Backup Documents 10/14/2025 Item #16C 2 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP t
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 1 V C 2
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. County Attorney Office CAO CtD
10/I y tZ,S
2. Board of County Commissioners Office BOCC
.C351y NO/ lolly
3. Minutes and Records Clerk of Court's Office
4. Send via email to:
kezia.domond(cf`,;collier.tov
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 Kezia Domond 2885 S. Horseshoe Dr 252-2743
Contact/ Department Grants Coordinator I
Agenda Date Item was 1 0.1 ^ .2025 Agenda Item Number 16.C.12
Approved by the BCCType of �t :J
Attached Document Grant Agreement Number of Original 1
Documents Attached
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 STAMP OK Certified KD
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 KD
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 KD
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 KD
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip
should be provided to the County Attorney Office at the time the item is input into SIRE. KD
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 10.14.2025 and all changes made during
the meeting have been incorporated in the attached document. The County Ct:D
Attorney's Office has reviewed the changes,if applicable.
9. Initials of attorney verifying that the attached document is the version approved by the
BCC,all changes directed by the BCC have been made,and the document is ready for the Cl D
Chairman's signature.
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
STATE OF FLORIDA 6 "
DEPARTMENT OF ENVIRONMENTAL PROTECTION
Standard Grant Agreement
This Agreement is entered into between the Parties named below,pursuant to section 215.971, Florida Statutes:
1. Project Title(Project): Agreement Number:
Collier County-Naples Park Public Utilities Renewal Project 103rd/104th Avenues L0018
2. Parties State of Florida Department of Environmental Protection,
3900 Commonwealth Boulevard (Department)
Tallahassee,Florida 32399-3000
Grantee Name: Collier County Entity Type: Local Government
Grantee Address: FEID: 596000558-007
3299 Tamiami Trail E.Suite 303,Naples,FL 34112
(Grantee)
3. Agreement Begin Date: Date of Expiration:
July I,2024 March 31,2029
4. Project Number: Project Location(s): Lat/Long: (26.2651,-81.8157)
di different from Agreement Number)
Project Description: The Grantee will construct a new potable water distribution system,a new wastewater collection system,and a new stormwater
system along 103rd and 104th Avenues North.
5. Total Amount of Funding: Funding Source? Award#s or Line-Item Appropriations_ Amount per Source(s): I
El State ❑Federal LP,GAA LI 1732A,FY 24-25,GR $ 4,500,000.001
$4,500,400.00 0 State ❑Federal _$
0 State ❑Federal
0 Grantee Match $
Total Amount of Funding Grantee Match, if any: $ 4.500.000.00
6. Department's Grant Manager Grantee's Grant Manager
Name: Arianna Kolesar Name: Diana Dueri
or successor or successor
Address: Florida Dept.of Environmental Protection Address: Collier County Board of County Commissione
3900 Commonwealth Blvd.,MS 3570 3339 Tamiami Trial E.Suite 303
Tallahassee,FL 32399-3000 Naples,FL 34112
Phone: 850-245-2948 Phone: (239)252-4218
...... _.... _.--
Email: Arianna.Kolesar@FloridaDEP.gov Email: Diana.dueri@colliercountyfl.gov
7. The Parties agree to comply with the terms and conditions of the following attachments and exhibits which are hereby
incorporated by reference:
B Attachment 1: Standard Terms and Conditions Applicable to All Grants Agreements
E Attachment 2: Special Terms and Conditions
E Attachment 3:Grant Work Plan
Attachment 4: Public Records Requirements
II Attachment 5: Special Audit Requirements
❑ Attachment 6:Program-Specific Requirements
❑ Attachment 7:Grant Award Terms(Federal)*Copy available at https:i/facts.fldfs.com,in accordance with section 215.985,F.S.
