Backup Documents 12/09/2025 Item #16D 6ORIGINAL DOCUMENT'S CHECKLIST & ROUTING SLIP imp
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 12.09.2025 Bt ricD 6
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 41 through 42 as appropriate for additional signatures, dates, and/or information needed. If the document is already complete with the
exrentinn of the r'hairman'c ah— tiro.., . lino *h...,.. h ,. I;___ u / a_.. -I —
Route to Addressees (List in routing order)
Office
Initials
Date
1. Adrienne Meijer
Community and Human
AM
11/05/2025
Services
2. County Attorney Office —Jeffrey A.
County Attorney Office
Klatzkow
Cl✓�
I Z / q � 75-
3. BCC Office
Board of County
Commissioners
12
4. Minutes and Records
Clerk of Court's Office
PRIMARY CONTACT INFORMATION " � t,
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 nmav need to rnntart ctaff for arlditinnal nr mic ;nn inf�r:....
Name of Primary Staff
Adrienne Meijer
Phone Number
239-252-5229
Contact / Department
Agenda Date Item was
Agenda Item Number
16.13. tf
Approved by the BCC
Type of Document
SHIP RENTAL REHABILITATION
Number of Original
Three (3) C, ir.S
Attached
AGREEMENT WITH COMMUNITY
Documents Attached
ASSISTED AND SUPPORTED LIVING, INC.
PO number or account
number if document is
to be recorded
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
L
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
NIA is not
the meeting have been incorporated in the attached document. The County
CL�
an option for
Attorne '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
an option for
Chairman's signature.
this line.
16D.6
Grant - SHIP FY 2025-2026
Agreement#: SHRR25-001
Activity: Rental Rehabilitation
SPONSOR: Community Assisted and
Supported Living, Inc. CASL
CSFA #: 40.901
Total Award Amount: $300,000.00
UEI #: HMBJWPX9JKA1
FEIN: 65-0869993
Period of Performance: November 1,
2025-May 31, 2028
FISCAL YEAR: December 31
MONITORING END: 2058
AGREEMENT BETWEEN COLLIER COUNTY
AND
COMMUNITY ASSISTED AND SUPPORTED LIVING, INC.
Rental Rehabilitation Program
THIS AGREEMENT is made and entered into this G'tk � day of nccei► Lcl , 2025, by
and between Collier County, a political subdivision of the State of Florida, (COUNTY) having its
principal address as 3339 Tamiami Trail East, Suite 213, Naples FL 34112, and Community Assisted
and Supported Living, Inc. (CASL) (SPONSOR) a not -for -profit existing under the laws of the State
of Florida, having its principal office 2911 Fruitville Road Sarasota, FL 32437.
WHEREAS, the William E. Sadowski Affordable Housing Act adopted by the State of Florida
in 1992 provided a dedicated revenue source for affordable housing in Florida and created the State
Housing Initiatives Partnership (SHIP) Program; and
WHEREAS, the State Housing Initiatives Program is established in accordance with Florida
Statues Chapter 420, Sections 420.907-.9079 F.S., and Chapter 67-37, Florida Administrative Code; and
WHEREAS, the COUNTY is a participant in the State Housing Initiatives Partnership Program;
and
WHEREAS, pursuant to the State Housing Initiatives Partnership Program, the COUNTY is
undertaking certain activities to primarily benefit persons or households earning not greater than 120
percent of annual median income (AMI) adjusted for family size; and
WHEREAS, the Fiscal Year 2025-2026 Local Housing Assistance Plan (LHAP), as amended,
was adopted by the Board of County Commissioners on April 8, 2025, Agenda item #16D10, Resolution
No. 2025-073; and
WHEREAS, the COUNTY and the SPONSOR desire to provide Rental Rehabilitation, in
accordance with this Agreement and the aforementioned Local Housing Assistance Plan; and
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WHEREAS, the COUNTY desires to engage SPONSOR to implement such undertakings, as
specified in Exhibit B, and determines that they are valid and worthwhile County purposes.
NOW, THEREFORE, in consideration of the mutual promises and covenants herein contained,
it is agreed by the Parties as follows:
PART I
SCOPE OF WORK
SPONSOR shall, in a satisfactory and proper manner and consistent with any standards required as a
condition of the providing SHIP funds, as determined by Collier County Community and Human
Services (CHS), perform the tasks necessary to conduct the program as follows:
Project Name: Rental Rehabilitation
Description of project and outcome: The Project is for the rehabilitation and or repair of five (5)
existing rental duplex properties owned by CASL.
Project Component One: The planned renovations may include but are not limited to
repair/replacement of roofs, permits, related construction materials, soffit, labor, fascia, gutters,
insurance and/or bonds, HVAC systems, and other related costs/fees.
A. Project Tasks:
1. Initiate Solicitation
2. Select Contractor Bid (a minimum of three bids are required)
3. Issue Contractor's Notice to Proceed
4. Obtain Liability, Workers Comp., and Property Insurance
5. Execute Contractor Agreement
6. Apply for Permits
7. Schedule Inspection for Certificate of Completion
B. SHIP Documentation Requirements Compliance Criteria:
Activities carried out with funds under this Agreement will be performed in compliance with
State Housing Incentives Partnership (SHIP) Program, Florida Statutes Chapter 420, Section
420.9071 F.S., and Chapter 67-37 of the Florida Administrative Code, and any amendments
thereto (also referred to as the SHIP Program).
1.1 DEFINITIONS AND PURPOSE
A. DEFINITIONS
Terms shall be as defined in the State Housing Incentives Partnership (SHIP) Program,
Florida Statute Chapter 420, Section 420.9071 F.S., and Chapter 67-37 of the Florida
Administrative Code, and any amendments thereto (also referred to as the SHIP Program).
B. PURPOSE
The purpose of this Agreement is to state the covenants and conditions under which
SPONSOR will implement the Scope of Service summarized in Section 1.2 and Exhibit B of
this Agreement.
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1.2 SCOPE OF SERVICE 1 6 D 6 4 W
1.3
1.4
SPONSOR shall, in a satisfactory and proper manner as determined by the COUNTY, perform
the necessary tasks to administer and implement the described services herein incorporated by
reference as Exhibit B (Rental Rehabilitation Project Requirements), in accordance with the
terms and conditions of Requests for Applications, Rental Rehabilitation, State Housing
Initiatives Partnership Funding Cycle Fiscal Years 2025-2026, and SPONSOR's Application
dated January 7, 2025.
GRANT AND SPECIAL CONDITIONS
A. Within sixty (60) calendar days of the execution of this Agreement, SPONSOR must deliver
to CHS for approval a detailed project schedule for the completion of the project.
B. SPONSOR must submit the following policies and procedures within sixty (60) days of this
Agreement:
® Fair Housing Policy
® Affirmative Action/Equal Opportunity Policy
® Conflict of Interest Policy (COI) and related COI Forms
® Procurement Policy
® Sexual Harassment Policy
® Section 504/ADA Policy
® Fraud, Waste, and Abuse Policy
® Language Assistance and Planning Policy (LAP)
® Violence Against Women Act (VAWA) Policy
® Tenant Waitlist Policy
® Tenant Grievance Policy
® Tenant Guidelines (Income)
® Marketing Plan
® Property Maintenance Plan
® Capital Needs Assessment Plan
C. Annual SPONSOR Training
All SPONSOR staff assigned to the administration and implementation of the Project
established by this Agreement shall attend the CHS-sponsored Annual Fair Housing training.
In addition, at least one staff member shall attend all other CHS-offered trainings relevant to
the Project, as determined by the Grant Coordinator, not to exceed three (3) sessions.
PROJECT DETAILS
A. Project Description/Budget
Description
State Amount
Project Component 1: The planned renovations may include but
are not limited to repair/replacement of roofs, permits, related
$300,000.00
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construction materials, soffit, labor, fascia, gutters, insurance
and/or bonds, HVAC systems, and other related costs/fees.
Total State Funds
$300,000.00
SPONSOR will accomplish the following checked project tasks:
❑ Pay all closing costs related to property conveyance
® Maintain beneficiary income certification documentation, using Exhibit D, as
amended or CHS Director -approved presumed benefit documentation, and
provide to the COUNTY as requested
® Maintain Eligibility Documentation, retained at SPONSOR location, and
provided to the COUNTY as requested
® Provide Quarterly Reports on project progress
® Ensure attendance by a representative from executive management at quarterly
partnership meetings, as requested by CHS
❑ Provide monthly construction and rehabilitation progress reports until completion
of construction or rehabilitation
❑ Identify Lead Project Manager
® Provide Project Plans and Specifications
® Ensure applicable number of units are Section 504/ADA accessible
B. Program Components/Eligible Activities
All services/activities funded must meet the program components, as detailed in Exhibit B.
C. Performance Deliverables
Program Deliverable
Supporting Documentation
Submission Schedule
Special Grant Policies
Policies as stated in this
Within 60 days of Agreement
Section 1.3 B
Agreement
execution
Insurance
Proof of coverage in
At time of Agreement
(Flood, Property, O&D)
accordance with Exhibit A
execution and annually
within 30 days after renewal
Detailed Project Schedule
Project Schedule
Within 60 days of Agreement
execution
Draft Procurement
Independent Costs Estimate,
Within 90 days of Agreement
Documents (Bid Packet)*
Contractor Bid Form, Bid
execution
Recommendation, All
Contractor Bids, Contractor
Agreement, Contractor
License, Bid Approval, Notice
to Proceed, Change Order,
Change Order Approval,
Project Plans and
Plans and Specifications
With the solicitation
Specifications
documents
Quarterly Progress Report
Progress report, detailing
30 days after the end of the
accomplishments Exhibit D
calendar quarter until
May 31, 2028
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Program Deliverable
Supporting Documentation
Submission Schedule
Fair Housing Call Report
Fair Housing Call Log
Quarterly within 30 days
following the end of the
quarter and annually after
closeout throughout the thirty
(30) year affordability
period.
Annual Audit Monitoring
Exhibit E
Annually, within 60 days
Report
after FY end
SPONSOR Financial and
Audit report, Management
Within 9 months for Single
Compliance Audit
Letter, and Supporting
Audit (otherwise 180 days)
Documentation
after the end of the
SPONSOR fiscal year
throughout the affordability
period
Continued Use Certification
Continued Use Certification
Annually
Tenant Lease Agreement
Lease Agreements
Prior to signature of first
tenant and any addendums or
changes thereafter
throughout the affordability
period.
Operating Expense Report
Actual vs. Budget, revenue and
30 days after the end of the
expense report and all
SPONSOR'S fiscal year
supporting documentation, as
requested
Operating Expense Budget
Detailed Operating budget for
Initial report due after lease -
Report
the next fiscal year
up and annually thereafter,
prior to start of SPONSOR
fiscal year, throughout the
affordability period
Capital Needs Assessment
Plan approved by the
Initial Plan due after lease -up
Plan
COUNTY
and annually thereafter, prior
to start of SPONSOR fiscal
year, throughout the
affordability period
Maintenance Plan
Plan approved by the
At the time of completion of
COUNTY
unit(s), with annual
submission if plan is revised
Register of Tenant Income
Summary of Tenant Income
At time of full lease -up and
and Rent
and Income Limit, Rent and
annually thereafter
Rent Limit, by unit (Rent Roll)
throughout the affordability
period
Maintenance Agreement
Executed 3`d Party Agreement
Initial lease -up and annually
thereafter throughout the
affordability period, if
applicable.
