Backup Documents 04/12/2022 Item #16G 1 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO I b 6
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
**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 Attorney Office.
Route to Addressee(s) (List in routing order) Office Initials Date
1. County Attorney Office )-At, CAO SA'0 LI/H/Z
2. Board of County Commissioners Office BOCC fftt
3. Minutes and Records Clerk of Court's Office
�� t' `� J�'z2
.� 4 'law? itvitak
4. Send signed copy to Heather Meyer GMD South/Airport
Heather.meyer@colliercountyfl.gov Authority
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 Heather Meyer/Airport Authority 239-252-5765
Contact/ Department
Agenda Date Item was April 12,2022 Agenda Item Number 16G.1
Approved by the BCC
Type of Document GOZ 16 FDOT Grant Amendment#4 Number of Original 1
Attached Documents Attached
PO number or account N/A
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 signature STAMP OK HM
2. Does the document need to be sent to another agency for additional signatures? If yes, HM
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 HM
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 HM
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 HM
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
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip HM
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 March 8,2022 and all changes made N/A is not
during the meeting have been incorporated in the attached document. The County 'Ak/fir, 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 *It, an option for
Chairman's signature. this line.
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
16 GI
MEMORANDUM
Date: April 18, 2022
To: Heather Meyer, Management/Budget Analyst
Operations Support Division
From: Mende Ragan, Deputy Clerk
Minutes & Records Department
Re: Grant Agreement #4 GOZ16 with FDOT
Attached for your records is one (1) scanned copy of the document referenced above,
(Item #16G1) approved by the Board of County Commissioners Tuesday, April 12,
2022.
If you have any questions, please call me at 252-8411.
Thank you.
Attachment
DocuSign Envelope ID:8E7C310E-32FC-4DE4-96A5-D087D1E9AF54
16G1
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION Form T20-000-04
AMENDMENT FOR EXTENSION OF PUBLIC TRANSPORTATION STRATEGIC
DEVELOPMENT
GRANT AGREEMENT D00O2,11
DATE: 2/28/22
TO: Heather Meyer
Immokalee Regional Airport
FROM: Kristi A Smith, CPM. PLS
CONTRACT NUMBER: GOZ16
AMENDMENT NUMBER: 4
FINANCIAL MANAGEMENT NUMBER: 433632-1-94-01
The Public Transportation Grant Agreement("Agreement')between the Florida Department of Transportation
("Department")and Immokalee Regional Airport ("Agency") dated 01/28/2019 , is scheduled to expire on the 30
day of June , 2022
The Agency requests an Amendment of the Agreement,to extend the end date of the Agreement to the 30 day of_
June_, 2023 , for additional time to complete the Project for the following reasons: The Collier County Airport
Authority kindly requests the expiration date for FM 433632-1-94-01 to be extended from June 30, 2022 to June 30,
2023 as a result of ongoing complications with the procurement and delivery of various materials and equipment. Due
to material shortages nationwide,we have encountered lona lead times on materials and equipment,particularly the
network equipment. Numerous items remain pending which are critical to the infrastructure of the secu•ity
enhancements at the Immokalee Regional Airport. In addition,our area is experiencing a labor shortage which is
causing further delays in getting the equipment installed and configured. In consideration of the items that are still on
backorder and accounting for the possibility of further delays,we are requesting a one year extension to ensure
sufficient time to complete the protect,schedule the final inspection and prepare the closeout documentation.
The Department agrees to the requested extension of the Agreement.All of the terms and conditions of the Agreement
and any amendments thereto shall remain in full force and effect
IN WITNESS WHEREOF,the Parties have executed this Amendment o4/20/'2022 I(tJa or le f Dy
Department).
Agenc Col I:r' •re ,ir••rt Author' STATE OF FLORIDA, DEPARTMENT OF TRANSPORTATION
1' .s friir Cleitun,obeta ned by.By' y_�4 ui. By obits
•n"1'.: .'i% �-.- CDS8AFBDe1T54C4...
1 " Name John M. Kubler, P.E.
-
William L:iVlciDaniel, Jr., Chairman
r . Title Director of Transportation Development
STATE OF FLORIDA, DEPART MENT OF TRANSPORTATION
' Attu0sn Legal Review
r:-, ,—Doeuagrnd by:
NEM Fe8MNIF9Senior A •rn-y('s to Legality and Form)
ATTEST Approved,: I. ,1lity
CRYSTAL K.KINZEL.C FRK '10411 13-
ItY442111LS.
CO,. 11/1 ,,
' aunty Attorney _1 .,,\
DocuSign Envelope ID:8E7C310E-32FC-4DE4-96A5-D087D1E9AF54
16G1
RESOLUTION NO. 2021- 60
RESOLUTION OF THE BOARD OF COUNTY COMMISSIONERS, ACTING
AS THE COLLIER COUNTY AIRPORT AUTHORITY, APPROVING AND
AUTHORIZING 'I'HE EXECUTION OF THE ATTACHED AMENDMENT NO.