❑ Attachment 8: Federal Regulations and Terms(Federal)
❑ Additional Attachments(if necessary):
13 Exhibit A: Progress Report Form
❑ Exhibit B: Property Reporting Form
8 Exhibit C: Payment Request Summary Form
❑ Exhibit D: Quality Assurance Requirements
❑ Exhibit E:Advance Payment Terms and Interest Earned Memo
❑ Exhibit F:Common Carrier or Contracted Carrier Attestation Form PUR1808(State)
DEP Agreement No. L0018
GAO Rev.6/14/24
6C2
0 Exhibit H: Non-Profit Organization Compensation Form(State) —
❑ Exhibit I: Forced Labor Attestation Form
0 Additional Exhibits(if necessary):
8. The following information applies to Federal Grants only and is identified in accordance with 2 CFR 200.331 (a)(1):
Federal Award Identification Number(s)(FAIN):
Unique Entity Identifier(UEI):
Federal Award Date to Department:
Federal Award Project Description:
Total Federal Funds Obligated by this Agreement:
Federal Awarding Agency:
Award R&D? ❑ Yes ON/A
IN WITNESS WHEREOF,this Agreement shall be effective on the date indicated by the Agreement Begin Date unless
another date is specified in the grant documents.
Collier County GRANTEE
Grantee Nam
• agif4/0A— /19//q/2
By
(Authorized Signature) Date Signed
Burt L.Saunders,Chairman
Print Name and Title of Person Signing
State of Florida Department of Environmental Protection DEPARTMENT
By
Secretary or Designee Date Signed
Angela Knecht,Director,Division of Water Restoration Assistance
Print Name and Title of Person Signing
✓l Additional signatures attached on separate page.
ATTEST
CRYSTAL K.KINZEL,
BY:
Attest,as to Chairti.n's
S19rtature-only
DEP Agreement No. 10018
CAO Rev.6/14/24
Digitally signed by Angela Knecht
Date: 2025.10.24 16:58:58 -04'00'
Arianna Kolesar
Digitally signed by Arianna
Kolesar
Date: 2025.10.24 16:22:14
-04'00'
Amanda Peck
Digitally signed by Amanda
Peck
Date: 2025.10.24 16:29:22
-04'00'
16C2
STATE OF FLORIDA
DEPARTMENT OF ENVIRONMENTAL PROTECTION
Special Audit Requirements
(State and Federal Financial Assistance)
Attachment 5
The administration of resources awarded by the Department of Environmental Protection (which may be referred to
as the "Department", "DEP", "FDEP"or "Grantor", or other name in the agreement)to the recipient(which may be
referred to as the "Recipient", "Grantee"or other name in the agreement)may he subject to audits and/or monitoring
by the Department of Environmental Protection,as described in this attachment.
MONITORING
In addition to reviews of audits conducted in accordance with 2 CFR Part 200, Subpart F-Audit Requirements, and
Section 215.97, F.S., as revised (see "AUDITS" below), monitoring procedures may include, but not be limited to,
on-site visits by DEP Department staff, limited scope audits as defined by 2 CFR 200.425, or other procedures. By
entering into this Agreement,the recipient agrees to comply and cooperate with any monitoring procedures/processes
deemed appropriate by the Department of Environmental Protection. In the event the Department of Environmental
Protection determines that a limited scope audit of the recipient is appropriate,the recipient agrees to comply with any
additional instructions provided by the Department to the recipient regarding such audit. The recipient further agrees
to comply and cooperate with any inspections, reviews, investigations, or audits deemed necessary by the Chief
Financial Officer(CFO)or Auditor General.
AUDITS
PART I: FEDERALLY FUNDED
This part is applicable if the recipient is a State or local government or a non-profit organization as defined in 2 CFR
§200.330
1. A recipient that expends $1,000,000 or more in Federal awards in its fiscal year, must have a single or
program-specific audit conducted in accordance with the provisions of 2 CFR Part 200,Subpart F.EXHIBIT
1 to this Attachment indicates Federal funds awarded through the Department of Environmental Protection
by this Agreement. In determining the federal awards expended in its fiscal year,the recipient shall consider
all sources of federal awards, including federal resources received from the Department of Environmental
Protection. The determination of amounts of federal awards expended should be in accordance with the
guidelines established in 2 CFR 200.502-503. An audit of the recipient conducted by the Auditor General in
accordance with the provisions of 2 CFR Part 200.514 will meet the requirements of this part.
