Backup Documents 06/24/2025 Item #16D 8 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP -ilk&D
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. Melissa Juarez Community and Human MJ 6/19/2025
Services
2. County Attorney Office County Attorney Office
LTA gfii 2 6/2V/25
3. BCC Office Board of County
Commissioners 65 by mi/s/ 4y/z..�
4. Minutes and Records Clerk of Court's Office
6,1 (/415'
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 Melissa Juarez,Grants Coordinator 252-2590
Contact/ Department
Agenda Date Item was 06/24/2025 Agenda Item Number 16.D.8
Approved by the BCC
Type of Document SECOND AMENDMENT BETWEEN Number of Original 3 Originals
Attached COLLIER COUNTY AND BAKER SENIOR Documents Attached
CENTER NAPLES,INC.
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 MJ
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 MJ
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
document or the fmal negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's MJ
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
��hS an option for
Attorney's Office has reviewed the changes,if applicable. I 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 �� an option for
Chairman's signature. �/' this line.
16D8
FAIN # — .__..
B-24 UC-12 0016
Federal Award Date __.
_.. EST-10/�4
Federal Award Agency HUD
CFDA Name Community
Development Block
Grant
CFDA/CSFA _. ' ___..
18
Total Amount of Federal 14.� . 2. ___ ._
$55,000.00$8�,499.97 _
Funds Awarded
Subrecipient Name BAKER
KER SENIOR
CENTER NAPLES,
INC.
Ut_--_EI#_---- _ WF52AFSKKT26—
FEIN 45-3980909
R&D NA
Indirect Cost Rate NA
Period of Performance 2.
10/O1/�024-09/30/2025
Fiscal Year End 6/30
1../ 025
Monitor End: 2 --�
.__._
SECOND AMENDMENT TO
AGREEMENT BETWEEN COLLIER COUNTY
AND
BAKER SENIOR CENTER NAPLES, INC.
CDBG Grant Program — Public Services
THIS AMENDMENT is made and entered into this 24 day of
___.....__7.-6e, 2025, by and
between Collier County, a political subdivision of the State of Florida, ("COUNTY") having its principal
address at 3339 Tamiami Trail East, Suite 213, Naples FL 34112, and BAKER SENIOR CENTER
NAPLES,INC.(Subrecipient),a private non-profit organization having its principal office at 6200 Autumn
Oaks Lane, Naples. Florida 34119-8633.
RECITALS
WHEREAS, the COUNTY has entered into an Agreement with the United States Department of
Housing and Urban Development(HUD) for a grant to execute and implement a Community Development
Block Grant (CDBG) Program in certain areas of Collier County, pursuant to Title I of the Housing and
Community Development Act of 1974 (as amended);and
WHEREAS, the Board of County Commissioners of Collier County ("Board") approved the
Collier County Consolidated Plan—One-year Action Plan for Federal Fiscal Year 2024-2025 for the CDBG
Program with Resolution 2024-138 on July 23, 2024—Agenda Item 16.D.4; and
WHEREAS, in accordance with HUD regulations and the Collier County Consolidated Plan
concerning the preparation of various Annual Action Plans,the COUNTY advertised the 2024-2025 Annual
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Action Plan,on June 17,2024,with a 30-day Citizen Comment period from July 3,2024 to August 3,2024;
and
WHEREAS,the SUBRECIPIENT has submitted a proposal for participation in the Collier County
CDBG program; and
WHEREAS, the County and Subrecipient wish to set forth the responsibilities and obligations of
each in undertaking the CDBG project — (PS24-04) Aging in Place with Dignity: Case Management
Services for Older Adults.
WHEREAS, on September 10, 2024, Agenda Item #16.D.3, the COUNTY entered into an
Agreement (the "Agreement") with SUBRECIPIENT which set forth the responsibilities and obligations
of each in undertaking the CDBG project — (PS24-04) Aging in Place with Dignity: Case Management
Services for Older Adults; and
WHEREAS, on March 11, 2025, Agenda Items #16.D.2, the Board of County Commissioners
(Board)approved the First Amendment between Collier County and the Baker Senior Center CDBG project
—(PS24-04)Aging in Place with Dignity: Case Management Services for Older Adults;
WHEREAS, the parties wish to amend the agreement, incorporated herein by reference, to
increase the award amount. update the language to Grant and Special Conditions, Grant Control
Requirements, Terms and Conditions and General Provisions. as well as the addition of new Exhibits.
NOW, THEREFORE, in consideration of foregoing Recitals and other good and valuable
consideration, the receipt and sufficiency of which is hereby mutually acknowledged, the parties agree to
amend the Agreement as follows.
Words Struck Through are deleted; Words Underlined are added.