2 AND ALL SUBSEQUENT AMENDMENTS TO PUBLIC TRANSPORTATION
GRANT AGREEMENT GOZ16 WITH THE FLORIDA DEPARTMENT OF
TRANSPORTATION UPON BOARD APPROVAL
WHEREAS, the Collier County Airport Authority has the authority to enter into the attached
agreement with the Florida Department of Transportation to undertake projects as authorized by
Chapter 332, Florida Statutes. and Section 14-60 of the Florida Administrative Code, and Ordinance
2004-03.
NOW, THEREFORE. BE IT RESOLVED HY THE Board of County Commissioners acting
as the Collier County Airport Authority. Collier County, Collier County, Florida, that:
1. Amendment No. 2 to Public Transportation Grant Agreement(PTGA)Number G0Z16 for
a time extension for security enhancements at the lmmokalee Regional Airport, Financial
Management Number 433632-1-94-01, attached hereto, is hereby approved.
2. The Chairman of the Board of County Commissioners,acting as the Collier County Airport
Authority, is authorized to enter into, modify or terminate Amendment No. 2 to PTGA
Number G0Z16 with the Florida Department of Transportation unless and until it may be
specifically rescinded.
3. Upon Board approval, the Chairman of the (Board of County Commissioners acting as the
Collier County Airport Authority, is authorized to enter into, modify or terminate all
subsequent amendments to PTGA Number GOZ 16 with the Florida Department of
Transportation unless and until it may be specifically rescinded.
4. This Resolution sl(141 take effect immediately upon adoption.
ADOPTED this a3 day of I µ 2021 after motion, second and majority vote in
favor of adoption.
AT'F�§T:' n ''1' COLLIER COUNTY AIRPORT AUTHORITY
CRYSTAL K. K.INIEL,CLERK
It
O
i '1 ;�'� LE1(K PENNY T .OR, IRPERSON
tle
cordon P
Approved for form and legality:
Jen r A. Belpedio el..N-
i_
Assistant County Attorney
16GI
DocuSign
Certificate Of Completion
Envelope Id:8E7C310E32FC4DE496A5D087D1E9AF54 Status:Completed
Subject:Please DocuSign: IMM_GOZ16_433632-1_Security Enhancements_Time Extension_Amendment No.4_Signed...
Contract Number(ex.C9Al2,optional):GOZ16
Document Contains Confidential Information?:No
Fin Proj Num(ex.123456-1-32-01,Optional):433632-1-94-01
Office(contact Procurement if add is needed):
Aviation
HR Action?:No
Source Envelope:
Document Pages:2 Signatures:2 Envelope Originator:
Certificate Pages:2 Initials:0 Dawn Gallon
AutoNav:Enabled 605 Suwannee Street
Envelopeld Stamping:Enabled MS 20
Time Zone:(UTC-05:00)Eastern Time(US&Canada) Tallahassee, FL 32399-0450
dawn.gallon@dot.state.fl.us
IP Address: 156.75.252.6
Record Tracking
Status:Original Holder:Dawn Gallon Location:DocuSign
4/20/2022 8:29:53 AM dawn.gallon@dot.state.fl.us
Signer Events Signature Timestamp
D«Signed by:
Don Conway Sent:4/20/2022
don.conway@dot.state.fl.us Viewed:4/20/2022 1:56:34 PM
Senior Attorney e37°1°5420ne4o9. Signed:4/20/2022 2:01:34 PM
Florida Department of Transportation
Security Level:Email,Account Authentication
Signature Adoption:Pre-selected Style
(None) Signed by link sent to don.conway@dot.state.fl.us
Using IP Address: 156.75.252.6
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
John Kubler .��D009811"W Dr Sent:4/20/2022 2:01:35 PM
john.kubler@dot.state.fl.us .J Viewed:4/20/2022 3:02:57 PM
Director of Transportation Developm °°aeose°e„saa.. Signed:4/20/2022 3:03:10 PM
Florida Department of Transportation
Security Level:Email,Account Authentication
Signature Adoption:Pre-selected Style
(None) Signed by link sent to john.kubler@dot.state.fl.us
Using IP Address: 156.75.180.190
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
In Person Signer Events Signature Timestamp
Editor Delivery Events Status Timestamp
Agent Delivery Events Status Timestamp
Intermediary Delivery Events Status Timestamp
Certified Delivery Events Status Timestamp
Carbon Copy Events Status Timestamp
Witness Events Signature Timestamp 1 6 G 1
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent Hashed/Encrypted 4/20/2022 8:35:36 AM
Certified Delivered Security Checked 4/20/2022 3:02:57 PM
Signing Complete Security Checked 4/20/2022 3:03:10 PM
Completed Security Checked 4/20/2022 3:03:10 PM
Payment Events Status Timestamps
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION Form 725-00044
AMENDMENT FOR EXTENSION OF PUBLIC TRANSPORTATION STRATEGIC
DEVELOPMENT
GRANT AGREEMENT O00O2/19
DATE: 2/28/22
TO: Heather Meyer
Immokalee Regional Airport
FROM: Kristi A. Smith, CPM, PLS
CONTRACT NUMBER: GOZ16
AMENDMENT NUMBER: 4
FINANCIAL MANAGEMENT NUMBER: 433632-1-94-01
The Public Transportation Grant Agreement("Agreement")between the Florida Department of Transportation
("Department")and Immokalee Regional Airport ("Agency"), dated 01/28/2019 , is scheduled to expire on the 30
day of June , 2022 .