Conflict of Interest Form
Subrecipient/Developer/Vendor
Upon execution of the
Conflict of Interest Disclosure
Agreement for all employees
Form
who work on activities
associated with the grant and
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Program Deliverable
Supporting Documentation
Submission Schedule
upon hiring of all new
employees.
Whistleblower Protections
Exhibit H
Upon execution of the
Certification
Agreement for all employees
who work on activities
associated with the grant and
upon hiring of all new
employees.
Affidavit Regarding Labor
Affidavit
Upon execution of the
and Services(Trafficking)
Agreement
* SPONSOR's Notice to Proceed may be withheld if procurement deliverables are not
submitted in a timely manner, as stated in Section 1.2.C, Performance Deliverables.
SPONSOR must submit to the COUNTY for approval, all Change Orders required during the
project. Failure to submit Change Orders in a timely manner, may result in delay or
withholding of payment, as well as a cease work order until all change orders have been
reviewed and approved, at which time a new Notice to Proceed will be issued. The COUNTY
recognizes that Change Orders require urgent attention. The COUNTY agrees to acknowledge
receipt of Change Orders within two (2) business days of submission. Barring any issues,
approval will be provided within five (5) business days of submission, with the exception of
those that constitute an emergency.
D. Payment Deliverables
Payment Deliverable
Payment Supporting
Documentation
Submission Schedule
Project Component 1: The
1. Exhibit C along with invoice
Monthly, by the 3Wh
planned renovations may
and proof of payment as
day of the month
include but are not limited to
evidenced by cancelled checks or
following the month of
repair/replacement of roofs,
bank statements, and any other
service.
permits, related construction
documents as requested.
materials, soffit, labor, fascia,
2. Contractor Bid
gutters, insurance and/or
Recommendation wBid Tab (first
bonds, HVAC systems, and
submission only)
other related costs/fees.
3.Approved Contractor
Recommendation/ Notice to
Proceed (first submission only)
4.Waiver of Lien Release Partial
and Final, as applicable
5. Contractor Agreement (first
submission only)
6. Permits
7. Certificate of Completion (final
only)
8. Contactor's Invoice
9. Promissory Note (final)
10. Mortgage (final)
11. Land Use Restriction
A reement final
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1.5 PERIOD OF PERFORMANCE
SPONSOR'S services shall begin on November 1, 2025, and end on May 31, 2028. This
Agreement must remain in effect throughout the development process of the Project and is
terminated upon completion of construction of SHIP -assisted units. In any event, SPONSOR
shall complete all services required hereunder prior to June 30, 2028. Any Funds not obligated
by the expiration date of this Agreement shall automatically revert to the COUNTY. SPONSOR
is responsible for ongoing reporting, subject to onsite monitoring, tenant income qualification
activities, and continued use for the affordability period of 30 years.
The County Manager or designee may extend the term of this Agreement for a period of up to
180 days after the end of the Agreement, following receipt of SPONSOR's written request
submitted no less than 20 days prior to period of performance end date. Extensions must be
authorized, in writing, by formal letter to SPONSOR.
An Agreement of Restrictive Covenants detailing affordability requirements in a form reasonably
acceptable to the COUNTY (Restrictive Covenants) will be placed on all properties that receive
SHIP funding from the COUNTY, which Restrictive Covenants will be used to enforce the
affordability requirements of the Project.
1.6 AGREEMENT AMOUNT
The COUNTY agrees to make available THREE HUNDRED THOUSAND DOLLARS and
NO CENTS ($300,000.00) for use by SPONSOR, during the term of the Agreement (hereinafter
referred to as the Funds).
Priority of Funds. The SPONSOR agrees to utilize funds available under this Agreement to
supplement rather than supplant funds otherwise available. To the extent available, the
SPONSOR must disburse funds available from program income, rebates, refunds, contract
settlements, audit recoveries, and interest earned on such funds before requesting additional cash
payments. Such payments or reimbursements shall constitute full and complete payment by the
COUNTY under this Agreement. In no event shall the COUNTY's obligation to make payment
to SPONSOR hereunder exceed THREE HUNDRED THOUSAND DOLLARS NO /100
($300,000.00).
Modification to the Budget and Scope may only be made if approved in advance. Cumulative
Fund shifts among line items may be approved administratively by the CHS Director or designee
for a total of up to 10 percent (10%) of the total funding agreement and shall not signify a change
in scope. Fund shifts that exceed 10 percent (10%) shall require formal amendment and approval
by the Board of County Commissioners (Board).
All services/activities specified in Part 1 Scope of Services shall be performed by SPONSOR or
its subcontractors who meet State requirements.
The COUNTY shall reimburse SPONSOR for the 'performance of this Agreement upon
completion or partial completion of the work tasks as accepted and approved by CHS. SPONSOR
may not request disbursement of SHIP Funds until Funds are needed for eligible costs, and all
disbursement requests must be limited to the amount needed at the time of the request. SPONSOR
F
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may expend Funds only for allowable costs resulting from obligations incurred during the term
of this Agreement. Allowable costs shall mean those necessary and proper costs identified in the
SPONSOR application and approved by the COUNTY unless any or all such costs are disallowed
by the State of Florida FHFC. Invoices for work performed are required every month. If no work
has been performed during the month, or if SPONSOR is not yet prepared to send the required
backup, a $0 invoice is required. Explanations will be required if two consecutive months of $0
invoices are submitted. Payments shall be made to SPONSOR when requested as work
progresses, but not more frequently than once per month. Reimbursement will not occur if
SPONSOR fails to perform the minimum level of service required by this Agreement.
No payment will be made until approved by CHS for grant compliance and adherence to any and
all applicable Local, State, or Federal requirements, including timely submission of Performance
Deliverables contained in Section 1 A.C. Late submission of deliverables may cause payment
suspension of any open pay requests until the required deliverables are received by CHS. Except
where disputed for noncompliance, payment will be made upon receipt of a properly completed
invoice, and in compliance with sections 218.70-.80, Florida Statutes, otherwise known as the
"Local Government Prompt Payment Act."
Final invoices are due no later than 90 days after the end of the Agreement. Work performed
during the term of the program but not invoiced within 90 days after the end of the Agreement
may not be processed without written authorization from the Grant Coordinator.
Withholding or Cancellation of Funds. The COUNTY reserves the right to withhold payments
pending timely delivery of program reports or documents as may be required under this
Agreement. SPONSOR agrees that funds determined by the COUNTY to be surplus upon
completion of the Project will be subject to cancellation by the COUNTY. The COUNTY shall
be relieved of any obligation for payments if funds allocated to the COUNTY cease to be
available for any cause other than misfeasance of the COUNTY itself. Payment may be
suspended by the COUNTY in the event of a default by SPONSOR.
1.7 RIGHT OF FIRST REFUSAL
If SPONSOR offers the Property for sale before thirty (30) years after the SPONSOR's receipt
of the Certificate of Occupancy, or at any other time when there are existing mortgages on the
Property funded by the SHIP Program, the SPONSOR must give a right of first refusal (ROFR)
for a 90-day period, to experienced non-profit organizations, reasonably approved by the
COUNTY, for purchase of the Property, at the then current market value, for continued
occupancy by eligible persons. The 90-day right of first refusal period begins when a legal
advertisement appears in a local newspaper of general circulation, or other method authorized by
statute or regulation, offering the Property for sale to non-profit organizations. COUNTY
approval of any non-profit organization submitting an offer of the full requested sale price, or
any other offer considered in the sole determination of the COUNTY to be reasonable, will be
based on the criteria listed in the affordable multi -family rental housing development strategy
sponsor selection criteria, in the COUNTY's FY 2019 — 2022 SHIP Local Housing Assistance
Plan. Either (a) the 90-day right of first refusal period expires and the SPONSOR is not a party
to an active contract for purchase and sale of the Property with an eligible non-profit organization,
reasonably approved by the COUNTY; or (b) a contract for purchase and sale of the property is
entered into by the SPONSOR and an eligible non-profit organization, reasonably approved by
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the COUNTY, within such 90-day ROFR period but terminated but terminated by either party
pursuant to the terms thereof subsequent to the 90-day period.
1.8 NOTICES
Notices required by this Agreement shall be in writing and delivered via mail (postage prepaid),
commercial courier, or 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: Adrienne Meijer, Grants Coordinator
Collier County Government
Community and Human Services
3339 Tamiami Trail East, Suite 213
Naples, FL 34112
Email to: Adrienne.Meijer@collier.gov
Telephone: 239-252-5229
SPONSOR ATTENTION: J. Scott Eller, Chief Executive Officer
Community Assisted and Supported Living, Inc.
2911 Fruitville Road
Sarasota, FL 34237
Email to: scott.eller@caslinc.org
Telephone: 941-225-2373
Remainder of Page Intentionally Left Blank
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PART II
GRANT CONTROL REQUIREMENTS
2.1 AUDITS
During the term of this Agreement, SPONSOR shall submit to the COUNTY an Annual Audit
Monitoring report (Exhibit E) no later than 60 days after SPONSOR's fiscal year end. In addition,
SPONSOR shall submit to the COUNTY a Single Audit report, Management Letter, and
supporting documentation nine (9) months (or one hundred eighty (180) days for Sponsors
exempt from Single Audit) after the SPONSOR's fiscal year end. The COUNTY will conduct an
annual financial and programmatic review.
SPONSOR must fully clear any deficiencies noted in audit reports within 30 days after its receipt
of the report. SPONSOR's failure to comply with the above audit requirements will constitute a
violation of this Agreement and may result in the withholding of future payments. SPONSOR
hereby agrees to obtain an annual agency audit conducted in accordance with current COUNTY
policy concerning Sponsor audits and if applicable, Florida Statutes section 215.97 (Florida
Single Audit Act).
Pursuant to Florida Statutes section 215.97(6) (Florida Single Audit Act), if SPONSOR expends
a total amount of State awards equal to or in excess of $750,000 in any fiscal year, it must conduct
a State single or project -specific audit for that fiscal year, in accordance with section 215.97,
Florida Statutes, applicable rules of the Executive Office of the Governor and Comptroller, and
Chapter 10.650 of Rules of the Auditor General.
SPONSOR shall ensure that the audit complies with the requirements of section 215.97(7),
Florida Statutes. This includes submission of a reporting package, as defined by section
215.97(2)(d), Florida Statutes, and Chapter 10.650, Rules of the Auditor General. SPONSOR
must deliver the financial reporting package to the COUNTY within 60days after receipt, but not
later than 180 days after the SPONSOR's fiscal year end. SPONSOR shall submit the financial
reporting package and Exhibit E to the Grant Coordinator.
If SPONSOR expends less than $750,000 in State awards in its fiscal year, it is not required to
conduct an audit in accordance with the provisions of section 215.97, Florida Statutes. In
addition, if SPONSOR expends less than $750,000 in State awards in its fiscal year and still
elects to have an audit in accordance with provisions of section 215.97, Florida Statutes, the cost
of the audit must be paid from non -State Funds.
2.2 RECORDS AND DOCUMENTATION
SPONSOR shall maintain sufficient records in accordance with the Florida Housing Finance
Corporation (FHFC) program regulations, as provided in Exhibit B, to determine compliance
with the requirements of this Agreement, the SHIP Program, and all other applicable laws and
regulations. This documentation shall include, but is not limited to the following:
A. All records required by SHIP regulations.
to
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B. The SPONSOR shall maintain real property inventory records which clearly identify SHIP
properties purchased, constructed, improved, or sold. Properties retained shall continue to
meet eligibility criteria.
C. SPONSOR shall create and maintain public records that ordinarily and necessarily would be
required by COUNTY to perform the service.
