Backup Documents 05/13/2025 Item #16D 1 1 6 D
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 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. Monica Diaz, Accountant I Community & Human aT6 05/08/25
Services
2. Jeff Klatzkow, County Attorney County Attorney OfficeStIk/
0,6 5/13
3. Board of County Commissioners BCC Office
4. Minutes and Records Clerk of Court's Office /0
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 Monica DiazJCHS Accountant I Phone Number 239-252-4274
Contact/ Department
Agenda Date Item was May 13,2025 Agenda Item Number 1661).1
Approved by the BCC
Type of Document EHEAP Amendment 10 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 MD
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 MD
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 MD
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
mature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip MD
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 05/13/25 and all changes made during N/A is not an
the meeting have been incorporated in the attached document. The County 4,12 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 inV 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
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Collier County
Public Services Department
Community & Human Services Division
To: BCC Minutes and Records
From: Monica Diaz, CHS Accountant I
Re: EHEAP Amendment 10 Routing Instructions
May 13,2025
The attached EHEAP Amendment 10 is for after-the-fact BCC approval at the May 13,2025 BCC
meeting(Agenda Item 16.D.1)The agreement has been signed by the County Manager and does not
require BCC signature. Please retain for your records and e-mail a scanned copy to
Monica.Diaz@colliercountyfl.gov.
Please let me know if you have any questions regarding this request.
Thank you,
Monica Diaz
Community&Human Services Division •3339 Tamiami Trail East,Suite 213•Naples, FL 34112-5361 •239-252-CARE(2273)
239-252-CAFE(2233) •239-252-5713(RSVP) •www.colliercountyfl.gov
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HP021.R 1.203.2I.10
April 2021 -June 2024
AMENDMENT TEN
BETWEEN
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
AND
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC.
This Amendment,entered into between Collier Board of County Commissioners and Area Agency on Aging for Southwest
Florida, Inc. (Contractor), hereby amends contract FIP021.R1.203.21.
WHEREAS,the purpose of this Amendment is to decrease the Weather Related/Supply Shortage Crisis and increase Crisis
Assistance funding to title HP021 by$1,791.29.
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:
The Agency agrees to pay for contracted services according to the terms and conditions of this contract in an amount
not to exceed S110,453.60.The total contract amount is S327,000.65,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 8, 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 HP021.R1.203.21, as amended.
This Amendment is effective on the last date the Amendment has been signed by both Parties.
COLLIER COUNTY BOARD OF COUNTY AREA AGENCY ON AGING FOR
COMMISSIONERS. ,0 THWEST F ORIDA, INC.
SIGNED: —POriaZjaiY‘-- SIGNED: tip
411101111,11.1111,
•
NAME: Amy Pat erson NAME: Maricela Morado
TITLE: County Manager TITLE: President and CEO
DATE: DATE:
04.22.25
312 f2v2�
Federal Tax ID:59-6000558
Fiscal Year Ending Da : ./3
DUNS:076997790
Approv- •1•rm and legality
Page 1 of 3
Ia 414
Jeffrey A. • 1, •' ,County Attorney
CAO
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April 2021—June 2025 HP021.R 1.203.21.10
ATTACHMENT IR
EXHIBIT 5
FUNDING SUMMARY(2024-2025)
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#):2102FLLIEA FEDERAL AWARD DATE: 10/29/2021
UE1 NUMBER: RHZNJDNFJAL3
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
Emergency Home Energy Assistance United States Department of Health and 93.568 $110,453.60
for the Elderly Program Human Services
TOTAL FEDERAL AWARD $110,453.60
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
Page 2 of 3 ,NC)
16D1
April 2021-June 2025 HP021.203,21.10
BUDGET SUMMARY(2024-2025)
EMERGENCY HOME ENERGY ASSISTANCE FOR THE ELDERLY PROGRAM
For
Collier County Board of County Commissioners
PSA: 8
AGENCY: AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC.
Award***
TOTAL ADMINISTRATIVE BUDGET $9,363.16
TOTAL OUTREACH BUDGET $16,691.63
CRISIS ASSISTANCE $84,398.81
WEATHER RELATED/SUPPLY SHORTAGE CRISIS** $0.00
TOTAL SPENDING AUTHORITY $110,453.60
Projected minimum number of Individuals to be served Crisis Energy Assistance * 269
*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.
**Weather Related/Supply Shortage funds are a set-aside for emergency assistance. These funds must
be held in this budget line item category until December 15th of the program year,for use in response to
a possible disaster.
***Award amount to be spent July 1,2024 to June 30,2025. Please note this date may be extended by
the Florida Department of Commerce and will be communicated via email.
Page 3 of 3
CAC