contractor/Consultant 0 Owner PI Using Department r COES r Design Professional r1Regulatory Agency (Specify) P'IOther (Specify) SAWCC CONTRACT SPECIALIST PARTICIPATION IN NEGOTIATIONS: r ~ No Yes This form is to be signed and dated. APPROVED BY: Sandra Marrero Date: 8-21-09 Project Manager REVIEWED BY: Date: y-J,./-CJf Revised 11.19.2007