The Agency requests an Amendment of the Agreement,to extend the end date of the Agreement to the 30 day of_
June , 2023 , for additional time to complete the Project for the following reasons: The Collier County Airport
Authority kindly requests the expiration date for FM 433632-1-94-01 to be extended from June 30,2022 to June 30,
2023 as a result of ongoing complications with the procurement and delivery of various materials and equipment. Due
to material shortages nationwide,we have encountered long lead times on materials and equipment,particularly the
network equipment. Numerous items remain pending which are critical to the infrastructure of the security
enhancements at the Immokalee Regional Airport. In addition,our area is experiencing a labor shortage which is
causing further delays in getting the equipment installed and configured. In consideration of the items that are still on
backorder and accounting for the possibility of further delays,we are requesting a one year extension to ensure
sufficient time to complete the project, schedule the final inspection and prepare the closeout documentation. .
The Department agrees to the requested extension of the Agreement.All of the terms and conditions of the Agreement
and any amendments thereto shall remain in full force and effect.
IN WITNESS WHEREOF,the Parties have executed this Amendment on (to be completed by
Department).
Agenc .o 'ou w A ir.ort Authors STATE OF FLORIDA, DEPARTMENT OF TRANSPORTATION
40,40101
By: � � rr By
Name:
William L. McDaniel, Jr., Chairman
Title:
STATE OF FLORIDA, DEPARTMENT OF TRANSPORTATION
Attest as to Chareinan's Legal Review:
ATTEST Approved :. ,1. le -ality
CRYSTAL K.KINZEL,C FRK 'i„ll n
•Y / • bunty Attorney (,'..', \ �'
U6 GI
RESOLUTION NO. 2021- 60
RESOLUTION OF TILE BOARD OF COUNTY COMMISSIONERS, ACTING
AS THE COLLIER COUNTY AIRPORT AUTHORITY, APPROVING AND
AUTHORIZING THE EXECUTION OF THE ATTACHED AMENDMENT NO.
2 AND ALL SUBSEQUENT AMENDMENTS TO PUBLIC TRANSPORTATION
GRANT AGREEMENT GOZ16 WITH THE FLORIDA DEPARTMENT OF
TRANSPORTATION UPON BOARD APPROVAL
WHEREAS, the Collier County Airport Authority has the authority to enter into the attached
agreement with the Florida Department of Transportation to undertake projects as authorized by
Chapter 332, Florida Statutes, and Section 14-60 of the Florida Administrative Code, and Ordinance
2004-03.
NOW, THEREFORE, BE IT RESOLVED BY THE Board of County Commissioners acting
as the Collier County Airport Authority, Collier County, Collier County, Florida, that:
1. Amendment No. 2 to Public Transportation Grant Agreement(PTGA)Number GOZ16 for
a time extension for security enhancements at the Immokalee Regional Airport, Financial
Management Number 433632-1-94-01, attached hereto, is hereby approved.
2. The Chairman of the Board of County Commissioners,acting as the Collier County Airport
Authority, is authorized to enter into, modify or terminate Amendment No. 2 to PTGA
Number GOZ16 with the Florida Department of Transportation unless and until it may be
specifically rescinded.
3. Upon Board approval, the Chairman of the Board of County Commissioners acting as the
Collier County Airport Authority, is authorized to enter into, modify or terminate all
subsequent amendments to PTGA Number GOZ16 with the Florida Department of
Transportation unless and until it may be specifically rescinded.
4. This Resolution shall take effect immediately upon adoption.
ADOPTED this c23 day of I 2021 after motion, second and majority vote in
favor of adoption.
ATTEST: . `',„ COLLIER COUNTY AIRPORT AUTHORITY
CI YS:TAL K. KI1 EL, CLERK
ij
l� L.4..t�.. �, • O . • By:
+ �' �� LERK PENNY T OR, C I IRPERSON
Approved for form and legality:
Jen r A. Belpedio ,05)7�Nti
Assistant County Attorney ��
.
co,