D. SPONSOR shall make available to COUNTY or CHS, at any time upon request, all reports,
plans, surveys, information, documents, maps, books, records, and other data procedures
developed, prepared, assembled, or completed by the SPONSOR for this Agreement.
Materials identified in the previous sentence shall be in accordance with generally accepted
accounting principles (GAAP), procedures, and practices, which sufficiently and properly
reflect all revenues and expenditures of Funds provided directly or indirectly by this
Agreement, including Program Income. Program Income will be collected during payoffs
and recognized in the annual budget. These records shall be maintained to the extent of such
detail to properly reflect all net costs, direct and indirect labor, materials, equipment, supplies
and services, and other costs and expenses of whatever nature for which reimbursement is
claimed under the provisions of this Agreement.
E. 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,
SPONSOR shall maintain all documents and records in an orderly fashion in a readily
accessible, permanent, and secured location for three (3) years after the annual report is
submitted, as prescribed in Florida Statutes section 119.021 However, if any litigation, claim,
or audit is started before the expiration date of the three (3) year period, the records will be
maintained until all litigation, claim, or audit findings involving these records are resolved.
If SPONSOR ceases to exist after the closeout of this Agreement, it will notify the COUNTY
in writing, of the address where the records are to be kept, as outlined in Florida Statutes
section 119.021 SPONSOR shall meet all requirements for retaining public records and
transfer, at no cost to COUNTY, all public records in possession of the SPONSOR 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 COUNTY in a format that is compatible with the
COUNTY's information technology systems.
IF SPONSOR HAS QUESTIONS REGARDING THE
APPLICATION OF CHAPTER 1199 FLORIDA STATUTES TO
THE SPONSOW S DUTY TO PROVIDE PUBLIC RECORDS
RELATING TO THIS AGREEMENT, IT SHALL CONTACT
THE CUSTODIAN OF PUBLIC RECORDS AT 239-252-58379
An,gel.Batesgcollier.g,ov, 3299 Tamiami Trail East, Naples, FL
34112.
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F. SPONSOR is responsible for the creation and maintenance of income eligible files on clients
served, and documentation that all households are eligible under FHFC Income Guidelines.
Income certification documentation will be reviewed at interim and closeout monitorings.
SPONSOR agrees that CHS shall be the final arbiter on SPONSOR's compliance.
G. SPONSOR shall document how it complied with the Program components, applicable
regulations included in Exhibit B, and the eligibility requirement(s) under which Funding
was received. This includes special requirements such as necessary and appropriate
determinations, as defined in Exhibit B, including income certification and written
agreements with beneficiaries, where applicable.
H. DEVELOPER is encouraged to engage in efforts to assure compliance with the Fair Housing
Act (423501 et. seq) through Fair Housing activities offered to real estate brokers, the general
public, and other interested parties, and to track and report Fair Housing calls received.
DEVELOPER shall establish a system to log all Fair Housing calls. The system must track
the nature of the calls; actions taken in response to the calls; results of actions taken; and, if
the caller was referred to another agency, the results obtained by the referral agency.
DEVELOPER must submit this call log to the COUNTY quarterly.
I. SPONSOR shall take reasonable cybersecurity and other measures to safeguard information
including protected personally identifiable information (PII) 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 regarding privacy and responsibility
over confidentiality.
J. SPONSOR shall allow public access to all documents, papers, letters, or other public records
as defined in § 119.011(12), F.S., made or received by SPONSOR in conjunction with this
Agreement except that public records that are made confidential by law must be protected
from disclosure. Should the SPONSOR fail to comply with this provision the COUNTY may
unilaterally terminate this Agreement.
As required by § 119-0701, F.S., to the extent the SPONSOR is acting on behalf of the
COUNTY, the SPONSOR shall:
• Maintain public records that ordinarily and necessarily would be required by the
COUNTY to perform the service.
• Upon request from the COUNTY'S custodian of public records, provide to the
COUNTY a copy of requested records or allow the records inspected or copied within
a reasonable time at a cost that does not exceed the cost provided in Chapter 119, F.S.,
or as otherwise provided by law.
• Ensure public records exempt or confidential and exempt from public records
disclosure requirements are not disclosed except as authorized by law during this
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Agreement term and following completion of this Agreement if the SPONSOR does
not transfer the records to the COUNTY.
2.3 MONITORING
SPONSOR agrees that CHS may carry out at least one (1) annual on -site monitoring visit and
evaluation activities, as determined necessary. At the COUNTY's discretion, a desktop review
of the activities may be conducted in lieu of an on -site visit. The continuation of this Agreement
is dependent upon satisfactory evaluations. SPONSOR shall, upon the request of CHS, submit
information and status reports required by CHS or FHFC, to enable CHS to evaluate said progress
and allow for completion of required reports. SPONSOR shall allow CHS or FHFC to monitor
on site. Such site visits may be scheduled or unscheduled, as determined by CHS or FHFC.
At any time during normal business hours and as often as the COUNTY (and/or its
representatives) may deem necessary, SPONSOR shall make available for review, inspection, or
audit all records, documentation, and any other data relating to all matters covered by the
Agreement.
The COUNTY will monitor SPONSOR's performance to mitigate fraud, waste, abuse, or
nonperformance based on goals and performance standards, as stated with all other applicable
laws, regulations, and policies governing the Funds provided under this Agreement, further
defined by Florida Statute 215.85. Substandard performance, as determined by the COUNTY,
will constitute noncompliance with this Agreement. If SPONSOR does not take corrective action
within a reasonable time period after being notified by the COUNTY, Agreement suspension or
termination procedures will be initiated. SPONSOR agrees to provide FHFC, the Florida Office
of Inspector General, the COUNTY, or the COUNTY's internal auditor(s) access to all records
related to performance of activities in this Agreement.
2.4 PREVENTION OF FRAUD, WASTE, AND ABUSE
SPONSOR shall establish, maintain, and utilize internal control systems and procedures
sufficient to prevent, detect, and correct incidents of fraud, waste, and abuse in the performance
of this Agreement, and provide proper and effective management of all Program and Fiscal
activities of the Agreement. SPONSOR's internal control systems and all transactions and other
significant events shall be clearly documented and readily available for monitoring by the
COUNTY.
SPONSOR shall provide the COUNTY with complete access to all its records, employees, and
agents for the purpose of monitoring or investigating performance of the Agreement. SPONSOR
shall fully cooperate with COUNTY's efforts to detect, investigate, and prevent fraud, waste, and
abuse.
SPONSOR may not discriminate against any employee or other person who reports a violation
of the terms of this Agreement or any law or regulation to the COUNTY, or any appropriate law
enforcement authority, if the report is made in good faith.
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2.5 CORRECTIVE ACTION
Corrective action plans may be required for noncompliance, nonperformance, or unacceptable
performance under this Agreement. Penalties may be imposed for failure to implement or make
acceptable progress on such corrective action plans.
To effectively enforce COUNTY Resolution No. 2013-228, CHS has adopted an escalation
policy to ensure continued compliance by Sponsors, Developers, or any entity receiving grant
funds from CHS. The escalation policy for noncompliance is as follows:
A. Initial noncompliance may result in the COUNTY issuing Findings or Concerns to
SPONSOR, which requires SPONSOR to submit a corrective action plan to CHS within 10
business days following issuance of the report.
• Any pay requests that have been submitted to CHS for payment will be held until the
corrective action plan has been submitted.
• CHS will be available to provide Technical Assistance (TA) to SPONSOR, as needed,
in order to correct the noncompliance issue.
B. If SPONSOR fails to submit the corrective action plan in a timely manner, CHS may require
a portion of the awarded grant amount to be returned to the COUNTY.
• CHS may require SPONSOR to return to the COUNTY upwards of 5 percent (5%)
of the award amount, at the discretion of the Board.
• SPONSOR may be denied future consideration as set forth in Resolution No.
2013-228.
C. If SPONSOR remains noncompliant or repeats an issue that was previously corrected and
has been informed by CHS of its substantial noncompliance, by certified mail, CHS may
require SPONSOR to return to the COUNTY a portion of the awarded grant amount, or the
amount of the investment for acquisition of the properties conveyed.
• CHS may require SPONSOR to return to the COUNTY upwards of 10 percent (10%)
of the award amount, at the discretion of the Board.
• SPONSOR will be in violation of Resolution No. 2013-228.
D. If after repeated notification SPONSOR continues to be substantially noncompliant, CHS
may recommend the Agreement or award be terminated.
• CHS will make a recommendation to the Board to immediately terminate the
Agreement. SPONSOR will be required to repay all Funds disbursed by the
COUNTY for the terminated project. This includes the amount invested by the
COUNTY for the initial acquisition of properties or other activities.
• SPONSOR will be in violation of Resolution No. 2013-228.
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If SPONSOR has multiple agreements with CHS and is found to be noncompliant, the above
sanctions may be imposed across all awards at the Board's discretion.
2.6 REPORTS
Reimbursement may be contingent upon the timely receipt of complete and accurate reports and
the resolution of monitoring findings identified pursuant to this Agreement, as deemed necessary
by the County Manager or designee. Reports showing lack of proiect activity may result in
the withholding of payment or issuance of a Notice of Non -Compliance.
During the term of this Agreement, SPONSOR shall submit quarterly progress reports to the
COUNTY on the 30th day of January, April, July, and October, respectively, for the prior quarter
period end. As part of the report submitted in October or when final services are delivered,
whichever is earlier, SPONSOR also agrees to include a comprehensive final report covering the
agreed -upon Program objectives, activities, and expenditures, including but not limited to,
performance data on client feedback with respect to the goals and objectives set forth in Exhibit
D, which is the reporting form to be used in fulfilling this requirement. Other reporting
requirements may be required by the County Manager or designee if there are Program changes,
if the need for additional information or documentation arises, and/or if legislative amendments
are enacted. Reports and/or requested documentation not received by the due date shall be
considered delinquent and may be cause for default and termination of this Agreement.
Remainder of Page Intentionally Left Blank
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PART III
TERMS AND CONDITIONS
3.1 SUBCONTRACTS
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No part of this Agreement may be assigned or subcontracted without the written consent of the
COUNTY, which consent, if given at all, shall be at the COUNTY's sole discretion and
judgment. SPONSOR shall cause all provisions of this Agreement in its entirety to be included
in and made a part of any subcontract executed in the performance of this Agreement.
3.2 GENERAL COMPLIANCE
SPONSOR agrees to comply with the requirements as outlined in Florida Statutes Chapter 420,
Sections 420.907-420.9079 F.S., and Chapter 67-37 of the Florida Administrative Code.
SPONSOR also agrees to comply with all other applicable State and Local laws, regulations, and
policies governing the Funds provided under this Agreement.
SPONSOR is prohibited from using Funds provided herein, or personnel employed in the
administration of the program, for political activities, inherently religious activities, lobbying,
political patronage, and/or nepotism activities.
3.3 INDEPENDENT CONTRACTOR
Nothing contained in this Agreement is intended to, or shall be construed in any manner, as
creating or establishing the relationship of employer/employee between the parties. SPONSOR
shall always remain an "independent contractor" with respect to the services to be performed
under this Agreement. The COUNTY shall be exempt from payment of all Unemployment
Compensation, FICA, retirement benefits, life and/or medical insurance, and Workers'
Compensation Insurance as SPONSOR is an independent contractor.
3.4 AMENDMENTS
The COUNTY or SPONSOR may amend this Agreement at any time provided that such
amendments make specific reference to this Agreement, and are executed in writing, signed by
a duly authorized representative of each organization, and approved by the COUNTY's Board.
