Backup Documents 12/12/2023 Item #16D 7 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 D 7
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 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. Tracey Smith Community and Human TS 12/01/2023
Services
2. County Attorney Office—DDP County Attorney Office 90 f ( Z/I l•�/23
3. BCC Office Board of County
Commissioners RL i/s /421,3
4. Minutes and Records Clerk of Court's Office
IZ ig3 9;40li"
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 Tracey Smith, Grants Coordinator 252-1428
Contact/ Department
Agenda Date Item was 12/12/2023 Agenda Item Number
Approved by the BCC
Type of Document FIRST AMENDMENT BETWEEN COLLIER Number of Original 3
Attached COUNTY AND LEGAL AID SERVICE OF Documents Attached
BROWARD COUNTY, INC. D/B/A LEGAL
AID SERVICE OF COLLIER COUNTY
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 signature N/A
2. Does the document need to be sent to another agency for additional signatures? 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 Yes
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 N/A
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
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 TS
signature and initials are required.
7. hi most cases(some contracts are an exception),the original document and this routing slip
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 above date and all changes made during ^ P the meeting have been incorporated in the attached document. The County �J Y
Attorney's Office has reviewed the changes,if applicable.
9. Initials of attorney verifying that the attached document is the version approved by the
BCC,all changes directed by the BCC have been made,and the document is ready for the
Chairman's signature.
1 6 D7
DocuSign Envelope ID:4C9D2065-51D4-445D-AE6B-C2358C3528C0
FAIN# B-20-UW-12-0016
Federal Award Date 09/22/2020
Federal Award Agency HUD
CFDA Name Community
Development Block
Grant-CV
CFDA/CSFA# 14.218
Total Amount of Federal $308,382.00
Funds Awarded
Subrecipient Name Legal Aid Service of
Broward County,Inc.,
d/b/a Legal Aid Service
of Collier County
DUNS# UEI# 844481178
X6RGPC2DL1X5
FEIN 59-1547191
R&D NA
Indirect Cost Rate NA
Period of Performance 07/01/2021 -86�o 0
12/31/2023
Fiscal Year End 12/31
Monitor End: 12/31/2024
FIRST AMENDMENT TO
AGREEMENT BETWEEN COLLIER COUNTY,FLORIDA
AND
LEGAL AID SERVICE OF BROWARD COUNTY,INC.
D/B/A LEGAL AID SERVICE OF COLLIER COUNTY
CDBG-CV Services
This AMENDMENT is made and entered into as of this IZ day of Oetalleg
2023, by and between Collier County, a political subdivision of the State of Florida (COUNTY)
having its principal address at 3339 E Tamiami Trail, Suite 211,Naples,FL 34112 and Legal Aid
Service of Broward County, Inc., d/b/a Legal Aid Service of Collier County (SUBRECIPIENT),
a private non-profit organization having its principal office at 4436 Tamiami Trail East, Naples,
FL 34112.
RECITALS
WHEREAS, the COUNTY has entered into an Agreement with the United States
Department of Housing and Urban Development(HUD)for a grant(the"Grant")for the execution
and implementation of a Community Development Block Grant(CDBG)Program in certain areas
of Collier County, pursuant to Title I of the Housing and Community Development Act of 1974
(as amended), codified as 42 USC 5301 et. se. and subject to 24 CFR Part 570; and
WHEREAS,the Board of County Commissioners of Collier County(Board)approved the
Collier County Consolidated Plan - One-year Action Plan for Federal Fiscal Year 2019-2020 for
the CDBG Program on June 25, 2019 -Agenda Item 16.D.2; and
LEGAL AID SERVICE OF BROWARD COUNTY,INC.,D/B/A LEGAL AID SERVICE OF COLLIER COUNTY
CD-CV21-03
Legal and Fiscal Support/Services for Small Businesses Impacted by COVID 19 the 2020 Pandemic Page 1
QB\84612706.2 �+ 0
VI*
1 6 D 7 '
DocuSign Envelope ID:4C9D2065-51D4-445D-AE6B-C2358C3528C0
WHEREAS, in accordance with HUD regulations and the Collier County Consolidated
Plan concerning the preparation of various Annual Action Plans, the COUNTY advertised the
2019—2020 Annual Action Plan, on April 21, 2020, with a 5-day Citizen Comment period from
April 21, 2020 to April 26, 2020; and
WHEREAS, on May 12, 2020, Agenda Item 16.F.1(f) the Board ratified the County
Manager's action to amend the 2019-2020 One-Year Action Plan to recognize CDBG COVID-19
funding. On November 10, 2020, Agenda item 16.D.8, the Board approved another substantial
amendment recognizing further CDBG COVID-19 funding, bringing the total amount to
$4,232,728 respectively; and
WHEREAS, on July 13, 2021, Agenda Item 16.D.8, the COUNTY entered into an
Agreement with Legal Aid Service of Broward County, Inc., d/b/a Legal Aid Service of Collier
County to further undertake the responsibilities and obligations of the Community Development