* * *
PART I
SCOPE OF WORK
SUBRECIPIENT shall, in a satisfactory and proper manner and consistent with any standards required as
a condition of providing CDBG assistance as provided herein and, as determined by Collier County
Community and Human Services (CHS) Division, perform the tasks necessary to conduct the program as
follows:
Project Name: Aging in Place with Dignity: Case Management Services for Older Adults
Description of project and outcome: CHS, as an administrator of the CDBG program, will make
available CDBG FY 2024-2025 funds up to the gross amount of,$"A4a8.0 -S82,499.97 to Baker
BAKER SENIOR CENTER NAPLES,INC AMENDMENT#2
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Senior Center Naples, Inc. to be used to support the salary for one (1) two (2) geriatric case
managers and the necessary supplies and equipment to support low- to moderate-income adults.
Activities may include but are not limited to conducting intake assessments, assessing an
individual's needs, developing short/long-term comprehensive customized care plans, addressing
emotional concerns such as stress and anxieties, making home visits to evaluate living conditions,
assisting with emergency financial needs to prevent eviction/homelessness/unhealthy living
conditions, and other vital activities to support aging in place.
Project Component One: Salary for one (1) two (2) geriatric case managers to support low- to
moderate-income adults.
Project Component Two: Supplies to include but not limited to laptops, software/member fees, cell
phone and cell phone service, to support the geriatric case managers.
1.1 GRANT SPECIAL CONDITIONS
A. SUBRECIPIENT must submit the following resolutions and policies to the COUNTY
within sixty(60)days of execution of this Agreement:
• Affirmative Fair Housing Policy
• Affirmative Action/Equal Opportunity Policy
Conflict of Interest Policy (COl)and related COI Forms
Affidavit Regarding Labor and Services('Trafficking)
❑ Procurement Policy
❑ Uniform Relocation Act(URA) Policy
• Sexual Harassment Policy
Section 3 Policy
• Section 504/ADA Policy
• Fraud, Waste, and Abuse Policy
• Language Assistance and Planning Policy (LAP)
Limited English Proficiency Policy(LEP)
Violence Against Women Act (VAWA) Policy
LGBTQ Policy
* *
D. Conflict of Interest— SUBRECIPIENT must have written conflict of interest policies. The
CDI3G Program distinguishes between two tapes of conflict of interest: one related to
organizations that carry out the project (recipients or subrecipients), and another specific
to individuals involved in providing services and dav-to-dav project operations.
SUBRECIPIENT shall have written policies related to both types of conflicts of interest.
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With respect to the use of CDBG funds to procure services,equipment, supplies,or other
property,the SUBRECIPIENT shall comply with 2 C'FR part 200. With respect to all other
decisions involving the use of CDBG funds, the following restrictions shall apply: No
person who is an employee, agency consultant,officer, or elected or appointed official of
the Subrecipient and who exercises or has exercised any functions or responsibilities with
respect to assisted activities, or who is in a position to participate in a decision-making
process or gain inside information with regard to such activities, may obtain a person or
financial interest or benefit from the activity, or have an ._interest in any contract
subcontract,or agreement with respect thereto,or the process thereunder,either for himself
or herself or for those with whom he or she has family or business ties. during his or her
tenure for one year thereafter. If a conflict or a potential or perceived conflict of interest is
to occur, the SUBRECIPIENT must contact the COUNTY to determine whether an
exception will be allowed as prescribed by the applicable federal regulations.
DIE. Limited English Proficiency — Persons who, as a result of national origin, do not speak
English as their primary language and who have limited ability to speak, read, write, or
understand English ("limited English proficient persons" or "LEP persons") may be
entitled to language assistance under Title VI in order to receive a particular service,
benefit, or encounter. In accordance with Title VI of the Civil Rights Act of 1964 (Title VI)
and its implementing regulations, the SUBRECIPIENT agrees to take reasonable steps to
ensure meaningful access to activities funded with 1-IUD Funds by LEP persons. Any of
the following actions could constitute"reasonable steps",depending on the circumstances:
acquiring translators to translate vital documents; advertisements or notices; acquiring
interpreters for face to face interviews with LEP persons; placing advertisements and
notices in newspapers that serve LEP persons; partnering with other organizations that
serve LEP populations to provide interpretation, translation, or dissemination of
information regarding the project; hiring bilingual employees or volunteers for outreach
and intake activities; contracting with a telephone line interpreter service; etc.
1.2 PROJECT DETAILS
A. Project Description/Project Budget
Description —� - Federal Amount
Project Component One: Salary for one(1)two(2)geriatric case managers to support $4 -09
low- to moderate-income adults. $74,194.97
Project Component Two: Supplies, to include but not limited to: laptops, $8,305.00
software/member fees,cell phone and cell phone service,to support the geriatric case
managers.
Total Federal Funds: $55,000.00
$82,499.97
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* * *
C. Performance Deliverables
Program Deliverable Deliverable Supporting 1 Submission Schedule
Documentation
Insurance Exhibit A - Insurance Certificate Within 30 days of Agreement
execution and annually within
thirty (30)days of renewal.
Special Grant Condition Policies Policies as stated in this Within sixty(60)days of
(Section 1.1) Agreement Agreement execution.
Detailed Project Schedule Not Applicable Not Applicable.
Project Plans and Specifications Not Applicable Not Applicable.
Procurement Documents(Bid Not Applicable Not Applicable.
Packet)
Subcontractor Log Not Applicable Not Applicable.
