Backup Documents 04/08/2025 Item #16D 4 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 D 4
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. Parker Smith Community and Human PS 04/2/2025
Services
2. County Attorney Office County Attorney Office 1�/// 1
i IC/Mj
3. BCC Office Board of County ��
Commissioners ;15
y �S
4. Minutes and Records Clerk of Court's Office r I o1:446 WA
LIA81201-6
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 Parker Smith.Grants Coordinator I, Phone Number 239-252-6141
Contact/ Department Community and Human Services
Agenda Date Item was April 8, 2025 Agenda Item Number 16.D.4
Approved by the BCC
Type of Document Grant Amendment#1 between Collier County Number of Original 1
Attached and FL Department of Commerce for Funding Documents Attached
for Expansion of Golden Gate Senior Center
PO number or account
number if document is N/A
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? PS
2. Does the document need to be sent to another agency for additional signatures? If yes, PS,see
provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet. pg.2
3. Original document has been signed/initialed for legal sufficiency. (All documents to be PS,
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 PS
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 PS
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 PS
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip PS
should be provided to the County Attorney Office at the time the item is input into
MinuteTraq. 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! Lil '/Z .
8. The document was approved by the BCC on1 S6ftl 23 and all changes made during N/A is not
the meeting have been incorporated in the attached document. The County s .q44 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
I BCC, all changes directed by the BCC have been made,and the document is ready for the 9. an option for
Chairman's signature. this line.
*** ONLY USE FOR AGREEMENTS***
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
1 6 D 4
Instructions
1) Return signed originals to:
Parker Smith
Grants Coordinator I
Collier County Government I Community and Human Services
3339 E. Tamiami Trail, Bldg. H, Suite 213
Naples, FL 34112
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
1 6D 4
Docusign Envelope ID:DD472C4D-0583-4C26-BD8F-9FDB8461896F
a gFLORDA Department of Commerce—Small Cities Community Development Block Grant Program Form SC-44
`COMMERCE Modification to Subgrant Agreement July 6,2023
Modification Number 1 to Subgrant Agreement Between
the Florida Department of Commerce and
Collier County Board of County Commissioners
This Modification Number 1 is entered into by and between the State of Florida, Department of
Commerce, ("Commerce"), and Collier County Board of County Commissioners, ("the Subrecipient"), (each
individually a "Party" and collectively the "Parties").
WHEREAS, Commerce and the Subrecipient entered into Contract Number 22CV-E19, FLAIR
Contract Number I-I2513, on November 9, 2023 ("the Subrecipient"), pursuant to which Commerce provided
a subgrant in the amount of$981,067.00 to the Subrecipient under the Small Cities Community Development
Block Grant("CDBG") Program as set forth in the Agreement;
WHEREAS, Paragraph (4) of the Agreement provides that modifications to the Agreement shall be
valid when executed in writing by both Parties;
WHEREAS,Commerce and the Subrecipient desire to modify the Agreement;
NOW, THEREFORE, in consideration of the mutual promises of the Parties contained herein, the
Parties agree as follows:
(l Revise the Activity Work Plan
1. Attachment ,Activity Work Plan, of the Subgrant Agreement is hereby deleted and is replaced by the
revised Attachment which is attached hereto and incorporated herein by reference.
❑ Revise the Project Narrative
2. Attachment , of the Subgrant Agreement is hereby deleted and is replaced by the revised
Attachment_,which is attached hereto and incorporated herein by reference.
❑ Revise the Project Budget
3. Attachment , of the Subgrant Agreement is hereby deleted and is replaced by the revised
Attachment which is attached hereto and incorporated herein by reference.
❑ Change the Number of Accomplishments and/or Beneficiaries
1
16D ' 4
Docusign Envelope ID:DD472C4D-0583-4C26-BD8F-9FDB8461896F
FLORIDA Department of Commerce—Small Cities Community Development Block Grant Program Form SC-44
COMMERCE Modification to Subgrant Agreement July 6,2023
4. Attachments of the Subgrant Agreement are hereby deleted and are replaced by the revised
Attachments ,which are attached hereto and incorporated herein by reference.
❑ Include an Unaddressed Need from the Application for Funding as Addressed Need
5. Attachments of the Subgrant Agreement are hereby deleted and are replaced by the revised
Attachments ,which are attached hereto and incorporated herein by reference.
El Change the Participating Parties
6. (Type in the name of firm),is removed as a Participating Party to the Subgrant Agreement.
7. (Type in the name of new firm) is added as a Participating Party to the Subgrant Agreement. A copy of
the new Participating Party Agreement, containing provisions and caveats that meet or exceed the
conditions agreed to in the original Participating Party Agreement,is attached.
® Extend the Agreement
8. Paragraph (3) titled Period of Agreement on page 1 of the Subgrant Agreement is hereby deleted and
replaced by the following Paragraph (3):
(3) Period of Agreement
This Agreement begins on March 1, 2022, (the "Effective Date") and ends on March 31, 2026 (the
"Expiration Date"), unless otherwise terminated as provided in this Agreement (the "Termination Date").
The period of dine between the Effective Date and the Expiration Date or Termination Date is the
"Agreement Period."
® Other:
9. This Agreement is hereby reinstated as though it had not expired.
All provisions of the Subgrant Agreement and any attachments thereto in conflict with this Modification
shall be and are hereby changed to conform to this Modification, effective as of the date of the execution of this
Modification by both parties.
All provisions not in conflict with this Modification remain in full force and effect and are to be
performed at the level specified in the Agreement.
2
16D 4
Docusign Envelope ID:DD472C4D-0583-4C26-BD8F-9FDB8461896F
1"1_OR DA Department of Commerce—Small Cities Community Development Block Grant Program Form SC-44
COMMERCE Modification to Subgrant Agreement July 6,2023
Subrecipient: Collier County
Modification Number: 1
Contract Number: 22CV-E19
FLAIR Contract Number: H2513
IN WITNESS WHEREOF, the parties hereto have executed this document as of the dates set
herein.
WILC 'State of Florida
W partment of Commerce Subrecipient: Collier County
= Board of County mmissioners
13y: W44411 J,
Name: J.Alex Kelly Name: Burt Saunders
Title: Secretary Title: Chairperson
Date: Date: (1/3 f ZS
Approved as to form and legal sufficiency,
subject only to the full and proper execution
by the Parties '
Office of the General Counsel
r. �� and legality
Florida Department of Commerce Ap t�� ,' B Y
liar
By: Jeffre .K1.1zkow,County Attorney
Approved Date:
.
ATTEST, ', ;'t
CRYSTAL.I�.KI`NZtifiXL�C
BY:
" {V.1.1, " t...; -' '
Attest as to Chairman's, '
z_
signature crly
3