Backup Documents 02/14/2023 Item #16D 2 160 1
ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
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 routinglines#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. Wendy Klopf Community and Human Irk 02/14/2023
Services
2. Minutes & Records Clerk of Court's Office
O`er'/� l 1a 3 U:e� `yi
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3.
4.
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 Wendy Klopf/CHS Phone Number 252-2901
Contact/ Dept latent
Agenda Date Item was 02/14/2023 Agenda Item Number 16D2
Approved by the BCC
Type of Document AAA/ARP-EHEAP AMENDMENT Number of Original 1
Attached 203.22.002 Documents Attached
PO number or account NA
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? NA
2. Does the document need to be sent to another agency for additional signatures? If yes, NA
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 WK
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 NA
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 NA
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 NA
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip NA
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 02/14/2023 and all changes made WK
during the meeting have been incorporated in the attached document. The County
Attorney's Office has reviewed the changes,if applicable.
9. Initials of attorney verifying that the attached document is the version approved by the WK
BCC,all changes directed by the BCC have been made,and the document is ready for the
Chairman's signature.
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
16U 2
November 2021 - March 2023 EHEAP ARPA 203.22.02
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC.
EMERGENCY HOME ENERGY ASSISTANCE PROGRAM
WHEREAS,the purpose of this Amendment is to decrease funding by$7,000.00 and replace the Budget Summary.
NOW THEREFORE,in consideration of the mutual covenants and obligations set forth herein,the receipt and sufficiency
of which are hereby acknowledged,the Parties agree to the following:
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 officials as duly
authorized; and agree to abide by the terms, conditions and provisions of this EHEAP amendment as amended. This
Amendment is effective on the last date the Amendment has been signed by both Parties.
IN WITNESS WHEREOF,the Parties hereto have caused this contract to be executed by their undersigned officials as duly
authorized.
CONTRACTOR: COLLIER COUNTY AREA AGENCY ON AGING FOR
BOARD OF COUNTY COMMISSIONERS SOUTHWEST FLORIDA, INC.
SIGNED BY:
Wi Ilia msTanya a;°'p2;o,,;,47= SIGNED BY;//-
NAME: Tanya R Williams NAME: Maricela Morado
TITLE: Public Service Department Head TITLE: Interim Chief Fxecntive Officer/President
DATE: 01.12.2023 DATE: r /:i
as designee of the County Manager,
pursuant to Resolution No. 2018-202.
A oved as to Fo nd Legality:
Derek D. Perry
Assistant County Attorney
co
November 2021 -March 2023 EHEAP ARPA 203.22.002
EHEAP ARP ACT BUDGET SUMMARY
EMERGENCY HOME ENERGY ASSISTANCE FOR THE ELDERLY PROGRAM
COLLIER COUNTY
Total Award
TOTAL ADMINISTRATIVE BUDGET $8,300.00
TOTAL OUTREACH BUDGET $13,500.00
CRISIS ASSISTANCE $68,000.00
TOTAL $89,800.00
"Eligible households may be provided with more than one benefit,totaling no more than$5,000.00.The
minimum number of individuals to be served crisis energy assistance may reflect duplicated consumers if a
consumer receives multiple benefits.