Such amendments shall not invalidate this Agreement, nor relieve or release the COUNTY or
SPONSOR from its obligations under this Agreement.
The COUNTY may, at its discretion, amend this Agreement to conform with Federal, State, or
Local guidelines, policies, available funding amounts, or other reasons. If such amendments
result in a change in the funding, the scope of services, or schedule of activities to be undertaken
as part of this Agreement, such modifications will be incorporated only by written amendment
signed by both COUNTY and SPONSOR.
3.5 AVAILABILITY OF FUNDS
The parties acknowledge that the Funds originate from FHFC provided SHIP grant funds and
must be implemented in full compliance with all SHIP rules and regulations and any agreement
between COUNTY and FHFC governing FHFC Funds pertaining to this Agreement. In the event
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of curtailment or non -production of said state Funds, the financial resources necessary to continue
to pay SPONSOR all or any portion of the Funds will not be available. In that event, the
COUNTY may terminate this Agreement, which shall be effective as of the date it is determined
by the County Manager or designee, in his or her sole discretion and judgment, that the Funds
are no longer available. In the event of such termination, SPONSOR agrees that it will not look
to, nor seek to hold the COUNTY, nor any individual member of the County Commissioners
and/or County Administration, personally liable for the performance of this Agreement, and the
COUNTY shall be released from any further liability to SPONSOR under the terms of this
Agreement.
3.6 DEFAULTS, REMEDIES, AND TERMINATION
This Agreement may be terminated for convenience by either the COUNTY or SPONSOR, in
whole or in part, by setting forth the reasons for such termination, the effective date, and in the
case of partial terminations, the portion to be terminated. However, in the case of a partial
termination, if the COUNTY determines that the remaining portion of the award will not
accomplish the purpose for which the award was made, the COUNTY may terminate the award
in its entirety. This Agreement may also be terminated by the COUNTY, if the award no longer
effectuates the program goals or grantor agency priorities.
The following actions or inactions by SPONSOR shall constitute a Default under this Agreement:
A. Failure to comply with any of the rules, regulations, or provisions referred to herein, or
such statutes, regulations, executive orders, and FHFC guidelines, policies, or directives
as may become applicable at any time
B. Failure, for any reason, to fulfill its obligations under this Agreement in a timely and
proper manner
C. Ineffective or improper use of Funds provided under this Agreement
D. Submission of reports to the COUNTY that are incorrect or incomplete in any material
respect
E. Submission of any false certification
F. Failure to materially comply with any terms of this Agreement
G. Failure to materially comply with the terms of any other agreement between the
COUNTY and SPONSOR relating to the Project
In the event of any default by SPONSOR under this Agreement, the COUNTY may seek any
combination of one or more of the following remedies:
A. Require specific performance of the Agreement, in whole or in part
B. Require the use of, or change in, professional property management, if applicable
C. Require SPONSOR to immediately repay to the COUNTY all SHIP Funds it received
under this Agreement
D. Apply sanctions, if determined by the COUNTY to be applicable
E. Stop all payments until identified deficiencies are corrected
F. Terminate this Agreement by giving written notice to SPONSOR specifying the effective
date of such termination. If the Agreement is terminated by the COUNTY as provided
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herein, SPONSOR shall have no claim of payment or benefit for any incomplete project
activities undertaken under this Agreement.
3.7 INDEMNIFICATION
To the maximum extent permitted by Florida law, SPONSOR shall indemnify and hold harmless
Collier County, its officers, agents, and employees from any and all claims, liabilities, damages,
losses, costs, and causes of action which may arise out of an act or omission, including but not
limited to, reasonable attorneys' and paralegals' fees, to the extent caused by the negligence,
recklessness, or intentionally wrongful conduct of the SPONSOR or any of its agents, officers,
servants, employees, contractors, patrons, guests, clients, licensees, invitees, or any persons
acting under the direction, control, or supervision of the SPONSOR in the performance of this
Agreement. This indemnification obligation shall not be construed to negate, abridge, or reduce
any other rights or remedies which otherwise may be available to an indemnified party or person
described in this paragraph. SPONSOR shall pay all claims and losses of any nature whatsoever
in connection therewith and shall defend all suits in the name of the COUNTY and pay all costs
(including attorney's fees) and judgments which may issue thereon. This indemnification shall
survive the termination and/or expiration of this Agreement. This section does not pertain to any
incident arising from the sole negligence of Collier County. The foregoing indemnification shall
not constitute a waiver of sovereign immunity beyond the limits set forth in Section 768.28,
Florida Statutes. This section shall survive the expiration or termination of this Agreement.
3.8 COUNTY RECOGNITION/SPONSORSHIPS
SPONSOR agrees that all notices, informational pamphlets, press releases, advertisements,
descriptions of the Program sponsorships, research reports, and similar public notices, whether
printed or digital, prepared and released by SPONSOR for, on behalf of, and/or about the
Program shall include the statement:
"FINANCED BY FLORIDA HOUSING FINANCING COPORATION
(FHFC) AND COLLIER COUNTY COMMUNITY AND HUMAN
SERVICES DIVISION."
The statement shall appear in the same size letters or type as the name of the SPONSOR. This
design concept is intended to disseminate key information to the general public regarding the
development team as well as Equal Housing Opportunity. Construction signs shall comply with
applicable COUNTY codes.
3.9 INSURANCE
SPONSOR shall not commence any work or services pursuant to this Agreement until all
required insurance, as outlined in Exhibit A, has been obtained. Said insurance shall be carried
continuously during SPONSOR's performance under the Agreement. SPONSOR shall furnish a
Certificate of Insurance naming Collier County as an additional insured with general liability
limits of at least $1,000,000 per occurrence in accordance with Exhibit A.
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3.10 PURCHASING
All purchasing for consumables, capital equipment, and services shall be made by purchase order
or written contract in conformity and in full compliance with the procedures prescribed by
applicable Florida Statutes (for example, section 287.017) and the Collier County Purchasing
Policy, whichever is more stringent. Collier County Ordinance #2025-34 allows for contracting
with not -for -profits through the approved exemption.
Purchasing Threshold Policy
Range:
Competition Required
$0 - $10,000
Single Quote
$10,001 - $50,000
3 Quotes in Writing or through the COUNTY' S
bidding platform
$50,001 - $250,000
3 Quotes through COUNTY'S bidding platform
$250,001+
Formal Solicitation ITB, RFP, etc.
All improvements specified in Part I Scope of Work, shall be performed by SPONSOR
employees, or put out to competitive bidding, under a procedure acceptable to the COUNTY and
State requirements. SPONSOR shall enter into contracts with the lowest, responsible, and
qualified bidder. Contract administration shall be managed by SPONSOR and monitored by
CHS, which shall have access to all records and documents related to the Project.
It is expressly understood and agreed that any articles that are the subject of or required to carry
out this Agreement shall be purchased from the corporation identified under Chapter 946, F.S.,
in the same manner and under the same procedures set forth in §946.515(2) and (4), F.S.; and for
the purposes of this Agreement the SPONSOR shall be deemed to be substituted for the
COUNTY insofar as dealings with such corporation are concerned.
Recycled Products. The SPONSOR shall procure any recycled products or materials, which are
subject of or are required to carry out this Agreement, in accordance with §403.7065, F.S.
As provided in section 287.133, Florida Statutes, by entering into this Agreement or performing
any work in furtherance hereof, SPONSOR certifies that it, its affiliates, suppliers,
subcontractors, and consultants who will perform hereunder, have not been placed on the
convicted vendor list, maintained by the State of Florida Department of Management Services,
within the 36 months immediately preceding the date hereof. This notice is required by section
287.133(3)(a), Florida Statutes.
3.11 DEBARMENT
SPONSOR certifies that none of its officers or agents have been debarred from bidding,
proposing, or contracting for Federal, State, or Local government programs. SPONSOR assures
that all its subcontractors who will participate in activities subject to this Agreement, are eligible
and have not been debarred.
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3.12 GRANT CLOSEOUT PROCEDURES
SPONSOR's obligation to the COUNTY shall not end until all closeout requirements are
completed. SPONSOR may close out the project with the COUNTY after the thirty (30) year
affordability period has been met. The affordability period shall commence following the
recording of lien and/or deed restriction documentation, as applicable. Activities during this
closeout period shall include, but are not limited to making final payments, disposing of program
assets (including the return of all unused materials, equipment, program income balances, and
receivable accounts to the COUNTY), closeout monitoring, and determining the custodianship
of records. In addition to the records retention outlined in Section 2.2 of this Agreement,
SPONSOR shall comply with section 119.021, Florida Statutes, regarding records maintenance,
preservation, and retention. A conflict between State and Federal records retention requirements
will result in the more stringent law being applied, such that the record must be held for the longer
duration. SPONSOR must return to the COUNTY any balance of unobligated Funds which have
been advanced or paid. SPONSOR must also return to COUNTY any Funds paid exceeding the
amount to which the SPONSOR is entitled under the terms and conditions of this Agreement.
SPONSOR shall produce records and information that comply with Florida Statutes section
215.97, the Florida Single Audit Act.
3.13 OPPORTUNITIES FOR RESIDENTS AND CIVIL RIGHTS COMPLIANCE
SPONSOR agrees that no person shall be excluded from the benefits of or be subjected to
discrimination, based on race, creed, color, religion, national origin, sex, handicap, familial
status, marital status, or age under any activity carried out by SPONSOR in performance of this
Agreement. Upon receipt of evidence of such discrimination, the COUNTY shall have the right
to terminate this Agreement. SPONSOR will take affirmative action to ensure that all
employment practices are free from such discrimination. Such employment practices include but
are not limited to hiring, upgrading, demotion, transfer, recruitment or recruitment advertising,
layoff, termination, rate of pay or other forms of compensation, and selection for training,
including apprenticeship. SPONSOR agrees to post notices setting forth the provisions of this
nondiscrimination clause in conspicuous places available to employees and applicants for
employment.
To the greatest extent feasible, lower -income residents of the project area shall be given
opportunities for training and employment; and eligible business concerns located in or owned
in substantial part by persons residing in the project area shall be awarded contracts in connection
with the project. SPONSOR is encouraged to comply with Section 3 of the Housing and
Community Development Act of 1968.
3.14 OPPORTUNITIES FOR SMALL AND MINORITY AND WOMEN OWNED BUSINESS
ENTERPRISES
SPONSOR will use its best efforts to afford small businesses and minority and women owned
business enterprises the maximum practicable opportunity to participate in the performance of
this Agreement. As used in this Agreement, the term "small business" means a business that
meets the criteria set forth in section 3(a) of the Small Business Act, as amended (15 U.S.C. 632);
and "minority and women's business enterprise" means a business that is at least fifty-one (51)
percent owned and controlled by minority group members or women. For the purposes of this
definition, "minority group members" are Black Americans, Hispanic Americans, Asian/Pacific
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Americans, Native Americans, and Hasidic Jews. SPONSOR may rely on written representations
by businesses regarding their status as minority and women business enterprises, in lieu of an
independent investigation.
3.15 PROGRAM BENEFICIARIES
As defined by Florida Statutes Chapter 420, Section 420.9071-420.9079 F.S., and the Collier
County Local Housing Assistance Plan (LHAP), 18 of the 20 households benefiting from SHIP
funding through this Agreement must meet the requirement to be at or below 50 percent (50%)
of the Area Median Income (AMI), as established by HUD. The remaining two households must
meet the requirement to be no more than 80 percent (80%) of AMI. Additionally, the SHIP
program requires SPONSOR to meet specific income set -asides, which are described in Exhibit
B. Income eligibility of tenants will be validated by supporting documentation during interim
monitoring and at closeout.