Block Grant(CDBG) -CV Program (the "Agreement"); and
WHEREAS,on June 6,2023,the County Manager signed the request for extension of the
term of the Agreement to September 30, 2023; and
WHEREAS, the Agreement used the LMJ National Objective (as defined in the
Agreement); and
WHEREAS, the COUNTY, at the behest of HUD, has requested to change the National
Objective from LMJ to LMC, as each is defined in the Agreement; and
WHEREAS, the "persons served," as defined under the LMC category is referring to the
workers filling the FTE jobs created using funds granted under this Agreement and not the clientele
served by SUBRECIPIENT in general; and
WHEREAS, the parties agree that while the change of National Objectives may apply
retroactively in the Agreement pursuant to this Amendment, COUNTY acknowledges that this
change is strictly administrative in nature and SUBRECIPIENT's past reliance on the LMJ
National Objective instead of the LMC National Objective as originally agreed shall not constitute
a breach of this Agreement or a failure to administer the grant properly; and
WHEREAS, the parties wish to amend the Agreement by revising the period of
performance,revising prospective project component language,redistribute funds between project
components,remove the Section 3 policy requirement and revise the National Objective language
as it pertains to Low-to-Moderate income persons on the Exhibit C Quarterly Performance Report;
and
NOW, THEREFORE, in consideration of the covenants and agreements contained
herein, and for other good and valuable consideration, the Parties hereby agree that the Recitals,
as set forth above, are incorporated herein and made a part of the Agreement. The Parties further
agree that the COUNTY will provide the remaining, unexpended funds of the Grant to
SUBRECIPIENT upon and subject to all general conditions, terms, covenants, and agreements
herein set forth: the parties hereto agree to amend the Agreement as set forth below.
LEGAL AID SERVICE OF BROWARD COUNTY,INC.,DB/A LEGAL AID SERVICE OF COLLIER COUNTY
CD-CV21-03
Legal and Fiscal Support/Services for Small Businesses Impacted by COVID 19 the 2020 Pandemic Page 2
QB\84612706.2 O
G�'
DocuSign Envelope ID 4C9D2065-51D4-445D-AE6B-C2358C3528C0 1 6 D 7
Words Stmek-Through are deleted; Words Underlined are added.
PART I
SCOPE OF WORK
The SUBRECIPIENT shall,in a satisfactory and proper manner and consistent with any standards required
as a condition of providing CDBG-CV assistance as provided herein and,as determined by Collier County
Community and Human Services (CHS)Division, perform the tasks necessary to conduct the program as
follows:
Project Name: Legal,Financial and Accounting Support/Services for Small Businesses Impacted
by COVID 19 the 2020 Pandemic.
Description of project and outcome: Provide funding to cover CPA services, salary,payroll taxes,
and fringe benefits of legal staff. The program will provide legal,financial and accounting services
to small businesses and non-profit organizations that have been impacted by the COVID 19 2020
Pandemic.
Project Component One: Staffing—Salary,payroll taxes and fringe benefits for one(1)Full Time
Equivalent(FTE)Attorney and one(1)Full Time Equivalent(FTE)Paralegal—A FTE equivalent
may be more than 1 employee with time equating to 40 hours per week.
Project Component Two: Subcontracted CPA services - including but not limited to all software
&subscription costs and/or supplies necessary to support small businesses or nonprofits.
* * *
1.1 GRANT AND SPECIAL CONDITIONS
A. Within sixty(60) calendar days of the execution of this Agreement, the SUBRECIPIENT
must deliver, to CHS for approval, a detailed project schedule for the completion of the
project.
B. The following resolutions and policies must be submitted within sixty (60) days of this
Agreement:
Affirmative Fair Housing Policy
• Affirmative Action/Equal Opportunity Policy
▪ Conflict of Interest Policy
▪ Procurement Policy
❑ Uniform Relocation Act Policy
▪ Sexual Harassment Policy
Section 3 Policy
LEGAL AID SERVICE OF BROWARD COUNTY,INC.,D/B/A LEGAL AID SERVICE OF COLLIER COUNTY
CD-CV21-03
Legal and Fiscal Support/Services for Small Businesses Impacted by COVID 19 the 2020 Pandemic Page 3
QB\84612706.2 0
Vt"*
16D7
DocuSign Envelope ID:4C9D2065-51D4-445D-AE6B-C2358C3528C0
• Section 504/ADA Policy
• Fraud,Waste,and Abuse Policy
• Limited English Proficiency Policy(LEP)
• Violence Against Women Act(VAWA)Policy
LGBTQ Policy
1.2 PROJECT DETAILS
A. Project Description/Project Budget
Description Federal Amount
Project Component 1: Staffing—Salary, payroll taxes and fringe benefits $244,625.00$240,195.50
for one (1) Full Time Equivalent (FTE) Attorney and one (1) Full Time
Equivalent (FTE) Paralegal — A FTE equivalent may be more than 1
employee with time equating to 40 hours per week.