Quarterly Progress Report Exhibit C Quarterly,within 10 days following
the end of the quarter.
Fair Housing Calls Report Fair Housing Call Log Quarterly, within 10 days following
the end of the quarter.
Section 3 Report Not Applicable Not Applicable.
Complaint Logs EEO, AA and Incident Log Quarterly, within 10 days following
the end of the quarter.
Leverage Funds Report Exhibit C-1 Due upon submission of the final
pay request in Neighborly
Davis-Bacon Act Certified Not Applicable Not Applicable.
Payroll
Annual Audit Monitoring Exhibit E Annually, within 60 days after FY
Report end.
Financial and Compliance Audit Audit, Management Letter,and Annually: nine(9) months after FY I
Supporting Documentation end for Single Audit OR one
hundred eighty(I 80)days after FY
end.
Continued Use Certification Not Applicable Annually through 2030
Capital Needs Assessment Plan Not Applicable Not Applicable. l
Program Income Reuse Plan Not Applicable Not Applicable. -----
Equipment Collier County Exhibit F Annually, for five(5)years
Iiiventofy Tracking Form throughout the continued use
period.
Conflict of Interest Form Subrecipient/Developer/Vendor Upon execution of the agreement,
Conflict of Interest Disclosure for all employees who work on
Form activities associated with the grant,
and upon hiring of all new
employees.
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Whistleblower Protections Exhibit H
Affidavit Upon execution of the agreement
for all employees who work on
activities associated with the grant,
and upon hiring of all new
-- - _ employees.
D. Payment Deliverables
Paymenty Deliverable--- Payment Pa me Supporting Documentation —._
--_ ) fl? g 1 Submission Schedule
Project Component One: CDBG Submission of supporting documents Submission of
funds will be used to support the ' must be provided as backup, as evidenced monthly payment
salary for one(1)two(2)geriatric by timecards, payroll registers/summary, ' requests due 30 days
case managers to support low- to canceled checks or banking documents, after the prior month.
moderate-income adults. Exhibit B, and any other additional
documentation as requested.
10% retainage will be withheld with each
request for payment and will be released
upon completion of activities and final
closeout monitoring.
Project Component Two: --� --P Submission of supporting documents Submission of Supplies to include but not must be provided as backup, as evidenced monthly payment
limited to laptops, by invoices, receipts. canceled checks or requests due 30 days
software/member fees,cell phone banking documents, Exhibit B, and any after the prior month.
and cell phone service, to support other additional documentation as
the geriatric case managers. requested.
10% retainage will be withheld with each
request for payment and will be released
upon completion of activities and final
closeout monitoring.
Final 10 percent retainage will be paid upon completion of final monitoring clearance and documentation
of meeting the National Objective. SUBRECIPIENT'S failure to achieve the National Objective will
require repayment of the CDBG investment under this Agreement.
* * *
1.4 AGEEMENT AMOUNT
The COUNTY agrees to make available W-FTY 1,11-V#: 1'i1OU ANI) DOLLARS AND ZERO
98: EIGHTY-TWO CI IOUSAND ,_OUR HLNDREDNINTY NINE DOLLARS.
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AND NINTY SEVEN CENTS ($82,499,97) for use by SUBRECIPIENT, during the term of the
Agreement(hereinafter, shall be referred to as the Funds).
* * *
1.7 NOTICES
Notices required by this Agreement shall be in writing and delivered via mail (postage prepaid),
commercial courier, personal delivery, or sent by facsimile or other electronic means. Any notice
delivered or sent as aforesaid shall be effective on the date of delivery or sending. All notices and
other written communications under this Agreement shall be addressed to the individuals in the
capacities indicated below, unless otherwise modified by subsequent written notice.
COLLIER COUNTY ATTENTION: Julie Chard^n Melissa Juarez. Grant Coordinator
Collier County Government
Community and Human Services Division
3339 Tamiami Trail East, Suite 2 1 3
Naples, Florida 34112
Email:.
Melissa.Juarezacolliercountyfl.gov
Telephone: (239)252-$-38 2590
* * *
PART II
GRANT CONTROL
REQUIREMENTS
* * *
2.2 RECORDS AND DOCUMENTATION
D. Upon completion of all work contemplated under this Agreement, copies of all documents
and records relating to this Agreement shall be surrendered to CHS, if requested. In any
event, SUBRECIPIENT shall keep all documents and records in an orderly fashion, in a
readily accessible, permanent, and secured location for three (3) years after the date of
COUNTY'S submission of the final performance and evaluation report(CAPER)to HUD,
as prescribed in 2 CFR 200.334. 24CFR 570.493 and 24 CFR 570.502(a)(7)(ii). However,
if any litigation, claim, or audit is started before the expiration date of the three (3) year
period, SUBRECIPIENT will maintain the records until all litigation, claim, or audit
findings involving these records are resolved. If SUBRECIPIENT ceases to exist after the
closeout of this Agreement, it shall notify the COUNTY in writing, of the address where
the records are to be kept, as outlined in 2 CFR 200.337. SUBRECIPIENT shall meet all
requirements for retaining public records and transfer, at no cost to COUNTY, all public
records in SUBRECIPIENT'S possession upon termination of the Agreement,and destroy
any duplicate, exempt, or confidential public records that are released from public records
disclosure requirements. All records stored electronically must be provided to the
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COUNTY in a format that is compatible with the COUNTY'S information technology
systems.
