Backup Documents 05/13/2025 Item #16D 3 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 5.13.2025 BCC
MTG
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. Adrienne Meijer Community and Human AM 5/05/2025
Services
2. County Attorney Office—Jeffrey A. County Attorney Office
Klatzkow PKlPI S /3
l
3. BCC Office Board of County
Commissioners �y �S/ 13
4. Minutes and Records Clerk of Court's Office 5f ,/ c
PRIMARY CONTACT INFORMATION
Normally the primary contact is the person who created/prepared e Executive Summary. Primary contact information is needed in the event one of the addressees
above,may need to contact staff for additional or missing info ation.
Name of Primary Staff Adrienne Meijer Phone Number 239-252-5229
Contact/ Department
Agenda Date Item was Agenda Item Number 16.D. 3Approved by the BCC 5 /31 2( S---
Type of Document / SETS O LANDLORD PAYMENT Number of Original -3-S£-r3-9•' ✓
Attached AGREEMENTS FOR STEPHEN WACHMAN Documents Attached
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 STAMP OK AM
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 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 YES
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip N/A
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 N/A is not
the meeting have been incorporated in the attached document. The County I� / 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
BCC, all changes directed by the BCC have been made,and the document is ready for the ;Pik f, b an option for
Chairman's signature. this line.
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EMERGENCY EMERGENCY SOLUTIONS GRANT (ESG) OR
EMERGENCY SOLUTIONS GRANT RAPID UNSHELTERED
SURVIVOR HOUSING (ESG RUSH)
LANDLORD PAYMENT AGREEMENT
THIS AGREEMENT is entered into between Collier County Board of County Commissioners,
hereinafter referred to as the COUNTY and Stephen Wachman, hereinafter referred to as the
LANDLORD.
The undersigned LANDLORD hereby agrees to the following conditions in order to receive
LANDLORD payments from the COUNTY under the Emergency Solutions Grant Program (ESG) or
Emergency Solutions Grant Rapid Unsheltered Survivor Housing(ESG RUSH):
1. This agreement shall begin on 5`13 2.5 and shall end upon 30-days written notification
from either party to the other, or when unding for this program is no longer available.
2. The COUNTY agrees to provide the LANDLORD with a list of names and contact information
for all COUNTY personnel authorized to commit ESG or ESG RUSH funds. The LANDLORD
will only accept payment commitment from authorized COUNTY personnel. Changes
(addition/deletions)to the authorized personnel list must be approved in writing by an authorized
COUNTY representative.
3. The LANDLORD agrees to provide COUNTY with contact information for authorized CHS
representatives to resolve a crisis and/or apply benefit commitment on the client's behalf.
4. The LANDLORD agrees to provide the COUNTY with copy of all leases and modifications or
amendments for each eligible ESG or ESG RUSH program participant.
5. The COUNTY agrees to provide payments directly to the LANDLORD on behalf of the eligible
ESG or ESG RUSH program participant and as long as the grantor COUNTY and/or regulation
does not prohibit payment.
6. The LANDLORD assures that no household receiving ESG or ESG RUSH assistance will be
treated adversely because of such assistance under applicable provisions of federal, state or local
regulatory requirements. During the term of this agreement, LANDLORD agrees to give the
COUNTY a copy of any notice to the program participant to vacate the housing unit,or complaint
used under state or local law to commence an eviction action against the program participant.
7. The LANDLORD assures that eligible households on whose behalf ESG or ESG RUSH
assistance is received will not be discriminated against.
8. The LANDLORD understands that only eligible activities listed under 24 CFR 576.106, Short-
term and medium-term rental assistance, are to be paid with ESG or ESG RUSH funds.
9. The LANDLORD understands that only costs of short-term and medium-term rental assistance
in accordance with the terms of the ESG or ESG RUSH program are allowed.No
charges that result from illegal activities such as bad checks or meter tampering will be paid with
ESG or ESG RUSH funds.
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10. The LANDLORD understands that the ESG or ESG RUSH benefit amount must pay for the
complete charges owed by the ESG or ESG RUSH program participant and that acceptance of
ESG or ESG RUSH benefits will be deemed as LANDLORD's acknowledgement and
acceptance has become current on any and all payments due to LANDLORD as a result of the
ESG or ESG RUSH payment.