3.16 AFFIRMATIVE ACTION PLAN
SPONSOR agrees that it is committed to carrying out an Affirmative Action Program, pursuant
to the COUNTY's specifications, in keeping with the principles as provided in President's
Executive Order 11246 of September 24, 1966. Prior to the award of Funds, SPONSOR shall
submit a plan for an Affirmative Action Program to the COUNTY for approval. If the Affirmative
Action Program is updated during the performance period of this Agreement, the updated plan
must be submitted to the COUNTY within 60 days of any update/modification.
3.17 PROHIBITED ACTIVITY
SPONSOR, or personnel employed in the administration of the program, are prohibited from
using Funds provided herein, for political activities, sectarian or religious activities, lobbying,
political patronage, and/or nepotism activities.
3.18 CONFLICT OF INTEREST
SPONSOR 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 area or any parcels therein, which would conflict in any manner or degree
with the performance of this Agreement. SPONSOR also covenants it will not employ or
subcontract any person having any conflict of interest. SPONSOR agrees that it will comply with
all provisions of "Conflict of Interest," per Florida Statutes section 287.057 and any additional
State and County statutes, regulations, ordinances, or resolutions governing conflicts of interest.
All SPONSOR employees who work on activities associated with this Agreement shall complete
the Subrecipient/DeveloperNendor 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.
SPONSOR will notify the COUNTY, in writing, and seek COUNTY approval prior to entering
into any contract with an entity owned in whole or in part by a covered person or an entity owned
or controlled, in whole or in part, by the SPONSOR. The COUNTY may review the proposed
contract to ensure that the contractor is qualified, and costs are reasonable. Approval of an
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identity of interest contract will be at the COUNTY's sole discretion. This provision is not
intended to limit SPONSOR's ability to self -manage the Project using its own employees.
Any possible conflict of interest on the part of SPONSOR, its employees, or its contractors shall
be disclosed in writing to CHS provided, however that this paragraph shall be interpreted in such
a manner so as not to unreasonably impede the statutory requirement that maximum opportunity
be provided for employment and participation of low- and moderate -income residents of the
project target areas.
3.19 CONDITIONS FOR RELIGIOUS ORGANIZATIONS
State Funds may be used by religious organizations or on property owned by religious
organizations only in accordance with requirements set forth in Florida Statutes, section 196.011.
SPONSOR shall comply with First Amendment Church/State principles as follows:
A. It will not discriminate against any employee or applicant for employment and will not
limit or give preference in employment to persons based on religion.
B. It will not discriminate against any person applying for public services and will not limit
such services or give preference to persons based on religion.
C. It 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 it does not use direct State Funds to support any inherently
religious activities, such as worship, religious instruction, or proselytizing.
D. The Funds shall not be used for the acquisition, construction, or rehabilitation of
structures to the extent that those structures are used for inherently religious activities.
Where a structure is used for both eligible and inherently religious activities, SHIP funds
may not exceed the cost of those portions of the acquisition, construction, or rehabilitation
that are attributable to eligible activities in accordance with the cost accounting
requirements applicable to SHIP funds in this part. Sanctuaries, chapels, or other rooms
that a SHIP funded religious congregation uses as its principal place of worship, however,
are ineligible for SHIP funded improvements.
3.20 INCIDENT REPORTING
If SPONSOR provides services to clients under this Agreement, SPONSOR 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, SPONSOR must report to the COUNTY in writing, within
one business day of occurrence, any substantial, controversial, or newsworthy incidents. The
Collier County Incident Report Form (Exhibit G) shall be used to report all such incidents.
3.21 ENFORCEMENT OF AGREEMENT
The benefits of this Agreement shall inure to and may be enforced by the COUNTY for the
duration of the Agreement, whether or not the COUNTY shall continue to be the holder of the
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Mortgage; whether or not the Project loan may be paid in full; and whether or not any bonds
issued for the purpose of providing Funds for the project are outstanding. SPONSOR warrants
that it has not, and will not, execute any other agreement with provisions contradictory to, or in
opposition to, the provisions hereof; and that, in any event, the requirements of this Agreement
are paramount and controlling as to the rights and obligations herein set forth and supersede any
other requirements in conflict herewith. However, this shall not preclude the COUNTY from
subordinating its loan to construction financing.
3.22 SEVERABILITY
Should any provision of the Agreement be determined to be unenforceable or invalid, such
determination shall not affect the validity or enforceability of any other section or part thereof.
3.23 MISCELLANEOUS
SPONSOR and COUNTY each binds itself, its partners, successors, legal representatives, and
assigns of such other party in respect to all covenants of this Agreement.
SPONSOR represents and warrants that the financial data, reports, and other information it
furnished to the COUNTY regarding the Project are accurate and complete, and financial
disclosures fairly represent the financial position of SPONSOR.
SPONSOR understands that client information collected under this Agreement is private and the
use or disclosure of such information, when not directly connected with the administration of the
COUNTY' S or SPONSOR's responsibilities with respect to services provided under this
Agreement, is prohibited unless written consent is obtained from such person receiving service
and, in case of a minor, that of a responsible parent/guardian.
SPONSOR certifies that it has the legal authority to receive the Funds under this Agreement and
its governing body has authorized the execution and acceptance of this Agreement. SPONSOR
also certifies that the undersigned person has the authority to legally execute and bind SPONSOR
to the terms of this Agreement.
The section headings and subheadings contained in this Agreement are included for convenience
only and shall not limit or otherwise affect the terms of this Agreement.
The Grant Documents shall be construed in accordance with and governed by the laws of the
State of Florida, without giving effect to its provisions regarding choice of laws. Any suit or
action brought by either party to this Agreement against the other party relating to or arising out
of this Agreement must be brought in the appropriate federal or state courts in Collier County,
Florida, which courts have sole and exclusive jurisdiction on all such matter.
All activities authorized by this Agreement shall be subject to and performed in accordance with
the provisions of the terms and conditions of the Agreement between the COUNTY, the
Regulations, all applicable Federal, State, and Municipal laws, ordinances, regulations, orders,
and guidelines, including but not limited to any applicable regulations issued by the COUNTY.
Electronic Signatures. This Agreement, and related documents entered into in connection with
this Agreement, are signed when a party's signature is delivered by facsimile, e-mail, or any
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other electronic medium. These signatures must be treated in all respects as having the same
force and effect as original written signatures.
3.24 COPYRIGHTS AND PATENTS
If this Agreement results in a book or other copyright or patent materials, SPONSOR may
copyright or patent such, but Collier County and the State of Florida reserve a royalty -free,
nonexclusive, and irrevocable license to reproduce, publish, or otherwise use such materials and
to authorize others to do so.
3.25 WAIVER
The COUNTY'S failure to act with respect to a breach by SPONSOR does not waive its right to
act with respect to subsequent or similar breaches. The COUNTY'S failure to exercise or enforce
any right or provision shall not constitute a waiver of such right or provision.
Remainder of Page Intentionally Left Blank
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PART IV
GENERAL PROVISIONS
6 D 6
4.1 Florida Statutes Chapter 420, Sections 420.907-420.9079, Florida Statutes, and Rule 67-37
Florida Administrative Code as amended- All the regulations regarding the SHIP program
httl2://www.leg.state.fl.us/statutes/index.cfm?App mode=Display Statute&URL=0400-
0499/0420/0420.html
https://www.flrules.org/ atg ewa_ /�pterHome.asp?Chapter--67-37
4.2 Fair Housing Act (42 U.S.C. 3601-20) Reasonable Accommodations Under the Fair Housing
Act. https://www.hud.gov/sites/documents/DOC_7771.PDF
httl2s://www.justice.gov/crt/fair-housing-act-
Executive Order 11063 — Equal Opportunity in Housing https://www.archives.gov/federal-
register/codification/executive-order/ 11063.html
Executive Order 11259 - Leadership & Coordination of Fair Housing in Federal Programs
https://www.archives.gov/federal-register/codification/executive-order/ 12259.html
24 CFR Part 107 - Non- Discrimination and Equal Opportunity in Housing under E.O.
https://www.law.comell.edu/cfr/text/24/ ap rt-107
Title VI of the Civil Rights Act of 1964 as amended, Title VIII of the Civil Rights Act of 1968,
as amended https://www.hud.gov/programdescription/title6
4.3 Executive Order 11246 ("Equal Employment Opportunity"), as amended by Executive Orders
11375 and 12086 - which establishes hiring goals for minorities and women on projects assisted
with federal funds and as supplemented in Department of Labor regulations. EO 11246:
https://www.dol.gov/agencies/ofccp/executive-order-11246/as-amended
EO 11375 and 12086: see item #8 below
4.4 In regard to the sale, lease, or other transfer of land acquired, cleared, or improved with assistance
provided under this Agreement, SPONSOR shall cause or require a covenant running with the
land to be inserted in the deed or lease of such transfer, prohibiting discrimination herein as
defined, in the sale, lease, or rental, or in the use or occupancy of such land, or in any
improvements erected or to be erected thereon, providing that the COUNTY and the United
States are beneficiaries of and entitled to enforce such covenants. SPONSOR, in undertaking its
obligation to carry out the program assisted hereunder, agrees to take such measures as are
necessary to enforce such covenant, and will not itself so discriminate.
4.5 Title VII of the 1968 Civil Rights Act as amended by the Equal Employment Opportunity Act of
1972, 42 USC § 2000e, et. seq. SPONSOR will, in all solicitations or advertisements for
employees placed by or on behalf of SPONSOR, state that it is an Equal Opportunity or
Affirmative Action employer.
Title VII of the Civil Rights Act of 1964 1 U.S. Equal Employment Opportunity Commission
eeoc. ov
4.6 SPONSOR shall not assign or transfer any interest in this Agreement without the prior written
consent of the COUNTY thereto; provided, however, that claims for money due or to become
due to SPONSOR from CHS under this Agreement may be assigned to a bank, trust company,
or other financial institution without such approval. Notice of any such assignment or transfer
shall be furnished promptly to CHS.
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4.7 Age Discrimination Act of 1975, Executive Order 11063, and Executive Order 11246 as
amended by Executive Orders 11375, 11478, 12107, and 12086.
Age Discrimination Act of 1975
https://www.law.comell.edu/uscode/text/42/chqpter-76
11246: https://www.dol.gov/ofccp/regs/statutes/eoI1246.htm
11375: Amended by EO 11478
11478: https://www.archives.gov/federal-register/codification/executive-order/I
1478.html
12107: https://www.archives.gov/federal-register/codification/executive-order/12107.html
12086: https://www.archives.gov/federal-register/codification/executive-order/12086.html
4.8 Immigration Reform and Control Act of 1986
5.1200 - 99th Congress (1985-1986): Immigration Reform and Control Act of 1986 1
Con rg ess.gov I Library of Congress
4.9 Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) of 1996 exempts
non-profit charitable organizations from verifying an applicant's immigration status for federal
benefits at 8 U.S.C. §1642(d).