2. For the audit requirements addressed in Part I,paragraph 1,the recipient shall fulfill the requirements relative
to auditee responsibilities as provided in 2 CFR 200.508-512.
3. A recipient that expends less than $1,000,000 in federal awards in its fiscal year is not required to have an
audit conducted in accordance with the provisions of 2 CFR Part 200,Subpart F-Audit Requirements. If the
recipient expends less than $1,000,000 in federal awards in its fiscal year and elects to have an audit
conducted in accordance with the provisions of 2 CFR 200, Subpart F-Audit Requirements, the cost of the
audit must be paid from non-federal resources (i.e., the cost of such an audit must be paid from recipient
resources obtained from non-federal entities).
4. The recipient may access information regarding the Catalog of Federal Domestic Assistance(CFDA)via the
internet at https://sam.gov/content/assistance-listings.
Attachment 5
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t3GS-DEP 55-215 revised 11/19/24
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PART Ii: STATE FUNDED
This part is applicable if the recipient is a nonstate entity as defined by Section 215.97(2), Florida Statutes.
I. In the event that the recipient expends a total amount of state financial assistance equal to or in excess of
$750,000 in any fiscal year of such recipient (for fiscal years ending June 30, 2017, and thereafter), the
recipient must have a State single or project-specific audit for such fiscal year in accordance with Section
215.97, F.S.; Rule Chapter 691-5, F.A.C., State Financial Assistance; and Chapters 10.550 (local
governmental entities) or 10.650 (nonprofit and for-profit organizations), Rules of the Auditor General.
EXHIBIT I to this form lists the state financial assistance awarded through the Department of Environmental
Protection by this agreement. in determining the state financial assistance expended in its fiscal year, the
recipient shall consider all sources of state financial assistance, including state financial assistance received
from the Department of Environmental Protection, other state agencies, and other nonstate entities. State
financial assistance does not include federal direct or pass-through awards and resources received by a
nonstate entity for Federal program matching requirements.
2, in connection with the audit requirements addressed in Part II,paragraph 1;the recipient shall ensure that the
audit complies with the requirements of Section 215.97(8), Florida Statutes. This includes submission of a
financial reporting package as defined by Section 215.97(2), Florida Statutes. and Chapters 10.550 (local
governmental entities)or 10.650(nonprofit and for-profit organizations), Rules of the Auditor General.
3. If the recipient expends less than$750,000 in state financial assistance in its fiscal year(for fiscal year ending
June 30, 2017, and thereafter), an audit conducted in accordance with the provisions of Section 215.97,
Florida Statutes, is not required. In the event that the recipient expends less than $750,000 in state financial
assistance in its fiscal year,and elects to have an audit conducted in accordance with the provisions of Section
215.97, Florida Statutes,the cost of the audit must be paid from the non-state entity's resources(i.e.,the cost
of such an audit must be paid from the recipient's resources obtained from other than State entities).
4. For information regarding the Florida Catalog of State Financial Assistance(CSFA),a recipient should access
the Florida Single Audit Act website located at https:t/apps.fldfs.comlfsaa for assistance. In addition to the
above websites, the following websites may be accessed for information: Legislature's Website at
http:l/www.leg.state.fl.us/Welcome/index.cfm, State of Florida's website at http:///www.myflorida,com/,
Department of Financial Services' Website at http://www.fldfs.com/and the Auditor General's Website at
http://www.myflorida.com/audgen/.
