Backup Documents 12/08/2020 Item #16D 8 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 16 0 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 routing lines#1 through#2,complete the checklist,and forward to the County Attomey Office.
Route to Addressee(s) (List in routing order) Office Initials Date
1.
2.
3. County Attorney Office County Attorney Office SUla 12'G1 \2 Q 0
4. BCC Office Board of County
Commissioners ;� 1p71(i
5. Minutes and Records Clerk of Court's Office � 111 ` IV 1 1.j
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 Matthew Catoe—PSD Contact Information 239-252-4059
Contact/ Department
Agenda Date Item was 12/8/2020 Agenda Item Number 16.D.8
Approved by the BCC
Type of Document Application Number of Original 1
Attached Documents Attached
PO number or account
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 signatur STAMP OK •�iC. p.�G
2. Does the document need to be sent to another agency for addition ures? If yes, N/A
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 MC
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 MC
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 MC
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 MC
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip MC
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 12/8/2020 and all changes made during N/A is not
the meeting have been incorporated in the attached document. The County an option for
Attorney's Office has reviewed the changes,if applicable. this line.
9. Initials of attorney verifying that the attached document is the version approved by the N/A is not
BCC,all changes directed by the BCC have been made,and the document is ready for the an option for
Chairman's signature. this line.
608
Ann P. Jennejohn
From: Ann P.Jennejohn
Sent: Monday, December 14, 2020 2:22 PM
To: CatoeMatthew
Subject: Item #16D8 (12-8-20 BCC Meeting)
Attachments: Backup Documents 12_08_2020 Item #16D 8.pdf
Good Afternoon Matt,
An executed copy of the document referenced
above is attached for your records.
Thank you.
Ann Jennejohn
13MR Senior Deputy Clerk
VAT COI Clerk to the Value Adjustment Board
4`e.•, Office: 239-252-84O(
Fax: 239-252-8408 (if applicable)
Ann.Jennejohn@CollierClerk.com
t Office of the Clerk of the Circuit Court
rk �t�`(N e�1/4at-
& Comptroller of Collier County
32q Tavniawi Trail, Suite *401
Naples, FL- 34112-5324
www.CollierClerk.com
608
OMB Number:4040-0004
Expiration Date:12/31/2022
Application for Federal Assistance SF-424
*1.Type of Submission: *2.Type of Application: "If Revision,select appropriate letter(s):
❑ Preapplication ❑New A: Increase Award
Application ❑Continuation *Other(Specify):
❑ Changed/Corrected Application ®Revision
*3.Date Received: 4.Applicant Identifier:
5a.Federal Entity Identifier: 5b.Federal Award Identifier:
F20AC10210
State Use Only:
6.Date Received by State: 7.State Application Identifier:
8.APPLICANT INFORMATION:
*a.Legal Name: Collier County Board of County Commissioners
b.Employer/Taxpayer Identification Number(EIN/TIN): *c.Organizational DUNS:
59-6000558 0769977900000
d.Address:
*Streetl: 3299 Tamiami Trl E Ste 700
Street2:
*City: Naples
County/Parish:
*State: FL: Florida
Province:
*Country: USA: UNITED STATES
*Zip/Postal Code: 34112-5749
e.Organizational Unit:
Department Name: Division Name:
Public Services Parks and Recreation
f.Name and contact information of person to be contacted on matters involving this application:
Prefix: Mrs. *First Name: Melissa
Middle Name:
*Last Name: Hennig
Suffix:
Title: Regional Manager
Organizational Affiliation:
Employee
Telephone Number: 239-252-2957 Fax Number:
*Email: Melissa.Hennig@colliercountyfl.gov
608
Application for Federal Assistance SF-424
*9.Type of Applicant 1:Select Applicant Type:
B: County Government
Type of Applicant 2:Select Applicant Type:
Type of Applicant 3:Select Applicant Type:
*Other(specify):
*10.Name of Federal Agency:
DOI-US Fish and Wildlife Service
11.Catalog of Federal Domestic Assistance Number:
15.631
CFDA Title:
Partners for Fish and Wildlife
*12.Funding Opportunity Number:
F-FWS-NWRS-20-003
*Title:
Partners for Fish and Wildlife
13.Competition Identification Number:
F-FWS-NWRS-20-003-076244
Title:
Partners for Fish and Wildlife
14.Areas Affected by Project(Cities,Counties,States,etc.):
Add Attachment Delete Attachment View Attachment
*15.Descriptive Title of Applicant's Project:
Collier County Mcllvane Marsh Restoration Project
Attach supporting documents as specified in agency instructions.
Add Attachments Delete Attachments View Attachments
1608
Application for Federal Assistance SF-424
16.Congressional Districts Of:
*a.Applicant 19, 25 *b.Program/Project 19
Attach an additional list of Program/Project Congressional Districts if needed.
Add Attachment Delete Attachment View Attachment
17.Proposed Project:
*a.Start Date: 09/01/2020 *b.End Date: 08/31/2025
18.Estimated Funding($):
*a.Federal 15,000.00
*b.Applicant 15,000.00
*c.State 0.00
*d.Local 0.00
*e.Other 0.00
*f. Program Income 0.00
*g.TOTAL 30,000.00
*19.Is Application Subject to Review By State Under Executive Order 12372 Process?
0 a.This application was made available to the State under the Executive Order 12372 Process for review on
❑ b.Program is subject to E.O. 12372 but has not been selected by the State for review.
® c.Program is not covered by E.O. 12372.
*20.Is the Applicant Delinquent On Any Federal Debt? (If"Yes,"provide explanation in attachment.)
❑Yes ®No
If"Yes",provide explanation and attach
Add Attachment Delete Attachment View Attachment
21.*By signing this application,I certify(1)to the statements contained in the list of certifications**and(2)that the statements
herein are true, complete and accurate to the best of my knowledge. I also provide the required assurances** and agree to
comply with any resulting terms if I accept an award.I am aware that any false,fictitious,or fraudulent statements or claims may
subject me to criminal,civil,or administrative penalties.(U.S.Code,Title 218,Section 1001)
® **I AGREE
**The list of certifications and assurances, or an internet site where you may obtain this list, is contained in the announcement or agency
specific instructions.
Authorized Representative:
Prefix: Mr. *First Name: Burt
Middle Name:
*Last Name: Saunders
Suffix:
*Title: Chairman of the Board of County Commissioners
*Telephone Number: 239-252-8603 Fax Number:
*Email: Burt.Saunders&colliercountyfl.goy /.......1414,18611716"-*Signature of Authorized Representative: *Date Signed: 12/08/2020
ATTEST •;• Approved as to form and legality
CRYST,Afw K.KINZELCLERK , C
BY 'fi�r C.., :istant County Attu
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