4.10 Section 504 of the Rehabilitation Act of 1973, 29 USC 776(b) (5), 24 CFR 570.614 Subpart K.
Section 504: https://www.epa.gov/ocr
29 USC 776: https://law.onecle.com/uscode/29/776.html
24 CFR 570.614: https://www.law.comell.edu/cfr/text/24/570.614
4.11 The Americans with Disabilities Act of 1990:
https://www.hug_ og_v/program_offices/fair_housing equal opp
Americans with Disabilities Act of 1990, As Amended I ADA.g_ov
4.12 Arrest and Conviction Records: Federal and state laws restrict use of arrest and conviction
records in the employment context, except when specifically authorized. SPONSOR agrees to
avoid the misuse of arrest or conviction records to screen applicants for employment or
employees for retention or promotion that may have a disparate impact based on race or national
origin, resulting in unlawful employment discrimination unless use is otherwise specifically
authorized by law. See https://ojp.gov/about/ocr/pdfs/UseofConviction Advisory.pdf for more
details.
4.13 False Claim; Criminal, or Civil Violation: SPONSOR must promptly refer to COUNTY any
credible evidence that a principal, employee, agent, contractor, subgrantee, subcontractor, or
other person has either (i) submitted a false claim for grant funds under the False Claims Act or
(ii) committed a criminal or civil violation of laws pertaining to fraud, conflict of interest, bribery,
gratuity, or similar misconduct involving subaward agreement funds
4.14 Political Activities Prohibited: None of the Funds provided directly or indirectly under this
Agreement shall be used for any political activities or to further the election or defeat of any
candidates for public office. Neither this Agreement nor any Funds provided hereunder shall be
utilized in support of any partisan political activities or activities for or against the election of a
candidate for an elected office.
26
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4.15 Prohibition of Gifts to COUNTY Employees - No organization or individual shall offer or give,
either directly or indirectly, any favor, gift, loan, fee, service, or other item of value to any
COUNTY employee, as set forth in Chapter 112, Part III, Florida Statutes, Collier County Ethics
Ordinance No. 2004-05, as amended, and County Administrative Procedure 5311.
Florida Statutes-
https•//www lawserver.com/law/state/florida/statutes/florida statutes chapter 112 part iii
Collier County-
http://www.colliergov.net/home/showdocument?id=35137
4.16 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.
https•//www ecfr gov/current/title-2/subtitle-A/chapter-II/part-200/subpart-C/section-200.215
https://www.ecfr.aov/current/title-2/subtitle-A/chapter-1/part- 183
4.17 Foreign Countries of Concern Prohibition. It the SPONSOR has access to an individual's
Personal Identifying Information as defined in Rule 60A-1.020, F.A.C. and §501.171, F.S., the
SPONSOR and/or its subcontractors must complete an attestation (PUR 1355) as required by
§287.138, F.S. and Rule 60A-1.020, F.A.C. A violation by the SPONSOR or subcontractor shall
be grounds for consequences as provided in §287.138, F.S. Extensions and renewals are subject
to the requirement of §287.138, F.S.
4.18 Sudan, Iran, Cuba, Syria, and Israel Certifications. Where applicable, in compliance with
§287.135(5), F.S., the SPONSOR certifies that SPONSOR is not on the Scrutinized Companies
with Activities in Sudan List, or the Scrutinized Companies with Activities in Iran Terrorism
Sectors List, and it does not have business operations in Cuba or Syria, and is not participating
in a boycott of Israel.
4.19 Trafficking in Persons: The SPONSOR 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 SPONSOR and any employees of
the SPONSOR The details of the SPONSOR' S obligations related to prohibited conduct related
to the trafficking of persons are posted at
https:Hojp.j4ov/funding/Explore/ProhibitedConduct-Trafficking htm.
eCFR :: Appendix A to Part 175, Title 2 -- Award Term
Pursuant to Florida Statues 787.06, SPONSOR attests that it does not use coercion for labor or
services. SPONSOR 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.
http://www.ley,.state.fl.us/Statutes/index.cfm?App mode=Display Statute&URL=0700-
0799/0787/Sections/0787.06.htm1
4.20 Order of Precedence - In the event of any conflict between or among the terms of any of the
Contract Documents, the terms of the Agreement shall take precedence over the terms of all other
Contract Documents, except that the terms of any Supplemental Conditions shall take precedence
over the Agreement. To the extent any conflict in the terms of the Contract Documents cannot
be resolved by application of the Supplemental Conditions, if any, or the Agreement, the conflict
27
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shall be resolved by imposing the more strict or costly obligation under the Contract Documents
upon the Contractor at Owner's discretion.
4.21 Venue - Any suit of action brought by either party to this Agreement against the other parry,
relating to or arising out of this Agreement, must be brought in the appropriate federal or state
courts, in Collier County, FL which courts have sole jurisdiction on all such matters. (No
reference required for this item).
4.22 Dispute Resolution - Prior to the initiation of any action or proceeding permitted by this
Agreement to resolve disputes between the parties, the parties shall make a good faith effort to
resolve any such disputes by negotiation. Any situations when negotiations, litigation, and/or
mediation shall be attended by representatives of SPONSOR with full decision -making authority
and by COUNTY' S staff person who would make the presentation of any settlement reached
during negotiations to COUNTY for approval. Failing resolution, and prior to the
commencement of depositions in any litigation between the parties arising out of this Agreement,
the parties shall attempt to resolve the dispute through Mediation before an agreed -upon Circuit
Court Mediator certified by the State of Florida. Should either party fail to submit to mediation
as required hereunder, the other party may obtain a court order requiring mediation under section
44.102, Florida Statutes. The litigation arising out of this Agreement shall be adjudicated in
Collier County, Florida, if in state court; and the US District Court, Middle District of Florida, if
in federal court. BY ENTERING INTO THIS AGREEMENT, COLLIER COUNTY AND THE
SPONSOR EXPRESSLY WAIVE ANY RIGHTS EITHER PARTY MAY HAVE TO A TRIAL
BY JURY OF ANY CIVIL LITIGATION RELATED TO, OR ARISING OUT OF, THIS
AGREEMENT.
https://www.flsenate.gov/Laws/Statutes/2012/44.102
4.23 As provided in § 287.133, Florida Statutes, by entering into this Agreement or performing any
work in furtherance hereof, the SPONSOR certifies that it, its affiliates, suppliers, subcontractors,
and consultants who will perform hereunder, have not been placed on the convicted vendor list
maintained by the State of Florida Department of Management Services within the 36 months
immediately preceding the date hereof.
This notice is required by § 287.133 (3) (a), Florida Statutes.
http://www.le�4.state.fl.us/Statutes/index.cfm?App mode=Display Statute&Search_String=&U
RL=0200-0299/0287/Sections/0287.133.htm1
4.24 Florida Statutes section 448.095 Employment Eligibility. Per Florida Statute 448.095(3), all
Florida private employers are required to verify employment eligibility for all new hires
beginning January 1, 2021. Eligibility determination is not required for continuing employees
hired prior to January 1, 2021.
http://www.leg.state.tl.us/statutes/index.cfm?App mode=Display Statute&URL=0400-
0499/0448/0448.htm1
For purposes of satisfying the requirement of this condition regarding verification of employment
eligibility, the SPONSOR shall participate in, and use, E-Verify (www.e-verify.gov), provided
an appropriate person authorized to act on behalf of the recipient (or subrecipient) uses E-Verify
(and follows the proper E-Verify procedures, including in the event of a "Tentative Non -
confirmation" or a "Final Non -confirmation") to confirm employment eligibility for each hiring
for a position in the United States that is or will be funded (in whole or in part) with award funds.
28
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Questions about E-Verify should be directed to DHS. For more information about E-Verify visit
the E-Verify website (https://www.e-verify.gov/) or email E-Verify at E-Verify@dhs.gov. E-
Verify employer agents can email E-Verify at E-VerifyEmployerAgentkdhs.gov.
4.25 Unauthorized Aliens shall not be employed. Employment of unauthorized aliens shall be cause
of unilateral cancellation of this Agreement by the COUNTY for violation of §274A of the
Immigration and Nationality Act. The SPONSOR and its subcontractors will enroll in and use
the E-Verify system established by the U.S. Department of Homeland Security to verify the
employment eligibility of its employees and its subcontractors' employees performing under this
Agreement. Employees assigned to this Agreement means all persons employed or assigned
(including subcontractors) by SPONSOR or a subcontractor during the term of this Agreement
to perform work pursuant to this Agreement within the United Sates and its territories.
4.26 SPONSOR represents and warrants that no part of the funding under this Agreement will be used
in violation of any federal or state law, including but not limited to, 8 U.S.0 §1324 or 8 U.S.C.
§ 1325, or to aid or abet another in violating federal or state law. The COUNTY may terminate
this Agreement at any time if SPONSOR violates, or aids or abets another in violating any state
or federal law.
4.27 Florida Statutes section 713.20, Part 1, Construction Liens
Statutes & Constitution :View Statutes : Online Sunshine (state.fl.us)
4.28 Florida Statutes section 119.021 Records Retention
Statutes & Constitution: View Statutes: Online Sunshine (state.fl.us)
4.29 Florida Statutes section 119.071, Contracts and Public Records
http://www.leg.state.fl.us/Statutes/index.cfm?App mode=Display Statute&URL=0100-
0199/0119/Sections/0119.071.html
4.30 Whistleblower Protections:
a. In accordance with 2 CFR 200.217 and 41 U.S.C. § 4712, the SPONSOR 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;
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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 SPONSOR shall inform its employees in writing of whistleblower rights and remedies
provided under 2 CFR 200.217 and 41 U.S.C. § 4712, in the predominant native language of the
workforce.
https://uscode.house.gov/view.xhtml?req_ (title:41%20section:4712%20edition:prelim)
All SPONSOR employees directly involved with activities associated with this Agreement shall
complete and submit to the COUNTY the Collier County Whistleblower 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.
4.31 Executive Compensation. In accordance with §216.1366, F.S., for any contract or agreement for
services executed, amended, or extended on or after July 1, 2023, with a nonprofit organization
as defined in 215.97(2)(m), the Agreement must require the SPONSOR or contractor to provide
documentation that indicates the amount of state funds:
• Allocated to be used during the full term of the contract for remuneration to any member
of the Board of Directors or an officer of the SPONSOR.
• Allocated under each payment by the COUNTY to be used for remuneration of any
member of the Board of Directors or an officer of the SPONSOR. The documentation
must indicate the amounts and recipients of the remuneration.
4.32 Use of Funds for Diversity, Equity, and Inclusion Prohibited. No state funding under this
Agreement is being provided for, promoting, advocating for, or providing training or education
on "Diversity, Equity, and Inclusion" (DEI). DEI is any program, activity, or policy that classifies
individuals on the basis of race, color, sex, national origin, gender identity, or sexual orientation
and promotes the position that the group or an individual's action is inherently, unconsciously,
or implicitly biased on the bases of such classification.
ENTIRE AGREEMENT. This Agreement constitutes the entire agreement between COUNTY and
SPONSOR for the use of Funds received under this Agreement and it supersedes all prior or
contemporaneous communications and proposals, whether electronic, oral, or written between
COUNTY and SPONSOR with respect to this Agreement.
Signature Page to Follow
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IN WITNESS WHEREOF, the SPONSOR and the COUNTY, have each respectively, by an
authorized person or agent, hereunder set their hands and seals on the date first written above.
ATTEST:
CRYSTAL K. KINZEL, CLERK
Deputy Clerk
Dated: I Z
(SEAL) Attest as to Chairman's
L. Signature only
WITNESSES:
Wi ess #1 Signature
Witness # 1 PrintedjNanie
Witness #I hysical Address
Witness #2 Si t
ature
V6:,Vj �L T
Witness #2 Printed Name
k-�j KNo(l wooA fl Sotwsc)Ac, F�
Witness #2 Physical Address
Approved as to fonn an legality:
UDourtney L. DaSilva .
ia'ih Assistant County Attorney
Date: _ 21C
AS TO COUNTY:
BOARD OF COUNTY COMMISSIONERS
COLLIER COUNTY, FLORIDA
By:
MOT- L. SA D RS, CHAIRPERSON
Date: 12,1 ` 125
AS TO SPONSOR:
COMMUNITY ASSISTED AND SUPPORTED
LIVING, INC.