IF SUBRECIPIENT HAS QUESTIONS REGARDING THE
APPLICATION OF CHAPTER 119, FLORIDA STATUTES, TO
SUBRECIPIENT'S DUTY TO PROVIDE PUBLIC RECORDS
RELATING TO THIS AGREEMENT, IT SHALL CONTACT
THE CUSTODIAN OF PUBLIC RECORDS AT 239-252-2-67-95837
Mi Anvel.Batesli'colliet.rtitinta f7._gov, 3299 Tamiami
Trail East, Naples, FL 34112.
* * *
I. SUBRECIPIENT shall take reasonable cvbersccurity and other measures to safeuuard
information including protected personally identifiable information('l1) and other types
of information in accordance with 2 CFR 200.303(e). This includes,information that HUD
or the COUNTY designates as sensitive, or other information the COUNTY considers
sensitive and is consistent with applicable Federal, State,and Local laws retarding privacy
and responsibility over confidentiality.
SUBRECIPIENT shall provide the public with access to public records on the same
terms and conditions that the COUNTY would provide the records, and at a cost that does
not exceed the cost provided in Chapter 119, Florida Statutes or as otherwise provided by
law. SUBRECIPIENT shall ensure that exempt or confidential public records that are free
from public records disclosure requirements are not disclosed, except as authorized by 2
CFR 200.337 and 2 CFR 200.338.
* *
PART III
TERMS AND CONDITIONS
* * *
3.14 PROGRAM GENERATED INCOME
No Program Income is anticipated. However, if Program Income is derived from the use of CDBG
Funds disbursed under this Agreement, SUBRECIPIENT shall utilize such Program Income only
for CDBG-eligible activities approved by the COUNTY. Any Program Income (as such term is
defined under 24 CFR 570.500(a) gained from any SUBRECIPIENT activity funded by CDBG
Funds shall be reported to the COUNTY through an annual Program Income Reuse Plan, utilized
by the SUBRECIPIENT accordingly,and shall comply with 2 CFR 200.307,24 CFR parts 570.489,
570.500, and 570.504 in the operation of the Program. When Program Income is generated by
an activity that is only partially assisted by CDBG Funds, the income shall be prorated to
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reflect the percentage of CDBG Funds used. If there is a Program Income balance at the end of
the Program Year, such balance shall revert to the COUNTY's Community Block Grant Program,
for further reallocation.
Equipment/Supplies: Per 45 CFR 75, Equipment is defined as tangible personal property
(including information technology systems) having a useful life of more than one year and a per-
unit acquisition cost which equals or exceeds the lesser of the capitalization level established by
the non-Federal entity for financial statement purposes_, or $5,000. The Collier County Inventory
form(Exhibit F)must be completed by SUBRECIPIENT and submitted to the COUNTY annually.
Supplies are defined as all tangible personal property other than those described as Equipment.A
computing device is a supply if the acquisition cost is less than the lesser of the capitalization level
established by the non-Federal entity for financial state purposes or$5,000,regardless of the length
of its useful life.
During the continued use period. as referenced in Section 3.16(Grant Closeout Procedures)of this
Agreement,equipment/supplies under SUBRECIPIENT'S control that were acquired or improved,
in whole or in part,with CDBG Funds shall be used to meet one of the CDBG National Objectives,
pursuant to 24 CFR 570.208. If SUBRECIPIENT sells, transfers, disposes of or otherwise fails to
continue to use the CDBG-assisted equipment/supplies in a manner that meets a CDBG National
Objective, SUBRECIPIENT shall pay the COUNTY an amount equal to the current fair market
value of the equipment/supplies, less the percentage of non-CDBG funds used to acquire the
equipment/supplies.
At the end of the Grant period, the SUBRECIPIENT must request disposition instructions from the
COUNTY for unused equipment acquired under this Agreement. If the COUNTY fails to provide
the requested instructions within 120 days, the unused equipment with a value of$5,000 or less,
may be retained, sold, or otherwise disposed of with no further responsibility to the COUNTY.
However, the COUNTY is entitled to an amount calculated by multiplying the percentage of the
COUNTY's contribution towards the original purchase by the current market value or proceeds
from the sale. If the equipment is sold, the COUNTY may permit the SUBRECIPIENT to retain,
from the Federal share, $1,000 of the proceeds to cover the expenses associated with the selling
and handling of the equipment.
At the end of the Grant period, unused supplies with a value exceeding$5,000 acquired under this
Agreement must be sold by the SUBRECIPIENT. The COUNTY is entitled to compensation in an
amount calculated by multiplying the percentage of the COUNTY's contribution towards the cost
of the original purchase(s) by the current market value or proceeds from the sale. If supplies are
sold,the COUNTY may permit the SUBRECIPIENT to retain, from the Federal share, $1,000 of
the proceeds to cover expenses associated with the selling and handling of the supplies.