11. The LANDLORD agrees to assist the COUNTY in verifying the ESG or ESG RUSH program
participant's information and to make timely commitments to resolve any crisis situation.Subject
to the LANDLORD's privacy requirements, the LANDLORD agrees to provide the COUNTY
with the following detailed ESG or ESG RUSH program participant information: (1) current
amount owed (broken down by month) (2) due date/eviction dates informal eviction notice/3-
day notice and (3)amount necessary to resolve the situation.
12. In accordance with the Florida Local Government Prompt Payment Act, the COUNTY agrees to
provide payment to the LANDLORD as follows:
(a) Rental Arrears, Application Fees and/or Deposits: will be dispersed by the COUNTY within
60 days from the date of the COUNTY's approval of the program participant's eligibility if the
rental assistance is a valid ESG or ESG RUSH program expenditure.
(b)Ongoing rental assistance:will be disbursed by the COUNTY for eligible ESG or ESG RUSH
recipients in accordance with the rental agreement as issued by the LANDLORD on behalf of
the program participant under the same terms and conditions(i.e., same payment due date, grace
period, and late penalty requirements).
(c) Payments beyond 60 days will require interest to be paid from non-ESG or ESG RUSH funds.
(d) COUNTY's promise to pay can only be issued after an ESG or ESG RUSH participant has
been certified as Eligible under the ESG or ESG RUSH program.
13. This LANDLORD Agreement will be signed by COUNTY, and LANDLORD's authorized
representative.
14. If an ESG or ESG RUSH payment to the LANDLORD cannot be applied to an ESG ESG RUSH
program participant's account,the funds will be returned to the COUNTY.
15.The LANDLORD, with the exception of municipal providers, must be in "active"status with the
State of Florida: http://sunbiz.org/search.html. The LANDLORD's name must also be verified
against the System for Award Management website at http://www.sam.gov. The COUNTY
agrees to maintain documentation of verification that the business name of the LANDLORD on
this agreement is the same as the legal business name on the State of Florida System for Award
Management website.
16. The LANDLORD agrees to maintain documentation of verification that the owner's name or
business names of the LANDLORD on this agreement is the same name as that name on the
Collier County Property Appraiser, unless designated through a property management
agreement.
17. COUNTY does not assume any responsibility for, or liability to, any person injured as a result of
LANDLORD's action or failure to act in connection with the implementation of this agreement
or as a result of any other failure to act by the LANDLORD.
18. LANDLORD is not the agent of COUNTY and this agreement does not create any relationship
between COUNTY and any lender to LANDLORD or suppliers, employees, contractors or
subcontractors used by LANDLORD in connection with this agreement.
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19. Nothing in this agreement will be construed as creating any right of a program participant or a
third-party to enforce any provision of this agreement or to assess any claim against COUNTY,
or LANDLORD under this Rental Assistance Agreement.
20. Exhibit A, attached hereto and incorporated by reference, shall be attached to all leases entered
into with ESG or ESG RUSH funded tenants, unless similar language covering VAWA
requirements is already in the LANDLORD's standard lease.
SIGNATURE PAGE TO FOLLOW
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IN WITNESS THEREOF, the parties hereto have caused this agreement to be executed by their
undersigned officials as duly authorized.
ATTEST: BOARD OF COUNTY COMMISSIONERS OF
CRYSTAL K.K EL,CLERK COLLIER COUNTY, FLORIDA
' O• ByAgi/t,Z€411.0.4...
,Deputy Clerk BURT L. SAUNDERS, CHAIRMAN
Attest as to Chaitrnan's:
sigerature only- '
Dated: A J it ...../3/_ZD25
(SEAL)
Approved s $ . ; and Le•.I ity:
cif i
By: _ Illlu�
Jeffrey A. atz ow
Collier C. ty orney
Date: 1tI)5/+ ,
LANDLORD
BY: lea
LANDL RD OR AUTHORIZED SIGNOR
PRINTED NAME:
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ADDRESS 7 j 5- P:11(t J,MIk G i
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