By:
J. SeCfft ELLER, CEO
Date: tj
[Please provide eviclence ofsigning authority]
31
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EXHIBIT A
INSURANCE REQUIREMENTS
SPONSOR shall furnish to Collier County Board of County Commissioners, c/o Community and Human
Services Division, 3339 Tamiami Trail East, Suite 213, Naples, Florida 34112, Certificate(s) of
Insurance evidencing insurance coverage that meets the requirements as outlined below:
Workers' Compensation as required by Chapter 440, Florida Statutes.
2. Commercial General Liability, including products and completed operations insurance, in the
amount of $1,000,000 per occurrence and $2,000,000 aggregate. Collier County Board of County
Commissioners must be shown as an additional insured with respect to this coverage.
Automobile Liability Insurance covering all owned, non -owned and hired vehicles used in
connection with this Agreement, in an amount not less than $1,000,000 combined single limit
for combined Bodily Injury and Property Damage.
DESIGN STAGE (IF APPLICABLE)
In addition to the insurance required in 1 — 3 above, a Certificate of Insurance must be provided as
follows:
4. Professional Liability Insurance, in the name of the SPONSOR or the licensed design
professional employed by the SPONSOR, in an amount not less than $1,000,000 per
occurrence/$1,000,000 aggregate providing for all sums which the SPONSOR and/or the design
professional shall become legally obligated to pay as damages for claims arising out of the
services performed by the SPONSOR or any person employed by the SPONSOR in connection
with this Agreement. This insurance shall be maintained for a period of two (2) years after the
certificate of Occupancy is issued.
CONSTRUCTION PHASE (IF APPLICABLE)
In addition to the insurance required in 1 — 4 above, the SPONSOR shall provide, or cause its
Subcontractors to provide, original certificates indicating the following types of insurance coverage prior
to any construction:
5. Completed Value Builder's Risk Insurance on an "All Risk" basis, in an amount not less than
one hundred (100%) percent of the insurable value of the building(s) or structure(s). The
policy shall be in the name of Collier County Board of County Commissioners and the
SPONSOR.
6. In accordance with the requirements of the Flood Disaster Protection Act of 1973 (42 U.S.C.
4001), the SPONSOR shall assure that for activities located in an area identified by the Federal
Emergency Management Agency (FEMA) as having special flood hazards, flood insurance under
the National Flood Insurance Program is obtained and maintained, as a condition of financial
assistance for acquisition or construction purposes (including rehabilitation).
OPERATION/MANAGEMENT PHASE (IF APPLICABLE)
After the Construction Phase is completed and occupancy begins, the following insurance must be kept
in force throughout the duration of the loan and/or Agreement:
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7. Workers' Compensation as required by Chapter 440, Florida Statutes.
8. Commercial General Liability including products and completed operations insurance in the
amount of $1,000,000 per occurrence and $2,000,000 aggregate. Collier County Board of County
Commissioners must be shown as an additional insured with respect to this coverage.
9. Automobile Liability Insurance covering all owned, non -owned and hired vehicles used in
connection with this Agreement in an amount not less than $1,000,000 combined single limit for
combined Bodily Injury and Property Damage.
10. Property Insurance coverage on an "All Risk" basis, in an amount not less than one hundred
(100%) of the replacement cost of the property. Collier County Board of County Commissioners
must be shown as a Loss payee, with respect to this coverage A.T.I.M.A.
11. Flood Insurance coverage for those properties found to be within a flood hazard zone, for the full
replacement values of the structure(s) or the maximum amount of coverage available through the
National Flood Insurance Program (NFIP). The policy must show Collier County Board of
County Commissioners as a Loss Payee A.T.I.M.A.
33
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EXHIBIT It
RENTAL REHABILITATION PROJECT REQUIREMENTS
The Project will rehabilitate existing affordable residential rental housing in accordance with the S1IIP
Program and Collier County I.IIAP FY 2025-2028. SPONSOR shall perform the following activity
under this Agreement:
a) Rehabilitate existing rental property
1) Affordability of SHIP -Assisted Units: For the duration of the Affordability Period (30 years).
as defined in the Note and Mortgage/band Use Restriction Agreement (LURA) of even date.,
a minimum of 5 duplex units in the Project shall be SHIP -Assisted units.
All SHIP -Assisted units in the Project shall be fixed and rented. or held available for rental.
on a continuous basis to persons or families who at the commencement of occupancy shall
have a verified annual income that does not exceed 80 percent of the Area Median Income
(AMI) or 50 percent of the Area Median Income (AMI). as defined by the Department of
Housing and Urban Development (I IUD). Rents on these units shall be restricted to SHIP
Program rent limits. Maximum eligible income and rent limits are revised annually and are
available from the COUNTY.
SPONSOR covenants that a minimum of five (5) duplexes/20 households will be rented to
income -eligible tenants, as defined by HUD. All units carry rent and occupancy restrictions
throughout the 30-year affordability period., which remains in force regardless of transfer
of ownership and shall he in accordance with the LURA (incorporated by reference)
and Section 1.6 of this Agreement. SIIIP-Assisted units shall be reserved for and rented to
households which qualify for the following:
SHIP -Assisted Units According to Income Limits
CASL Duplex Rehabilitation Project — Unit and Ahtl Summar.
The table below outlines the number of duplexes, bedrootn counts, and Area Median
Income (AMI) distribution for the project.
Property
otal
# of # of Bedroom
Total
�—
# of Bedrooms
LI }�
Duplexes er Duplex _
Bedrooms
AMI Level _Jby
AMl
_ _
Duplex
5 4
20
50% AMI
18
Duplex
-
-
-
80% AMI
2
_
Total
Households
20
This Agreement incorporates. by reference. terms and conditions described in the Mortgage
and Note of even date. and any other agreements enforcing the SHiP requirements associated
with said Mortgage and Note. The Project budget of (THREE HUNDRED THOUSAND
DOLLARS and NO CENTS ($300,000.00) is provided by the COUNTY through the SHIP
Program. Project construction will commence and be completed as defined and set forth in
34
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1 6 D. 6
rehabilitation commence later than 120 days from the date of this Agreement, nor will
rehabilitation be completed later than 24 months from the date of this Agreement.
Rehabilitation will progress in accordance with the construction schedule submitted by
SPONSOR to obtain financing.
2) Compliance: SPONSOR shall determine and verify the income eligibility of tenants for the
Project in accordance with the Department of Housing and Urban Development (HUD) CFR
Part 5 and Housing Opportunity through Modernization Act of 2016 (HOTMA) Final Rule
as implemented by COUNTY. Income shall be calculated by annualizing verified sources of
income for the household, as the amount of income to be received during the 12 months
following the determination effective date. The Annual Gross Income, as defined in Florida
Statutes Chapter 420, Section 420.9071(4) F.S., must be used to determine eligibility, and the
SHIP Program income limits cannot be exceeded. SPONSOR shall maintain complete and
accurate income records pertaining to each tenant occupying a SHIP -assisted unit. Onsite
inspections will be conducted annually, upon reasonable prior written notice, to verify
compliance with tenant income, rents, and minimum property standards as stated in Florida
Statutes Chapter 420, Sections 420.907-420.9079 F.S., and Rule 67-37, Florida
Administrative Code, as they may be amended from time to time.
3) Restriction on Use: SPONSOR is required to comply with all applicable program
requirements of the SHIP Program, including but not limited to Florida. Statutes Chapter 420,
Sections 420.907-420.9079 F.S. and Rule 67-37, Florida Administrative Code. Any or all of
these regulations may but are not required to be specifically set forth in any additional loan
documents executed in connection with the Loan. SPONSOR shall include such language as
the COUNTY may require in any agreements with potential tenants of the Project, or any
portion, thereof to evidence such requirements.
4) Default of Subordinate Mortgage: The Subordinate Mortgage and Note shall provide that a
default shall occur if:
A. Sale: if proceeds are not sufficient to pay off the mortgage note, the property owner (not -
for -profit or for -profit) may contact the COUNTY regarding a settlement amount of the
SHIP loan.
B. Title transfer: either voluntarily or by operation of law, divested of title by judicial sale,
levy, or other proceedings, including foreclosure or Deed in Lieu.
C. Refinance: a refinance of the first mortgage may be approved without repayment if the
request is submitted in writing and the refinance is at a lower fixed rate with no cash out,
in accordance with the "Subordination Policy."
D. Property will no longer serve the intended target population.
E. Repayment of the loan is required in full when any of the aforementioned conditions are
met.
Other defaults that may trigger repayment, if not cured within any applicable cure or notice
period following a monitoring include:
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F. Lack of SPONSOR compliance with the State statutes or County Codes, which is not
corrected within 30 days of written notice from the COUNTY.
G. If applicable, the SPONSOR has not begun to offer at least 5 duplex rental housing units
to low-income families and individuals, in accordance with the provisions of Part 1 of
Exhibit B on or before, July 1, 2025.
H. SPONSOR abandons, and/or ceases to use the Property as affordable rental housing to
tenants, without the prior written approval of the COUNTY.
5) Assurance of Public Purpose: SPONSOR covenants that if it is unable or unwilling to develop
the property in accordance with the terms and conditions incorporated herein, no lease, sale,
or title transfer to any third party shall occur prior to giving the COUNTY a 90-day
notification. The COUNTY shall have the right, solely at the COUNTY's discretion, to
purchase or find another SPONSOR to purchase the Project and carry out the eligible
activities of the Program, for an amount not to exceed the amount of Funds provided by the
COUNTY through the SHIP Program.
6) Affirmative Marketing: SPONSOR shall adopt appropriate procedures for affirmatively
marketing the SHIP -assisted units. Affirmative marketing consists of good faith efforts to
provide information and otherwise attract eligible persons from all racial, ethnic, and gender
groups in the housing market area to the available housing. SPONSOR shall be required to
use affirmative fair housing marketing practices in soliciting renters, determining eligibility,
concluding transactions, and affirmatively further fair housing efforts. SPONSOR must
maintain a file containing all marketing efforts (i.e., copies of newspaper ads, memos of
phone calls, copies of letters, etc.) to be available for inspection upon request by the
COUNTY. SPONSOR must provide a description of intended actions that will inform and
otherwise attract eligible persons from all racial, ethnic, and gender groups in the housing
market to the available housing. SPONSOR must provide the COUNTY with an assessment
of the affirmative marketing program. Assessment must include a) methods used to inform
the public and potential renters about Federal fair housing laws and affirmative marketing
policy, b) methods used to inform and solicit applications from persons in the housing market
who are not likely to apply without special outreach; c) records describing actions taken by
the SPONSOR and/or owner to affirmatively market units; and d) records to assess the results
of these actions.