* * *
3.20 CONFLICT OF INTEREST
SUBRECIPIENT covenants that no person under its employ,who presently exercises any functions
or responsibilities in connection with the Project, has any personal financial interest, direct or
indirect, in the Project areas or any parcels therein, which would conflict in any manner or degree
with the performance of this Agreement;and that SUBRECIPIENT shall not employ or subcontract
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with any person having any conflict of interest. The SUBRECIPIENT covenants that it will comply
with all provisions of 24 CFR 570.611 "Conflict of Interest," 2 CFR 200.318, and the State and
County statutes, regulations, ordinances, or resolutions governing conflicts of interest. All
SUBRECIPIENT employees who work on activities associated with this Agreement shall complete
the Subrecipient/Developer/Vendor Conflict of Interest Disclosure Form prior to execution of this
Agreement. Any employees hired later during the period of performance for this Agreement who
will work on activities associated with this Agreement shall also complete and submit to the
COUNTY the Conflict of Interest Disclosure Form.
* * *
3.23 INCIDENT REPORTING
If SUBRECIPIENT provides services to clients under this Agreement, SUBRECIPIENT and any
subcontractors shall report to the COUNTY knowledge or reasonable suspicion of abuse, neglect,
or exploitation of a child, aged person, or disabled person.
During the term of this Agreement, SUBRECIPIENT must report to the COUNTY in writing,
within one business day of occurrence,any substantial,controversial,or newsworthy incidents.The
Collier County Staridafd-8+14r +eat Incident Report Form (Exhibit G) shall be used to report all
such incidents.
* * *
PART IV
GENERAL PROVISIONS
* * *
4.46 Equal Treatment of Faith-Based Organizations: By regulation, HUD prohibits all recipient
organizations from using financial assistance from HUD to fund explicitly religious activities.The
SUBRECIPIENT agrees to avoid such prohibited conduct. For more information, see
hops,r'%njp,gow/ahonit/ocr;'partnerships htm. Discrimination on the basis of religion in employment
is generally prohibited by federal law, but the Religious Freedom Restoration Act is interpreted on
a case-by-case basis to allow some faith-based organizations to receive HUD funds while taking
into account religion when hiring staff. Questions in this regard should be directed to the Office for
Civil Rights.
A. Organizations that are religious or faith-based are eligible, on the same basis as any
other organization, to participate in CDBG.
B. The SUBRECIPIENT may not engage in inherently religious activities, such as
worship. religious instruction, or proselytization as part of the programs or services
funded under CDBG. If the SUBRECIPIENT conducts such activities, the activities
must be offered separately, in time or location, from the programs or services funded
under CDBG, and participation must be voluntary for the program participants.
C. A religious SUBRECIPIENT that receives CDBG funding will retain its independence
from Federal, State. and local governments, and may continue to carry out its mission,
including the definition. practice, and expression of its religious beliefs, provided that
BAKER SENIOR CENTER NAPLES.INC, AMENDMENT#2
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it does not use direct CDBG funds to support any inherently religious activities, such
as worship, religious instruction, or proselytization. Among other things, faith-based
Subrecipients may use space in their facilities to provide CDBG funded services,
without removing religious art, icons, scriptures, or other religious symbols. In
addition, a Subrecipient retains its authority over its internal governance, and it may
retain religious terms in its name, select its board members on a religious basis, and
include religious references in its mission statements and other governing documents.
D. The Subrecipient that participates in CDBG shall not, in providing program assistance,
discriminate against a program participant or prospective program participant on the
basis of religion or religious belief.
E. If the SUBRECIPIENT voluntarily contributes its own funds to supplement federally
funded activities, the SUBRECIPIENT has the option to segregate the federal funds or
commingle them. However, if the funds are commingled,the requirements listed above
apply to all of the commingled funds.
* * *
4.54 Trafficking in Persons: SUBRECIPIENT agrees to, at any tier, comply with all applicable
requirements(including requirements to report allegations)pertaining to prohibited conduct related
to the trafficking of persons, whether on the part of the SUBRECIPIENT and any employees of
SUBRECIPIENT. The details of SUBRECIPiENT'S obligations related to prohibited conduct
related to the trafficking of persons are posted at:
ht s://ojp,*2v//funding/Explore/ProhibitedConduct_I_ratlicking,htin.
Pursuant to Florida Statues 787.06, SUBRECIPIENT attests that it does not use coercion for labor
or services. SUBRECIPIENT shall provide an affidavit, under penalty of perjury, signed by an
officer or representative of the organization attesting that it does not use coercion for labor services.
httpf ‘ ww.Ic&state ll.use'Statutes/indea.cfnt''App_mode, Displav_Statut'&l;Rl =-0700-
0799/0787/Sections/0787.06.html
* *
4.64 2 CFR 200.15 Never contract with the enemy. Federal agencies, recipients, and subrecipients are
subject to the guidance implementing Never Contract with the Enemy in 2 CFR part 183.
hops:/!witw,ecir.gov/current/title-2/suhtitle-A/clupier-ll/part-200/subpart (•/section-200.215
lit ip //www.ecfr pv/current/title-2/ ubtitle_A!chapter-l/part-18
4:644.65 OSHA. Where SUBRECIPIENT employees are engaged in activities not covered under
the Occupational Safety and Health Act of 1970, they shall not be required or permitted to work,
be trained, or receive services in buildings or surroundings or under working conditions which are
unsanitary, hazardous, or dangerous to the participant's health or safety.
