Backup Documents 04/23/2024 Item #16D 5 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 16 0 5
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 routingjines#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. Joshua Thomas, Grants Coordinator Community & Human ,T 04/23/24
Services
2. Derek D. Perry County Attorney Office 0 n f LJt�) 1
�/
3. Minutes and Records Clerk of Court's Office 97..k___
4/2fvl
1
,11
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 Joshua Thomas/CHS Operations Grants Phone Number 239-252-8995
Contact/ Department Coordinator
Agenda Date Item was April 23,2024 Agenda Item Number 16 D5
Approved by the BCC
Type of Document ARPA 203.22 Amendment 2 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 is OK 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 JT
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 N/A
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 N/A
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip JT
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 04/23/24 and all changes made during JT Nan
the meeting have been incorporated in the attached document. The County on ).).
Attorney's Office has reviewed the changes,if applicable. F Ii i
9. Initials of attorney verifying that the attached document is the version approved by the /')0 .n :. i
a/ { ,
BCC, all changes directed by the BCC have been made,and the document is ready for t Ion$,
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
September 2021 -2024 ARPA 203.22.02
AMENDMENT TWO Z 6 0 5
BETWEEN
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
AND
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC.
This Amendment, entered into between Collier County Board of County Commissioners and Area Agency on
Aging for Southwest Florida, Inc. (Contractor),hereby amends contract ARPA 203.22.
WHEREAS,the purpose of this Amendment is to increase funding to title RP3B by$54,000.00.
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:
1. Section 4 of Page One is hereby replaced:
4. Contract Amount:
The Agency agrees to pay for contracted services according to the terms and conditions of this contract in an amount
not to exceed $1,196,888.00 subject to the availability of funds. Any costs or services paid for under any other
contract or from any other source are not eligible for payment under this contract.
2. Attachment IX,Budget Summary, is hereby replaced.
3. Attachment II,Exhibit 2,Funding Summary is hereby replaced.
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 have caused this three(3)page Amendment to be executed by their officials as
duly authorized, and agree to abide by the terms,conditions and provisions of Contract ARPA 203.22,as amended. This
Amendment is effective on the last date the Amendment has been signed by both Parties.
AREA AGENCY ON AGING FOR SOUTHWEST COLLIER COUNTY BOARD OF COUNTY
FLO DA,INC. COMMISSIONERS
SIGNED: SIGNED: WilliamsTany DigitallyWilliamsTanyasignedby
Kr Date:2024.03.22
a 13:37:28-04'00'
NAME: MARICELLA MORADO NAME: TANYA R. WILLIAMS
TITLE: CEO/PRESIDENT TITLE: PUBLIC SERVICES DEPARTMENT HEAD
As Designee of the County Manager,Pursuant to
DATE: DATE: Resolution No. 2U 1 8-2U2
03. aa.a
Ap Toyed s t Bo and g (1,� Federal Tax ID:59-6000558
Fiscal Year Ending Date:09/30
�� DUNS:076997790
De .Perry n\`L
Assistant County Attorney PO
G
Page 1 of 3
September 2021 -2024 ARPA 203.22.02
ATTACHMENT II-EXHIBIT 2 FUNDING SUMMARY (2021-2024) 16 II 5
Note:Title 2 CFR,as revised,and Section 215.97,F.S.,require that the information about Federal Programs and State Projects
included in Attachment II,Exhibit 1,be provided to the recipient.Information contained herein is a prediction of funding sources and
related amounts based on the contract budget.
1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS CONTRACT CONSIST OF
THE FOLLOWING:
GRANT AWARD(FAIN#):2101FLSSC6,2101FLCMC6,2101FLHDC6, FEDERAL AWARD DATE:05/03/2021
2101FLPHC6,2101FLFCC6
DUNS NUMBER:966140837
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
American Rescue Plan for Supportive Services U.S.Health and Human Services 93.044 $406,888.00
under Title III-B of the Older Americans Act
American Rescue Plan for Congregate Meals under U.S.Health and Human Services 93.045 $300,000.00
Title III-C1 of the Older Americans Act
American Rescue Plan for Home Delivered Meals U.S.Health and Human Services 93.045 $350,000.00
under Title III-C2 of the Older Americans Act
American Rescue Plan for Family Caregivers under U.S.Health and Human Services 93.052 $140,000.00
Title III-E of the Older Americans Act
TOTAL FEDERAL AWARD $1,196,888.00
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT TO THIS
CONTRACT ARE AS FOLLOWS:
FEDERAL FUNDS:
2 CFR Part 200—Uniform Administrative Requirements,Cost Principles,and Audit Requirements for Federal Awards.
OMB Circular A-133—Audits of States,Local Governments,and Non-Profit Organizations
2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS CONTRACT CONSIST OF THE
FOLLOWING:
MATCHING RESOURCES FOR FEDERAL PROGRAMS
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL STATE AWARD
STATE FINANCIAL ASSISTANCE SUBJECT TO SECTION 215.97,F.S.
PROGRAM TITLE FUNDING SOURCE CSFA AMOUNT
TOTAL AWARD
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO THIS
CONTRACT ARE AS FOLLOWS:
STATE FINANCIAL ASSISTANCE
Sections 215.97&215.971,F.S.,Chapter 691-5,F.A.C.,State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws,rules,and regulations
GPO
Page 2of3
September 2021 -2024 ARPA 203.22.02
1 6 a 5
ATTACHMENT IX -BUDGET SUMMARY
IIIB iIig IIIC1 IIIC2
Transporation
Collier $396,888.00 $10,000.00
$300,000.00 $ 350,000.00
IIIE IIIES IIIEG TOTAL
Collier $120,000.00 $14,000.00 $6,000.00 $1,196,888.00
GPO
Page 3 of 3