PART IIi: OTHER AUDIT REQUIREMENTS
(NOTE: This part would be used to sped'any additional audit requirements imposed by the State awarding entity
that are solely a matter of that State awarding entity's policy(i.e., the audit is not required by Federal or State laws
and is not in conflict with other Federal or State audit requirements). Pursuant to Section 215.97(8), Florida Statutes,
State agencies may conduct or arrange for audits ofState financial assistance that are in addition to audits conducted
in accordance with Section 215.97, Florida Statutes. in such an event, the State awarding agency must arrange for
funding the full cost of such additional audits.)
PART IV: REPORT SUBMISSION
I. Copies of reporting packages for audits conducted in accordance with 2 CFR Part 200, Subpart F-Audit
Requirements,and required by PART I of this form shall be submitted,when required by 2 CFR 200.512,by
or on behalf of the recipient directly to the Federal Audit Clearinghouse(FAC)as provided in 2 CFR 200.36
and 200.512
A. The Federal Audit Clearinghouse designated in 2 CFR §200.501(a)(the number of copies required by
2 CFR§200.501(a)should be submitted to the Federal Audit Clearinghouse),at the following address:
Attachment 5
2 of 6
BGS-DEP 55-215 revised 11/19/24
cAo
16Ca
By Mail:
Federal Audit Clearinghouse
Bureau of the Census
1201 East 10th Street
Jeffersonville, IN 47132
Submissions of the Single Audit reporting package for fiscal periods ending on or after January 1,
2008,must be submitted using the Federal Clearinghouse's Internet Data Entry System which can
be found at http://harvester.census.gov/facweb/
2. Copies of financial reporting packages required by PART II of this Attachment shall be submitted by or on
behalf of the recipient directly to each of the following:
A. The Department of Environmental Protection at one of the following addresses:
By Mail:
Audit Director
Florida Department of Environmental Protection
Office of Inspector General, MS 40
3900 Commonwealth Boulevard
Tallahassee, Florida 32399-3000
Electronically:
FDEPSingleAudit@dep.state.fl.us
B. The Auditor General's Office at the following address:
Auditor General
Local Government Audits/342
Claude Pepper Building, Room 401
1 11 West Madison Street
Tallahassee, Florida 32399-1450
The Auditor General's website(http://flauditor.gov/)provides instructions for filing an
electronic copy of a financial reporting package.
3. Copies of reports or management letters required by PART Ili of this Attachment shall be submitted by or
on behalf of the recipient directly to the Department of Environmental Protection at one of the following
addresses:
By Mail:
Audit Director
Florida Department of Environmental Protection
Office of Inspector General, MS 40
3900 Commonwealth Boulevard
Tallahassee, Florida 32399-3000
Electronically:
FDEPSingleAuditdep.state.fl.us
4. Any reports, management letters, or other information required to be submitted to the Department of
Environmental Protection pursuant to this Agreement shall be submitted timely in accordance with 2 CFR
200.512, section 215.97, F.S., and Chapters 10.550 (local governmental entities) or 10.650 (nonprofit and
for-profit organizations), Rules of the Auditor General,as applicable.
Attachment 5
3 of 6
BGS-DEP 55-215 revised 11/19/24
GAO
16C2
5. Recipients,when submitting financial reporting packages to the Department of Environmental Protection for
audits done in accordance with 2 CFR 200, Subpart F-Audit Requirements, or Chapters 10.550 (local
governmental entities) and 10.650 (non and for-profit organizations), Rules of the Auditor General, should
indicate the date and time the reporting package was delivered to the recipient and any correspondence
accompanying the reporting package.
PART V: RECORD RETENTION
The recipient shall retain sufficient records demonstrating its compliance with the terms of the award and this
Agreement for a period of five (5)years from the date the audit report is issued, and shall allow the Department of
Environmental Protection, or its designee, Chief Financial Officer, or Auditor General access to such records upon
request. The recipient shall ensure that audit working papers are made available to the Department of Environmental
Protection, or its designee,Chief Financial Officer, or Auditor General upon request for a period of three(3)years
from the date the audit report is issued,unless extended in writing by the Department of Environmental Protection.
Attachment 5
4 of 6
BGS-DEP 55-215 revised I1/1912.1 CAO
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