Project Component 2: Subcontracted CPA services - including but not $ 63,757.00$68,186.50
limited to all software & subscription costs and/or supplies necessary to
support small businesses or nonprofits.
Total Federal Funds: $308,382.00
The SUBRECIPIENT will accomplish the following checked project tasks:
❑ Pay all closing costs related to property conveyance
Maintain and provide to the COUNTY, as requested, beneficiary and/or income
certification documentation
• Maintain and provide National Objective Documentation
® Provide Quarterly Reports on National Objective and project progress
• Ensure attendance by a representative from executive management at scheduled
partnership meetings, as requested by CHS
❑ Ensure attendance by SUBRECIPIENT and General Contractor at Pre-Construction
meetings,prior to SUBBRECIPIENT issuance of Notice to Proceed(NTP)
❑ Provide monthly construction and rehabilitation progress reports until completion of
construction or rehabilitation
U Identify Lead Project Manager
Provide Site Design and Specifications
I I Comply with Davis-Bacon Labor Standards
▪ Comply with Section 3 and maintain documentation
Provide certified payroll weekly throughout construction and rehabilitation
Comply with Uniform Relocation Act(URA), if necessary
Ensure applicable numbers of units are Section 504/ADA accessible
• Ensure the applicable continued use period for the project is met
LEGAL AID SERVICE OF BROWARD COUNTY,INC.,D/B/A LEGAL AID SERVICE OF COLLIER COUNTY
CD-CV21-03
Legal and Fiscal Support/Services for Small Businesses Impacted by COVID 19 the 2020 Pandemic Page 4
QB\84612706.2 0
16D7
DocuSign Envelope ID:4C9D2065-51 D4-445D-AE6B-C2358C3528C0
B. National Objective
The CDBG-CV program funds awarded to Collier County must benefit low-to moderate-income
persons(LMI).As such,the SUBRECIPIENT shall ensure that all activities and beneficiaries meet
the definition of:
n LMA—Low/Mod Area Benefit
LMC—Low/Mod Clientele Benefit
LMH—Low/Mod Housing Benefit
LMJ Low/Mod Job Benefit
LMA: Must document where at least 51 percent of the residents are LMI persons, based on HUD
determined eligible census tracts. Failure to achieve the national objective under this Agreement
will require repayment of the CDBG-CV investment under this Agreement.
LMC: Must document that at least 51 percent of persons served, are low- to moderate-income
persons or households, in order to meet a CDBG-CV National Objective. Failure to achieve the
national objective under this Agreement will require repayment of the CDBG-CV investment under
this Agreement.
LMH: Must document providing or improving permanent residential structures, which upon
completion will be occupied by LMI households. Structures with three or more units must contain
at least 51 percent occupied by LMI households, and structures with less than three units must be
occupied by 100 percent LMI households. Failure to achieve the national objective under this
Agreement will require repayment of the CDBG-CV investment under this Agreement.
LMJ: Must document job creation and retention. The LMI benefit national objective addresses
activities designed to create or retain permanent jobs, at least 51 percent of which(computed on a
full-time equivalent basis)will be made available to or held by LMI persons.Failure to achieve the
national objective under this Agreement will require repayment of the CDBG-CV investment under
this Agreement.
D. Payment Deliverables
Payment Deliverable Payment Supporting Documentation Submission Schedule
Project Component 1: Staffing— Submission of monthly invoices and Monthly submission
Salary,payroll taxes and fringe backup as evidenced by invoices/ within 30 days of the
benefits for one(1)Full Time timesheets/payroll registers/banking prior month.
Equivalent(FTE)Attorney and documents/cancelled checks, staff
one(1)Full Time Equivalent resumes, documentation of payroll taxes
(FTE)Paralegal(both 100%)=A and fringe benefits,Exhibit B and any
FTE equivalent may be more than additional documentation as requested.
1 employee with time equating to 10%retainage($21,462.50)released
40 hours per week. upon final monitoring clearance and
meeting the National Objective.
Project Component 2: Submission of supporting documents Monthly submission
Subcontracted CPA services. must be provided as backup,as evidenced within 30 days of the
by a subcontract agreement(copy prior month.
