Backup Documents 06/11/2024 Item #16D 4 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 16. 04
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 Attomey Office.
Route to Addressee(s) (List in routing order) Office Initials Date
1. Joshua Thomas, Grants Coordinator Community & Human 06/12/24
Services
2. Carly J. Sanseverino County Attorney Office C/�?A 9
3. Minutes and Records Clerk of Court's Office J�, `,, 'r'
ent
PRIMARY CONTACT INFORMATION ` Ji"t T
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 June 11,2024 Agenda Item Number 16 D4
Approved by the BCC
Type of Document EHEAP Amendments 5 and 6 Number of Original 2
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
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 06/11/24 and all changes made during JT N/A is not an
the meeting have been incorporated in the attached document. The County 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 an
BCC,all changes directed by the BCC have been made,and the document is ready for the 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
irrrN CA
Wanda Rodriguez
From: Joshua Thomas
Sent: Monday, June 17, 2024 12:11 PM 1 6 D
To: Wanda Rodriguez
Subject: RE: EHEAP Amendments 5 &6 - agenda item 16D4 6/11/24 BCC
Correct
Joshua Thomas
Grants Coordinator I
Community & Human Services f
Office:239-252-8995 Collier Cour
3339 Tamiami Trail East 0 X D I
Naples, FL 34112
Joshua.Thomas(cr�colliercountyfl.clov
From: Wanda Rodriguez<Wanda.Rodriguez@colliercountyfl.gov>
Sent: Monday,June 17, 2024 12:10 PM
To:Joshua Thomas<Joshua.Thomas@colliercountyfl.gov>
Subject: RE: EHEAP Amendments 5 & 6 - agenda item 16D4 6/11/24 BCC
I'm not sure what kind of processing is needed here. There are no signature boxes, so nothing to sign
or attest to. Are you just providing copies to Minutes & Records for their records?
'Wanda. Rodriguez, ACT, CT:M
Office of the County .Attorney
(239) 252-8400
cor t i ifrj r `�
C w COLLIER COUNTY j
4 program 4, ///S��II���NyyyCCCC���E v
I .A Ce t f ed Put is Manag
,.,lle.w`a 5ei�t::r'rrrai.
From:Joshua Thomas<Joshua.Thomas@colliercountyfl.gov>
Sent: Monday, June 17, 2024 12:08 PM
To: Wanda Rodriguez<Wanda.Rodriguez@colliercountyfl.gov>
Subject: RE: EHEAP Amendments 5 & 6- agenda item 16D4 6/11/24 BCC
I am working out of another office without a phone.The item does not require a chairman signature, but they get
routed to CAO and Minutes and Records for processing.
1
Joshua Thomas
Grants Coordinator 16
Community & Human Services
Office:239-252-8995
3339 Tamiami Trail East 1E10 x Naples, FL 34112 I
Joshua.Thomas( colliercountyfl.gov
From: Wanda Rodriguez <Wanda.Rodriguez@colliercountyfl.gov>
Sent: Monday,June 17, 2024 12:05 PM
To:Joshua Thomas<Joshua.Thomas@colliercountyfl.gov>
Subject: EHEAP Amendments 5 & 6 -agenda item 16D4 6/11/24 BCC
The above item has been routed to our office with a pink routing slip. Please give me a call
concerning this item at your earliest convenience. Thank you,
)1'6i1 Rods-iquez,
Office of the County ,Attorney
(239) 252-8123
cot[_F_top
C.
OUOLYSENNG1.11 ate �'J�
2.0
pr W COLLIER COUNTY i
•� pc ,rram 4, SIDE te
NALA aril ed Pubiic Manag ` 2005
otRoivfa5tarr i,-s.xircv �1�'f.
Under Florida Law, e-mail addresses are public records. If you do not want your e-mail address released in response to a
public records request, do not send electronic mail to this entity. Instead, contact this office by telephone or in writing.
2
1604
pril 2021 -June 2024 EHEAP 203.21.05
AMENDMENT FIVE
BETWEEN
EMERGENCY HOME ENERGY ASSISTANCE PROGRAM •
AND
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC.
This Amendment, entered into between Emergency Home Energy Assistance Program and Area Agency on
Aging for Southwest Florida,Inc. (Contractor),hereby amends contract EHEAP 202.21.
WHEREAS,the purpose of this Amendment is to transfer funding from title EHEAP Outreach to EHEAP
Crisis by$13,000.00
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. Attachment IX,Budget 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.
AM 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 two (2) page Amendment to be executed by their officials as
duly authorized, and agree to abide by the terms, conditions and provisions of Contract EHEAP 202.21, 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
FLORIDA,INC. CO C MISSIONERS
SIGNED: D:
NAME: Maricela Morado NAME: Tanya R. Williams
TITLE: President/CEO TITLE: Public Services Department Head
As Designee of the County Manager Pursuant to
DATE: DATE: Resolution 2018-202
Federal Tax ID:59-6000558
Fiscal Year Ending Date:09/30
DUNS:076997790
coo
PSA:8April 2021- September 2023
EHEAP 203.21.05
BUDGET SUMMARY FY 23 (July 1,2023-June 30,2024
EMERGENCY HOME ENERGY ASSISTANCE PROGRAM FOR THE ELDERLY PROGRAM
COUNTY:COLLIER
TOTAL ADMINISTRATION BUDGET $8,500.00
TOTAL OUTREACH BUDGET $2,500.110
TOTAL CRISIS ASSISTANCE $89,000.00
TOTAL $ 100,000.00
O
1 6 n 4
.pril 2021 -June 2024 EHEAP 203.21.06
AMENDMENT SIX
BETWEEN
EMERGENCY HOME ENERGY ASSISTANCE PROGRAM
AND
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC.
This Amendment,entered into between Emergency Home Energy Assistance Program and Area Agency on
Aging for Southwest Florida,Inc.(Contractor),hereby amends contract EHEAP 203.21.
WHEREAS,the purpose of this Amendment is to increase funding from Weather Crisis to EHEAP Crisis by Sl,662.14.
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.Attachment IX, Budget 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 two(2)page Amendment to be executed by their officials as duly
authorized,and agree to abide by the terms,conditions,and provisions of Contract EHEAP 203.21,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
FLORIDA, C COM tooNERS
SIGNED: SI r
NAME: Maricela Morado NAME: Tanya R. Williams
TITLE: President and CEO TITLE: Public Services Department Head
As Designee of the County Manger Pursuant to
Resolution 20t8-202
DATE: DATE:
ob.\\ . PIA
Federal Tax ID:59-6000558
Fiscal Year Ending Date:09/30
DUNS:076997790
Page 1 of 2 F.,;(;)
1b04
April 2021-June 2024 EHEAP 203.21.06
•
BUDGET SUMMARY FY 23(July 1,2023-June 30,2024)
EMERGENCY HOME ENERGY ASSISTANCE PROGRAM FOR THE ELDERLY
PSA:8 •
COU vTY:COLLIER
TOTAL ADMINISTRATION BUDGET $8,500.00
TOTAL OUTREACH BUDG S 2,500.00
F.I'
TOTAL CRISIS ASSISTANCE S 90,662.15
TOTAL S 101,662.15
CEO
Page 2 of 2