4.654.66 Right to Know. Participants employed or trained for inherently dangerous occupations,
e.g., fire or police jobs, shall be assigned to work in accordance with reasonable safety practices.
The SUBRECIPIENT will comply with all applicable"Right to Know"Acts.
BAKER SENIOR CENTER NAPLES,INC AMENDMF;Nr#2
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Aging in Place NV th Dignity:Case Management Services for Older Adults
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4464.67 Whistleblower Protections:
a. In accordance with 2_Cf:R.217 and 41 U.S.C. § 4712, the SUBRECIPIENT may not
discharge, demote, or otherwise discriminate against an employee in reprisal for disclosing
to any of the list of persons or entities provided below, information that the employee
reasonably believes is evidence of gross mismanagement of a federal contract or grant, a
gross waste of federal funds, an abuse of authority relating to a federal contract or grant. a
substantial and specific danger to public health or safety, or a violation of law, rule, or
regulation related to a federal contract (including the competition for or negotiation of a
contract)or grant.
b. The list of persons and entities referenced in the paragraph above includes the following:
i. A member of Congress or a representative of a committee of Congress;
ii. An Inspector General;
iii. The Government Accountability Office:
iv. A Treasury employee responsible for contract or grant oversight or management;
v. An authorized official of the Department of Justice or other law enforcement agency;
vi. A court or grand jury; or
vii. A management official or other employee of Recipient. contractor, or subcontractor
who has the responsibility to investigate, discover, or address misconduct.
The SUBRECIPIENT shall inform its employees in writing of the whistleblower rights and
remedies provided undersection ' CFR 2O0.217and_11 L!..S.( § I712, in the predominant
native language of the workforce.
https://uscode,house.gov/view xht nl`hecg (attic 4 I°i,20scetion:4 7 I2%2Ocdition prcliin1
All SUBRECIPIENT employees directly involved with activities associated with this Agreement
shall complete and submit to the COUNTY the Collier County Whistleblowcr Protections
Certification form (Exhibit H) prior to execution of this Agreement. Any new employees hired
during the period of performance of this Agreement shall also complete and submit the form to the
COUNTY.
1. Exhibit C is hereby amended as set forth in Exhibit C attached hereto and incorporated
herein.
2. Exhibit F is hereby amended as set forth in Exhibit F attached hereto and incorporated
herein.
3. Exhibit G is hereby added as set forth in Exhibit G attached hereto and incorporated
herein.
4. Exhibit H is hereby added as set forth in Exhibit hI attached hereto and incorporated
herein.
5. Except as set forth herein,the Agreement remains in full force and effect.
Remainder of Page Intentionally Left Blank
(Signature Page to Follow)
BAKER SENIOR CENTER NAPLES,INC AMENDMENT 42
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IN WITNESS WHEREOF,the SUBRECIPIENT and COUNTY, have each respectively, by an authorized
person or agent, hereunder set their hands and seals on the date first written above.
ATTEST: AS TO COUNTY:
CRYSTAL . KINZEL, CLERK
BOARD OF COUNTY COMMISSIONERS
#11,4*
COLLIER COUNTY, FLORIDA
,t ; ,,Deputy Clerk
41Z410.04--
' L. SAUN E S, CHAIRPERSON
Dated: (Q 7
-26-
(SEAL) Date: ._. /ZS
Attest as to Chairman
signature one
AS TO SUBRECIPIENT:
WITNESSES:
____ BAKER SENIOR CENTER NAPLES, INC.
Witness#1 Si ature
7:7--,. By:
P.1 3', ,(lo ccif,u D ACLY N FAFFE , PRESIDENT/CEO
Witness#1 Printed Name
( 2._ /^ �C � Date: 6'I -22
fitness:2,e_S)gr re
[Please provide evidence of signing authority]
Witness#2 Printed Name
(Appro I-11 s s , and legality:
.21111011k
'Blom.
Jeffrey . 1 _kow
Collier unt Attorney
Date: Iv C. 1 , 015
BAKER SENIOR CENTER NAPLES,INC AMENDMENT#2
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Aging in Place with Dignity:Case Management Services for Older Adults
CAC)
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EXHIBIT C
QUARTERLY PERFORMANCE REPORT DATA
The COUNTY is required to submit Performance Reports to HUD through the Integrated Disbursement
and Information System(IDIS). The COUNTY reports information on a quarterly basis. To facilitate in the
preparation of such reports,SUBRECIPIENT shall submit the information contained herein within ten(10)
days of the end of each calendar quarter. At COUNTY's discretion, SUBRECIPIENT may be required to
enter the information collected on this exhibit into an online grant management system.