LEGAL AID SERVICE OF BROWARD COUNTY,INC.,D/B/A LEGAL AID SERVICE OF COLLIER COUNTY
CD-CV21-03
Legal and Fiscal Support/Services for Small Businesses Impacted by COVID lg the 2020 Pandemic Page 5
QB\84612706.2 0
DocuSign Envelope ID:4C9D2065-51D4-445D-AE6B-C2358C3528C0 1 6 ® 7
Including but not limited to all included in the first pay request), invoices
software costs and/or supplies which document the client listing and
necessary to support small hours of service provided,proof of
businesses. reimbursement via check stubs, credit
card statements,bank statements and any
other additional documentation as
requested. 10%retainage($6,375.70)
released upon final monitoring clearance
and meeting the National Objective.
* *
1.3 PERIOD OF PERFORMANCE
SUBRECIPIENT services shall begin on July 1, 2021 and shall end on June 30, 2023 December
31, 2023, unless terminated earlier, in accordance with provisions of Paragraph 3.9 Defaults,
Remedies,and Termination.In accordance with 2 CFR 200 Subpart E-Cost Principles and Section
215.97(1)(d) Florida Statutes, the SUBRECIPIENT may expend funds authorized by this
Agreement only for allowable costs resulting from obligations incurred during the specific
Agreement period.
If the SUBRECIPIENT complies with all requirements set forth herein, this Agreement shall
terminate June 30, 2023 December 31, 2023, whereupon all obligations of the SUBRECIPIENT
for repayment of funds shall cease. Notwithstanding the foregoing, the COUNTY expressly
reserves and does not waive its rights to recover any damages arising from or relating to the
SUBRECIPIENT's breach of any of the Grant Documents, including but not limited to this
Agreement and/or any attachments hereto which occurred in whole or in part before said
termination.
* * *
PART II
GRANT CONTROL
REQUIREMENTS
2.2 RECORDS AND DOCUMENTATION
IF SUBRECIPIENT HAS QUESTIONS REGARDING THE
APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO THE
SUBRECIPIENT'S DUTY TO PROVIDE PUBLIC RECORDS RELATING
TO THIS AGREEMENT, CONTACT THE CUSTODIAN OF PUBLIC
RECORDS AT 239 252 6832, 239-252-
2679,Michael.Brownlee@colliercountyfl.gov, 3299 Tamiami Trail E,Naples
FL 34112.
LEGAL AID SERVICE OF BROWARD COUNTY,INC.,D/B/A LEGAL AID SERVICE OF COLLIER COUNTY
CD-CV21-03
Legal and Fiscal Support/Services for Small Businesses Impacted by COVID 19 the 2020 Pandemic Page 6
QB\84612706.2 0
1 6 D7
DocuSign Envelope ID:4C9D2065-51 D4-445D-AE6B-C2358C3528C0
IN WITNESS WHEREOF, the SUBRECIPIENT and the COUNTY, have each
respectively, by authorized person or agent, hereunder set their hands and seals on the date first
written above.
ATTEST: AS TO COUNTY:
CRYSTAL K. ► I . CLERK BOARD OF COUNTY COMMISSIONERS OF
COLLIER COUNTY, FLORIDA
h " 4L;:uty Clerk By: l--�
{R� , RICK LOCASTRO, CHAIRMAN
Datedc.t. ,,..64
DEL�� 2 1 2 O 2 3
A�gest c =.irman's
su ti�ture only
WITNESSES: AS TO SUBRECIPIENT:
LEGAL AID SERVICE OF BROWARD
Witns #1 c ire COUNTY, INC. DB/A LEGAL AID SERVICE
OF COLLIER COUNTY
-DocuSIyned by:
Witness #1 Printed Name
By: f t61561A,
BRETTErTMIPSON, ESQ, EXECUTIVE
Witness #2 Signa ttre DIRECTOR
Date:11/8/2023
Witness 1/2 Printed Name
App ov d as to form and legality:
Derek D. Perry P\►�\
Assistant County Attorney
Date: i a , 2 ) 23
LEGAL AID SERVICE OF BROWARD COUNTY,INC.,D/B/A LEGAL AID SERVICE OF COLLIER COUNTY
CD-CV21-03
Legal and Fiscal Support/Services for Small Businesses Impacted by COVID 19 the 2020 Pandemic Page 7
QB\84612706.2 O
16D7
DocuSign Envelope ID.4C9D2065-51 D4-445D-AE6B-C2358C3528C0
EXHIBIT B
COLLIER COUNTY COMMUNITY&HUMAN SERVICES
SECTION I: REQUEST FOR PAYMENT
SUBRECIPIENT Name:Legal Aid Service of Broward County,Inc. d/b/a Legal Aid Service of
Collier County
SUBRECIPIENT Address: 4436 Tamiami Trail East,Naples,FL 34112
Project Name: Legal,Financial and Accounting Support/Services for Small Businesses Impacted
by COVID 19 the 2020 Pandemic
Project No: CD-CV21-03 Payment Request#
Total Payment Minus Retainage
Period of Availability: 07/01/2021 through 06/ 23 12/31/2023
Period for which the Agency has incurred the indebtedness through
SECTION II: STATUS OF FUNDS
Subrecipient CHS Approved
1.Grant Amount Awarded $ $
2.Total Amount of Previous Requests $ $
3.Amount of Today's Request(Net of Retainage,if $ $
applicable)
4. Current Grant Balance (Initial Grant Amount Award $ $
request)(includes Retainage)
I certify that this request for payment has been made in accordance with the terms and conditions of the
Agreement between the COUNTY and us as the SUBRECIPIENT.To the best of my knowledge and belief,
all grant requirements have been followed.
Signature Date
Title
Authorizing Grant Coordinator Authorizing Grant Accountant
- - I
Supervisor(Approval required$15,000 and Division Director(Approval Required
above) $15,000 and above)
LEGAL AID SERVICE OF BROWARD COUNTY,INC.,D/B/A LEGAL AID SERVICE OF COLLIER COUNTY
CD-CV21-03
Legal and Fiscal Support/Services for Small Businesses Impacted by COVID 1 g the 2020 Pandemic Page 8
QB\84612706.2 O
Gt'
16D7
DocuSign Envelope ID:4C9D2065-51D4-445D-AE6B-C2358C3528C0
EXHIBIT C
QUARTERLY PERFORMANCE REPORT DATA
The COUNTY is required to submit Performance Reports to HUD through the Integrated
Disbursement and Information System (IDIS). The COUNTY reports information on a quarterly
basis. To facilitate in the preparation of such reports, SUBRECIPIENT shall submit the
information contained herein within ten (10) days of the end of each calendar quarter. At
COUNTY's discretion, SUBRECIPIENT may be required to enter the information collected on
this exhibit into an online grant management system.
Subrecipient Name: Legal Aid Service of Broward Date:
County,Inc.,d/b/a Legal Aid Service of Collier County
Project Title: Legal,Financial and Accounting IDIS#:
Support/Service for Small Businesses Impacted by
COVID 19 the 2020 Pandemic
Program Contact: Telephone Number:
Activity Reporting Period Report Due Date
October 1"—December 31st January 10th
January 1"—March 31" April 10th
April 1"—June 30t' July 10th
July 1"—September 30th October 10th
REPORT FOR QUARTER ENDING:(check one that applies to the corresponding grant period):
12/31/20XX 3/31/20XX 6/30/20XX 9/30/20XX
Please note: The HUD Program year begins July 1—June 30.Each quarterly report must include cumulative data
beginning from the start of the program year July 1,2021.
1. Please list the outcome goal(s)from your approved application and SUBRECIPIENT Agreement and indicate your
progress in meeting those goals since July 1,2021.
a. Outcome Goals:list the outcome goal(s)from your approved application and SUBRECIPIENT Agreement _ _
Outcome 1: Provide free legal,financial and accounting services to small businesses or non-profits impacted by
COVID-19.
Outcome 2: Create or retain at least 15 FTE Low to Moderate(LMJ)income jobs for Low-to-Moderate persons to
be retained for 1 year from date of hire for new employees or 1 year from the date of engagement between the
Subrecipient and the employer for existing employees to meet the National Objective.held for a period of 1 year
to meet the National Objective. The National Objective may be met after the end of the period of performance.(If
an individual vacates the position,the newly hired replacement will complete the remainder of the 1 year period).
Outcome 3:
b. Goal Progress: Indicate the progress to date in meeting each outcome goal.
Outcome 1: Number of unduplicated small businesses or non-profits who received free legal,financial and
accounting services this quarter.
Outcome 2: LMJ number of jobs created or retained for Low-to-Moderate persons.
Outcome 3:
2. Is this project still in compliance with the original project schedule: Yes n No n
If No,Explain:
3. Since Oster July 1,2021;of the persons assisted,how many...
Answer ONLY for Public Facilities&Infrastructure Activities *03 Matrix Codes
a. ...now have new access(continuing)to this service or benefit? 0
b. ...now have improved access to this service or benefit? 0
LEGAL AID SERVICE OF BROWARD COUNTY,INC.,D/B/A LEGAL AID SERVICE OF COLLIER COUNTY
CD-CV21-03
Legal and Fiscal Support/Services for Small Businesses Impacted by COVID 19 the 2020 Pandemic Page 9
QB\84612706.2 O
Vt
� 6D7
DocuSign Envelope ID:4C9D2065-51D4-445D-AE6B-C2358C3528C0
c. ...now receive a service or benefit that is no longer substandard? 0
Total 0
4. What funding sources did the SUBRECIPIENT apply for this period?
Section 108 Loan Guarantee $ CDBG-CV $
Other Consolidated Plan Funds $ HOME $
Other Federal Funds $ ESG $
$ HOPWA $
$ Total Entitlement $
Funds
5. What is the total number of UNDUPLICATED Persons(LMC)or Households(LMH)served this QUARTER,if
applicable? Answer question 5a or 5b;NOT both
For LMC activities: people,race/ethnicity,and income data are reported by persons.