Subrecipient Name: Baker Senior Center Naples, Inc. Date:
Project Title: Aging in Place with Dignity: Case Management IDIS#:
Services for Older Adults
Program Contact: Tim Morrison Telephone Number: (239)325-4444 ext.2212 1
Activity Reporting Period Report Due Date
October 1 S'—December 3 Is' January 10'h
January 151—March 31s1 April 10'h
April IS'—June 3011' July 10'h
July IS'—September 30'h October 10'1'
REPORT FOR QUARTER ENDING: (check one that applies to the corresponding grant period):
012/31/2024 ❑3/31/2025 ❑ 6/30/2025 ❑ 9/30/2025 Final / /20
Please note: The HUD Program year begins October 1,2024—September 30,2025. Each quarterly report must include
cumulative data beginning from the start of the program year October 1,2024.
I. Please list the outcome goal(s)from your approved application and SUBRECIPIENT Agreement and indicate your
progress in meeting those goals since October 1,2024.
a. Outcome Goals: list the outcome goal(s)from your approved application and SUBRECIPIENT Agreement
Outcome 1: A minimum of thirtyforty(40)unduplicated clients will be served.
Outcome 2: Conduct and document up to six(6)ten(10)telephone socialization calls to homebound case
management clients.
Outcome 3: Documentation that 51%of the total households served qualify as low-to moderate-income,for
achievement of the LMC National Objective.
b. Goal Progress: Indicate the progress to date in meeting each outcome goal.
Outcome 1:
Outcome 2:
Outcome 3:
2. Is this project still in compliance with the original project schedule: Yes 0 No Q
If No, Explain:
3. Since October 1,2024;of the persons assisted, how many...
Answer ONLY for Public Facilities& Infrastructure Activities *03 Matrix Codes
a. ...now have new access(continuing)to this service or benefit? 0
b. ...now have improved access to this service or benefit? 0
c. ...now receive a service or benefit that is no longer substandard? 0
Total 0
4, What funding sources did the SUBRECIPIENT apply for this period?
Section 108 Loan Guarantee S CDBG $
Other Consolidated Plan Funds $ HOME
Other Federal Funds $ ESG S
BAKER SENIOR CENTER NAPLES,INC. AMENDMENT#2
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$ HOPWA $
$ Total Entitlement $
Funds
5. ] What is the total number of UNDUPLICATED Persons(LMC)or Households(LMH)served this QUARTER, if
applicable? Answer question 5a or 5b; NOT both
For LMC activities: people, race/ethnicity,and income data are reported by persons.
For LMH activities: households, race/ethnicity,and income level are reported by households, regardless
the number of persons in the household.
a. Total No. Persons/Adults served(LMC) 0 Total No. persons served under 18 0
(LMC)
Quarter Total No.of Persons 0 Quarter Total No.of Persons I 0
b. Total No. of Households served 0 Total No.of female head of household 0
(LMH)
6. What is the total number of UNDUPLICATED clients served since October, if applicable?
Answer question 6a or 6b,NOT both
For LMC activities: race/ethnicity and income data are reported by persons.
a. Total No. Persons/Adults served(LMC) 0 Total No. Persons served under 18 0
_ (LMC)
YTD Total: 0 YTD Total 0
b. Total No. Households served(LMH) 0 Total No. female head of household(LMH) 0
YTD Total 0 YTD Total 0
Complete EITHER question 7 or 8, NOT both
Complete question 7a and 7b if your program only serves clients in one or more of the listed HUD Presumed
Benefit categories.
7. PRESUMED BENEFICIARY DATA ONLY: PRESUMED BENEFICIARY DATA ONLY
(LMC)Quarter (LMC)YTD
Indicate the total number of UNDUPLICATED persons Indicate the total number of UNDUPLICATED
served this quarter who fall into each presumed benefit persons served since October I who fall into each
category(the total should equal the total in question #6a presumed benefit category (the total should equal the
or 6b): total in question#6a or 6b):
a Presumed Benefit Activities Only(LMC)QTR b Presumed Benefit Activities Only(LMC)YTD
0 Abused Children ELI 0 Abused Children ELI
0 Homeless ELI 0 Homeless Person ELI
Person
0 Migrant Farm LI 0 Migrant Farm Workers Li
Workers
0 Battered LI 0 Battered Spouses LI
Spouses
0 Persons LI 0 Persons w/HIV/AIDS LI
w/HIV/AIDS
0 Elderly Persons LI or MOD 0 Elderly Persons LI or
MOD
0 Illiterate Adults LI 0 Illiterate Adults LI
0 Severely LI 0 Severely Disabled Adults LI
Disabled Adults
0 Quarter Total 0 YTD Total
8. Complete question 8a and 8b if any client in your program does not fall into a Presumed Benefit category.
Other Beneficiary Data: Income Range Other Beneficiary Data: Income Range
Indicate the total number of UNDUPLICATED persons Indicate the total number of UNDUPLICATED
BAKER SENIOR CENTER NAPL,ES,INC AMENDMENT#2
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served this Quarter who fall into each income category i persons served since October I (YTD)who fall into
(the total should equal the total in question#6): each income category (the total should equal the total
in question #6):
a ELI Extremely Low income(0-30%) 0 b Eli j Extremely Low 0
Income(0-30%)
LI Low Income(31-50%) 0 LI l,o�' Income 0 i
MOD Moderate Income(51-80%) 0 MOD Moderate Income 0
(51-80%)
NON-L/M Above Moderate Income(>80%) 0 NON-UM Above Moderate 0
Income(>80%)
Quarter Total 0 YTD Total 0
9, Is this project in a Low/Mod Area(LMA)? YES NO
Was project completed this quarter? YES NO loves.complete all of this section 9.