For LMH activities: households,race/ethnicity,and income level are reported by households,regardless
the number of persons in the household.
a. Total No.Persons/Adults served(LMC) 0 Total No.persons served under 18 0
(LMC)
Quarter Total No.of Persons 0 Quarter Total No.of Persons 0
b. Total No.of Households served 0 Total No.of female head of household 0
(LMH)
6. What is the total number of UNDUPLICATED clients served since October July 1,if applicable?
Answer question 6a or 6b,NOT both
For LMC activities:race/ethnicity and income data are reported by persons.
a. Total No.Persons/Adults served(LMC) 0 Total No.Persons served under 18 0
(LMC)
YTD Total: 0 YTD Total 0
b. Total No.Households served(LMH) 0 Total No.female head of household(LMH) 0
YTD Total 0 YTD Total 0
Complete EITHER question 7 or 8,NOT both
Complete question 7a and 7b if your program only serves clients in one or more of the listed HUD Presumed
Benefit categories.
7. PRESUMED BENEFICIARY DATA ONLY: PRESUMED BENEFICIARY DATA ONLY
(LMC)Quarter (LMC)YTD
Indicate the total number of UNDUPLICATED persons Indicate the total number of UNDUPLICATED
served this quarter who fall into each presumed benefit persons served since October July 1 who fall into
category(the total should equal the total in question#6a each presumed benefit category(the total should
or 6b): equal the total in question#6a or 6b):
a Presumed Benefit Activities Only(LMC)QTR b Presumed Benefit Activities Only(LMC)YTD
0 Abused Children ELI 0 Abused Children ELI
0 Homeless ELI 0 Homeless Person ELI
Person
0 Migrant Farm LI 0 Migrant Farm Workers LI
Workers
0 Battered LI 0 Battered Spouses LI
Spouses
0 Persons LI 0 Persons w/HIV/AIDS LI
w/HIV/AIDS
0 Elderly Persons LI or MOD 0 Elderly Persons LI or
MOD
0 Illiterate Adults LI 0 Illiterate Adults LI
0 Severely LI 0 Severely Disabled Adults LI
LEGAL AID SERVICE OF BROWARD COUNTY,INC.,D/B/A LEGAL AID SERVICE OF COLLIER COUNTY
CD-CV21-03
Legal and Fiscal Support/Services for Small Businesses Impacted by COVID 19 the 2020 Pandemic Page 10
QB\84612706.2 0
DocuSign Envelope ID:4C9D2065-51D4-445D-AE6B-C2358C3528C0 1 6 D 7
Disabled Adults
0 Quarter Total 0 YTD Total
8. Complete question 8a and 8b if any client in your program does not fall into a Presumed Benefit category.
Other Beneficiary Data: Income Range Other Beneficiary Data: Income Range
Indicate the total number of UNDUPLICATED persons Indicate the total number of UNDUPLICATED
served this Quarter who fall into each income category persons served since October July 1 (YID)who fall
(the total should equal the total in question#6): into each income category(the total should equal the
total in question#6):
a ELI Extremely Low Income(0-30%) 0 b ELI Extremely Low 0
Income(0-30%)
LI Low Income(31-50%) 0 LI Low Income 0
MOD Moderate Income(51-80%) 0 MOD Moderate Income 0
_ (51-80%)
NON-L/M Above Moderate Income(>80%) 0 NON-L/M Above Moderate 0
Income(>80%)
Quarter Total 0 YTD Total 0
9. Is this project in a Low/Mod Area(LMA)? YES NO
Was project completed this quarter? YES NO If yes,complete all of this section 9.
Date project completed
Block Group Census Tract Total Beneficiaries Low/Mod Low/Mod Percentage
Beneficiaries
0 0 0 0 0
Date LMA Narrative approved by CHS?
What documentation supports project completion? (i.e.,
Certificate of Completion or Certificate of Occupancy,
etc.)
10. Racial&Ethnic Data(if applicable)
Please indicate how many UNDUPLICATED Please indicate how many UNDUPLICATED clients
clients served this Quarter fall into each race served since October July 1 (YTD)fall into each race
category.In addition to each race category,please category.In addition to each race category please indicate
indicate how many persons in each race category how many persons in each race category consider
consider themselves Hispanic. (Total Race column themselves Hispanic. (Total Race column should equal the
should equal the total in question 6.) total in question 6.)
a. RACE ETHNICITY b. RACE ETHNICITY
/HISPANIC /HISPANIC
White 0 0 White 0 0
Black/African American 0 0 Black/African American 0 0
Asian 0 0 Asian 0 0
American Indian/Alaska Native 0 0 American Indian/Alaska 0 0
Native
Native Hawaiian/Other Pacific Islander 0 0 Native Hawaiian/Other Pacific 0 0
Islander I
Black/African American&White 0 0 Black/African American& 0 0
White
American Indian/Alaska Native& 0 0 American Indian/Alaska 0 0
Black/African American Native&Black/African
American
Other Multi-racial 0 0 Other Multi-racial 0 0
0 0 0 0
LEGAL AID SERVICE OF BROWARD COUNTY,INC.,D/B/A LEGAL AID SERVICE OF COLLIER COUNTY
CD-CV21-03
Legal and Fiscal Support/Services for Small Businesses Impacted by COVID 19 the 2020 Pandemic Page 1 I
QB\84612706.2 0
Gt'
16D7
DocuSign Envelope ID:4C9D2065-51 D4-445D-AE6B-C2358C3528C0
Name:
Signature:
Title:
Your typed name here represents your electronic signature
LEGAL AID SERVICE OF BROWARD COUNTY,INC.,D/B/A LEGAL AID SERVICE OF COLLIER COUNTY
CD-CV21-03
Legal and Fiscal Support/Services for Small Businesses Impacted by COVID 19 the 2020 Pandemic Page 12
QB\84612706.2 0
16D7
DocuSign-
Certificate Of Completion
Envelope Id:4C9D206551 D4445DAE6BC2358C3528C0 Status:Completed
Subject:Complete with DocuSign:Legal Aid County Amendment-DDP.pdf
Source Envelope:
Document Pages: 12 Signatures: 1 Envelope Originator:
Certificate Pages:5 Initials:0 Lorijane Graham
AutoNav:Enabled 411 E.Wisconsin Ave.
Envelopeld Stamping:Enabled Milwaukee,WI 53202
Time Zone:(UTC-06:00)Central Time(US&Canada) Lorijane.Martin@quarles.com
IP Address:38.101.16.250
Record Tracking
Status:Original Holder:Lorijane Graham Location:DocuSign
11/8/2023 12:15:08 PM Lorijane.Martin@quarles.com
Signer Events Signature Timestamp
Brent Thompson e—Da"iSjnidbj Sent:11/8/2023 12:24:30 PM
bthompson@legalaid.org txu41 tLakrotA, Viewed: 11/8/2023 12:37:01 PM
'-6ED8E0EC0339462...
Security Level:Email,Account Authentication Signed: 11/8/2023 12:37:20 PM
(None)
Signature Adoption:Pre-selected Style
Using IP Address:23.31.46.105
Electronic Record and Signature Disclosure:
Accepted: 11/8/2023 12:37:01 PM
ID:31 ca63f1-a30a-40b7-b39b-dfbf60800104
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
Brooke Benzio ��� Sent: 11/8/2023 12:24:31 PM
brooke.benzio@quarles.com
Security Level:Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Janina Evans COPIED Sent: 11/8/2023 12:24:31 PM
jevans@legailaid.org
Security Level:Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Jeff Ahren ����� Sent: 11/8/2023 12:24:32 PM
jahren@legalaid.org
Security Level: Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
16D7
Carbon Copy Events Status Timestamp
Pam Lundborg ���� Sent:11/8/2023 12:24:32 PM
pam.lundborg@quarles.com Viewed: 11/8/2023 12:38:26 PM
Security Level:Email,Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Witness Events Signature Timestamp
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent Hashed/Encrypted 11/8/2023 12:24:32 PM
Certified Delivered Security Checked 11/8/2023 12:37:01 PM
Signing Complete Security Checked 11/8/2023 12:37:20 PM
Completed Security Checked 11/8/2023 12:37:20 PM
Payment Events Status Timestamps
Electronic Record and Signature Disclosure
Electronic Record and Signature Disclosure created on:9/16/2020 1:58:31 PM D
Parties agreed to:Brent Thompson
ELECTRONIC RECORD AND SIGNATURE DISCLOSURE
From time to time, Quarles &Brady LLP (we,us or Company)may be required by law to
provide to you certain written notices or disclosures. Described below are the terms and
conditions for providing to you such notices and disclosures electronically through the DocuSign
system. Please read the information below carefully and thoroughly, and if you can access this
information electronically to your satisfaction and agree to this Electronic Record and Signature
Disclosure (ERSD),please confirm your agreement by selecting the check-box next to `I agree to
use electronic records and signatures' before clicking `CONTINUE' within the DocuSign
system.