Date project completed
i Low/Mod
Block Group Census Tract Total Beneficiaries I Low/Mod Percentage
Beneficiaries
-
0 0 0 (I I 0
Date LMA Narrative approved by CHS?
What documentation supports project completion? (i.e.,
Certificate of Completion or Certificate of Occupancy.
etc.)
10. , Racial& Ethnic Data(if applicable) I
Please indicate how many UNDUPLICATED Please indicate how many UNDUPLICATED clients
clients served this Quarter fall into each race ! served since October(YTD) fall into each race category. In
category. In addition to each race category,please . addition to each race category please indicate how many
indicate how many persons in each race category persons in each race category consider themselves
consider themselves Hispanic. (Total Race column Hispanic. (Total Race column should equal the total in
should equal the total in question 6) _question 6.)
a. RACE ETHNICITY b. RACE I ETHNICITY
/HISPANIC /HISPANIC
White 0 0 White 0 0
Black/African American 0 0 Black/African American 0 ; 0
Asian 0 0 Asian 0 0
0 0 American Indian/Alaska 0 0
American Indian/Alaska Native Native
Native Hawaiian/Other Pacific Islander 0 0 j Native I lawaiian/Other Pacific 0 0
Islander Black/African American&White 0 0 Black/African American&~ 0 __
0
White
American Indian/Alaska Native& 0 0 American Indian/Alaska 0 0
Native&Black/African
Black/African American
American
Other Multi-racial 0 0 Other Multi-racial : 0 0
0 0 f 0 0
1 hereby certify the above information is true and accurate.
Name:
Signature:
Title:
Your typed name here represents Four electronic signature
BAKER SENIOR CENTER NAPLES,INC. AMENDMENT#2
PS24-04
Aging in Place with Dignity:Case Management Services for Older Adults
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Collier County
Community & Human Services Division
EXHIBITG
INCIDENT REPORT FORM
Organization Name:
Organization Address:
Project No:
Grant Coordinator:
Date of Incident Time of Incident: 1
Report Submitted By:
(Name& Phone)
Description of Incident:
Location/Address of Incident:
Was Police Report Filed? 0 Yes ❑No
If Yes, Police Report Number: Jurisdiction:
Were there any warning signs that this type of Incident could occur'? 0 Yes 'D No
If Yes, Explain:
What actions will be taken to prevent a recurrence of a similar incident?
I certify under penalty ofperjury under F.S. 837.06 that the contents of this affidavit are true and correct.
Signature of Person Making Report Date
Printed Name
Title
Return completed form to: Kristi Sonntag, Director,CHS
Collier County Community and Human Services Division
3339 Tamiami Trail East, Bldg. H,Suite 213 t+
Naples, FL 34112 Fax: (239)252-2638 VL'�
16D8
EXHIBIT H
COLLIER COUNTY COMIll l NITY & HUMAN SERVICES
WHISTLEBLOWER PROTECTIONS AFFIDAVIT
SUBRECIPIENT Name:
SUBRECIPIENT Address:
Project Name:
Project No:
In accordance with 2 CFR 200.217 and 41 U.S.C. § 4712. SUBRECIPIENT may not discharge.
demote, or otherwise discriminate against an employee in reprisal for disclosing to any of the list
of' persons or entities provided below, information that the employee reasonably believes is
evidence of gross mismanagement of a federal contract or grant. a gross waste of federal funds, an
abuse of authority relating to a federal contract or grants.a substantial and specific danger to public
health or safety. or a violation of law, rule,or regulation related to a federal contract (including the
competition for or negotiation of a contract) or grant.
The list of persons and entities referenced in the paragraph above includes the following:
• A member of'Congress or a representative of a committee of Congress
• An Inspector General
• The Government Accountability Office
• A Treasury employee responsible for contract or grant oversight or management
• An authorized official of the Department of Justice or other law enforcement agency
• A court or grand jury
• A management official or other employee of SUBRECIPIENT,contractor,or subcontractor
who has the responsibility to investigate, discover, or address misconduct
SUBRECIPIENT shall inform its employees in writing of whistleblower rights and remedies
provided under section 41 U.S.C. § 4712, in the predominant native language of the workforce.
By signing this affidavit. I certify that Subrecipient Name will comply with all Whistleblower
rights and protections for its employees.
Name:
Signature:
Title:
Your typed name here represents your electronic signature