Getting paper copies
At any time, you may request from us a paper copy of any record provided or made available
electronically to you by us. You will have the ability to download and print documents we send
to you through the DocuSign system during and immediately after the signing session and, if you
elect to create a DocuSign account, you may access the documents for a limited period of time
(usually 30 days) after such documents are first sent to you. After such time, if you wish for us to
send you paper copies of any such documents from our office to you, you will be charged a
$0.00 per-page fee. You may request delivery of such paper copies from us by following the
procedure described below.
Withdrawing your consent
If you decide to receive notices and disclosures from us electronically, you may at any time
change your mind and tell us that thereafter you want to receive required notices and disclosures
only in paper format. How you must inform us of your decision to receive future notices and
disclosure in paper format and withdraw your consent to receive notices and disclosures
electronically is described below.
Consequences of changing your mind
If you elect to receive required notices and disclosures only in paper format, it will slow the
speed at which we can complete certain steps in transactions with you and delivering services to
you because we will need first to send the required notices or disclosures to you in paper format,
and then wait until we receive back from you your acknowledgment of your receipt of such
paper notices or disclosures. Further, you will no longer be able to use the DocuSign system to
receive required notices and consents electronically from us or to sign electronically documents
from us.
All notices and disclosures will be sent to you electronically
1 6 D7
Unless you tell us otherwise in accordance with the procedures described herein, we will provide
electronically to you through the DocuSign system all required notices, disclosures,
authorizations, acknowledgements, and other documents that are required to be provided or made
available to you during the course of our relationship with you. To reduce the chance of you
inadvertently not receiving any notice or disclosure, we prefer to provide all of the required
notices and disclosures to you by the same method and to the same address that you have given
us. Thus, you can receive all the disclosures and notices electronically or in paper format through
the paper mail delivery system. If you do not agree with this process,please let us know as
described below. Please also see the paragraph immediately above that describes the
consequences of your electing not to receive delivery of the notices and disclosures
electronically from us.
How to contact Quarles & Brady LLP:
You may contact us to let us know of your changes as to how we may contact you electronically,
to request paper copies of certain information from us, and to withdraw your prior consent to
receive notices and disclosures electronically as follows:
To contact us by email send messages to: daniel.miller@quarles.com
To advise Quarles & Brady LLP of your new email address
To let us know of a change in your email address where we should send notices and disclosures
electronically to you, you must send an email message to us at daniel.miller@quarles.com and in
the body of such request you must state: your previous email address, your new email
address. We do not require any other information from you to change your email address.
If you created a DocuSign account, you may update it with your new email address through your
account preferences.
To request paper copies from Quarles & Brady LLP
To request delivery from us of paper copies of the notices and disclosures previously provided
by us to you electronically, you must send us an email to daniel.miller@quarles.com and in the
body of such request you must state your email address, full name, mailing address, and
telephone number. We will bill you for any fees at that time, if any.
To withdraw your consent with Quarles & Brady LLP
To inform us that you no longer wish to receive future notices and disclosures in electronic
format you may:
16D7
i. decline to sign a document from within your signing session, and on the subsequent page,
select the check-box indicating you wish to withdraw your consent, or you may;
ii. send us an email to daniel.miller@quarles.com and in the body of such request you must state
your email, full name,mailing address, and telephone number. We do not need any other
information from you to withdraw consent.. The consequences of your withdrawing consent for
online documents will be that transactions may take a longer time to process..
Required hardware and software
The minimum system requirements for using the DocuSign system may change over time. The
current system requirements are found here: https://support.docusign.com/guides/signer-guide-
si gning-system-requirements.
Acknowledging your access and consent to receive and sign documents electronically
To confirm to us that you can access this information electronically, which will be similar to
other electronic notices and disclosures that we will provide to you,please confirm that you have
read this ERSD, and(i)that you are able to print on paper or electronically save this ERSD for
your future reference and access; or(ii)that you are able to email this ERSD to an email address
where you will be able to print on paper or save it for your future reference and access. Further,
if you consent to receiving notices and disclosures exclusively in electronic format as described
herein,then select the check-box next to `I agree to use electronic records and signatures' before
clicking `CONTINUE' within the DocuSign system.
By selecting the check-box next to `I agree to use electronic records and signatures', you confirm
that:
• You can access and read this Electronic Record and Signature Disclosure; and
• You can print on paper this Electronic Record and Signature Disclosure, or save or send
this Electronic Record and Disclosure to a location where you can print it, for future
reference and access; and
• Until or unless you notify Quarles &Brady LLP as described above, you consent to
receive exclusively through electronic means all notices, disclosures, authorizations,
acknowledgements, and other documents that are required to be provided or made
available to you by Quarles &Brady LLP during the course of your relationship with
Quarles &Brady LLP.