7) Tenant Leases and Protections: Tenants applying for rental housing units shall be qualified
on a first -qualified, first -served basis. Tenants must be income -eligible and must occupy the
rental unit as a primary residence. SPONSOR shall comply with the provisions of the Florida
Landlord Tenant Act defined in Chapter 83, Part II, of the Florida Statutes, SHIP Program,
and COUNTY requirements, which prohibit certain lease terms. All tenant leases for assisted
units shall be expressly subordinate to the Mortgage and shall contain clauses, among others,
wherein each individual lessee:
A. Agrees that the household income, household composition, and other eligibility
requirements shall be deemed substantial and material obligations of the tenancy; that the
tenant will comply promptly with all requests for information with respect thereto from
SPONSOR or the COUNTY; and that tenant's failure to provide accurate information
about household income or refusal to comply with a request for information with respect
36
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thereto shall be deemed a violation of a substantial obligation of his/her tenancy; and
B. Agrees not to sublease to any person or family who does not meet income qualifications
as determined, verified, and certified by SPONSOR; and
C. States that the rental unit is the primary residence of the tenant; Provides disclosure on
any property in a flood zone and
D. Agrees that the lease shall be for a one-year period, unless other terms are mutually
agreed upon by SPONSOR and tenant.
SPONSOR will submit to the COUNTY, a copy of the tenant/owner lease agreement prior to
signature by the tenant. The COUNTY will review the lease for compliance with affirmative
marketing, tenant selection, and SHIP provisions stated in Florida Statutes Chapter 420,
Sections 420.907-420.9079 F.S., and Rule 67-37, Florida Administrative Code.
8) Project Requirements: SPONSOR agrees not to undertake any activity that may adversely
affect historic or environmental sensitivity of the site, and to mitigate any findings identified
in an environmental assessment. SPONSOR agrees that if the Project is located in a
Designated Flood Zone, all government requirements for construction in a flood zone shall
be satisfied.
Within 60 days of Agreement execution, SPONSOR shall develop and submit to CHS a
rehabilitation schedule to include the following:
TENTATIVE SCHEDULE (Not Condition of Payment)
Initial Plans & Bid Specifications
February 28, 2026
Bid Solicitation - (CASL projects will have
multiple bids to be awarded due to the types of
rehabilitation work to beperformed)
April 30, 2026
Construction Contract & Permitting
June 30,2026
Exterior/Interior Work Commenced
September 30,2026
Construction Completion
May 31, 2028
Project rehabilitation will commence and be completed in accordance with the schedule
submitted, and in no event will rehabilitation commence later than 120 days from the date of
this Agreement, nor will the Project be completed later than 24 months from the execution
date of this Agreement.
Further, "project completion date" will mean issuance of all certificates of occupancy and
completion of initial lease -up.
9) Property Standards: SPONSOR attests that the Project will meet the standards of the Florida
Building Code and all applicable local codes, standards, ordinances, and zoning ordinances
at the time of project completion and throughout the duration of the affordability period. The
Project will also meet the accessibility requirements at 24 CFR part 8, which implements
Section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794); covered multifamily
37
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w
a6b6
dwellings, as defined at 24 CFR 100.201; and the design and construction requirements at 24
CFR 100.205, which implement the Fair Housing Act (Florida Statutes sections
760.20-760.37).
In accordance with the Local Housing Assistance Plan, SPONSOR shall follow each SHIP
Program strategy requirement below:
Energy Efficient Best Practices: Section 420.9075(3)(d), Florida Statutes defines Energy
Efficient Best Practices as: Innovative design, green building principles, storm resistant
construction, or other elements that reduce long term costs relating to maintenance, utilities,
orinsurance.
Collier County requires the use or inclusion, when appropriate, of the following: energy star
appliances; low-E windows; additional insulation (for increased R-value); ceramic tile; tank -
less water heater; 15 SEER air conditioning units; stucco; florescent light bulbs; and impact
resistant windows and doors.
10) PropertyManagement: The COUNTY reserves the right to require SPONSOR to enter into
a contract with a COUNTY approved property management firm for professional
management services of the Property, providing leasing, rent collection, property
maintenance and repair, and other property management tasks as the COUNTY may require.
Such contract shall stipulate that the contract will not be amended or terminated without prior
written consent of the COUNTY.
11) Program Set -Asides: SPONSOR must meet the following SHIP mandated program set -
asides:
a) At least 100 percent (100%) of the total available funds must be used for eighteen
(18) households with less than 50 percent (50%) AMI, and two (2) households with
no more than 80 percent (80%) AMI, adjusted for household size, as defined by HUD;
b) At least 20 percent (20%) of households assisted must be special needs, as defined in
Florida Statutes section 420.0004(13).
38
CAO
6 D- 6
EXHIBIT C
COLLIER COUNTY COMMUNITY & HUMAN SERVICES
SECTION I: REQUEST FOR PAYMENT
SPONSOR Name: Community Assisted and Supported Living, Inc.
SPONSOR Address: 2911 Fruitville Road Sarasota, FL 34237
Project Name: Rental Rehabilitation
Project No: SHRD-25-001_ Payment Request #
Total Payment Minus Retainage
Period of Availability: _ through
Period for which the SPONSOR has incurred the indebtedness through
SECTION II: STATUS OF FUNDS
Sponsor
CHS Approved
1. Grant Amount Awarded
$
$
2. Total Amount of Previous Requests
$
$
3. Amount of Today's Request (Net of Retainage,
if applicable)
$
$
4. Current Grant Balance (Initial Grant Amount
Award request) (includes Retainage)
$
$
By signing this report, I certify to the best of my knowledge and belief that this request for payment is true, complete and
accurate, and the expenditures, disbursements and cash receipts are for the purposes and objectives set forth in the term and
conditions of the State award. I am aware that any false, fictitious, or fraudulent information, or the omission of any material
fact, may subject me to criminal, civil, or administrative penalties for fraud, false statements, false claims or otherwise (U.S.
Code Title 18, Section 1001 and Title 31, Sections 3729-3730 and 3801-3812; and/or Title VI, Chapter 68, Sections 68.081-
083, and Title XLVI Chapter 837, Section 837-06).
Signature
Title
Authorizing Grant Coordinator
Supervisor (Approval required $14,999 and below)
Date
Authorizing Grant Accountant
Division Director (Approval Required $15,000
and above)
39
EAU
16D6
10M11.1118C
QUARTERLY PROGRESS REPORT
Complete form for preceding quarter and submit to Community and Human Services staff by the 30th of the
following quarterly month.
Status Report for the Quarter Ending:
Submittal Date:
Project Name:
Project Number:
SPONSOR Name:
Contact Person
Telephone: Fax: Email:
PROPERTY UNIT DATA
Number of units under rehab this period
Number of units completed this period
Number of units completed to date
EXPENDITURE DATA
Amount of funds expended this period
Amount of funds expended to date
New Contracts executed this period
Name of Contractor
Address
Amount of Contract
INCOME DATA
Client
Income Category
Income Amount
What events/actions are scheduled for the next month?
Identify any issues that may cause delay in meeting scheduled expenditure deadline dates.
Signature
Date
40
CAO
16D6
EXHIBIT E
ANNUAL AUDIT MONITORING REPORT
If SPONSOR expends $750,000 or more in State financial assistance during its fiscal year, it must have a
State Single or Project Specific audit conducted in accordance with Section 215.97, Florida Statutes;
applicable rules of the Department of Financial Services; and Chapters 10.550 (local governmental entities)
or 10.650 (nonprofit and for -profit organizations), and Rules of the Auditor General. If SPONSOR expends
less than $750,000 in State financial assistance during its fiscal year, it shall provide certification to the
COUNTY that single audit was not required. In determining State financial assistance expended, SPONSOR
must consider all sources of State financial assistance, including assistance received from Department of
Children & Families, other State agencies, and other nonstate entities. This form may be used to monitor
Florida Single Audit Act Florida Statutes Section 215.97 requirements.
SPONSOR Name
First Date of Fiscal Year MM/DD/YY
Last Date of Fiscal Year MM/DD/YY
Total State Financial Assistance Expended
$
during most recently completed Fiscal Year
Check A. or B. Check C if applicable
A. The state expenditure threshold for our fiscal year ending as indicated above has been met
❑
and a Single Audit as required by Section 215.97, Florida Statutes has been completed or will
be completed by . Copies of the audit report and management letter are
attached or will be provided within 30 days of completion.
B. We are not subject to the requirements of Section 215.97, Florida Statutes because we:
❑
❑ Did not exceed the expenditure threshold for the fiscal year indicated above
❑ Are exempt for other reasons — explain
An audited financial statement is attached and if applicable, the independent auditor's
management letter.
C. Findings were noted, a current Status Update of the responses and corrective action plan is
included.
❑
While we understand that the audit report contains a written response to the finding(s), we are
requesting an updated status of the corrective action(s) being taken. Please do not provide just
a copy of the written response from your audit report, unless it includes details of the actions,
procedures, policies, etc. implemented and when it was or will be implemented.
Certification Statement
I hereby certify that the above information is true and accurate.
Signature
Date:
Print Name and Title:
07/24/24
41
Effective January 1, 2025 EXHIBIT F
6D6
RESIDENT INCOME CERTIFICATION — Rental
Florida Housing Finance Corporation
State Housing Initiatives Partnership (SHIP) Program
Effective Date: Allocation Year:
Calculations performed using (check
Pre-HOTMA Guidance
HOTMA
❑
one):
Guidance
A. Certification Information (select one)
a. Initial Certification
b. Annual Recertification
B. Subsidy Use (check all that apply)
Multifamily Rental
Transitional Housing
Security and Deposits
Direct Rental Assistance
Homeless Prevention
Other
C. Household Information: Include all household members
Member
Full Name
Relationship
to Head
Age
I
HEAD
2
3
6
7
8
D. Assets: All household members including assets owned by minnrq
Member
Asset Description
Cash Value
Income from
Assets
Total Cash Value of Assets D(a)
Total Actual Income from Assets D(b)
Total Imputed Income from Assets D (c)
Total Income from Assets D (d)
SHIP H-RIC
Rev. 01/2025
Page 42 of 47 1 i
Effective January 1, 2025 1 6 D 6
E. Anticipated Annual Income: Includes unearned income and support paid on behalf of minors.
Member
Wages /
Salaries
(include
tips,
commission,
bonuses and
Benefits /
Pensions
Public
Assistance
Other
Income
*Asset Income
(Enter the
greater of
box D(b)
or
box D(c),
above,
in box E(e)
below)
Totals
a
b
c
d
e
Enter total of items E(a) through E(e). This amount is the Annual Anticipated
Household Income
$
F. Recipient Statement: The information on this form is to be used to determine maximum income for eligibility.
I/we have provided, for each person set forth in Item C, acceptable verification of current and anticipated annual
income. I/we certify that the statements are true and complete to the best of my/our knowledge and belief and are
given under penalty of perjury. WARNING: Florida Statute 817 provides that willful false statements or
misrepresentation concerning income and assets or liabilities relating to financial condition is a misdemeanor of the
first degree and is punishable by fines and imprisonment provided under S 775.082 or 775.83.
Date
Signature of Head of Household
Date
Signature of Spouse or Co -Head of Household
Date
Signature of Household Member (over 18 years)
Date
Signature of Household Member (over 18 years)
Date
Signature of Household Member (over 18 years)
Date
Signature of Household Member (over 18 years)
SHIP H-RIC
Rev.01/2025
Page 43 of 47 CAO
Effective January 1, 2025
G. SHIP Administrator Statement: Based on the representations herein, and upon the proofs and documentation
submitted pursuant to item F, hereof, the family or individual(s) named in item C of this Resident Income
Certification is/are eligible under the provisions of Chapter 420, Part V, Florida Statutes, the family or individual(s)
constitute(s) a: (check one)
Extremely Low Income (ELI) Household means individuals or families whose annual
income does not exceed 30% of the AMI as determined by HUD with adjustments for
household size. '
Maximum Income Limit:
Very Low Income (VLI) Household means individuals or families whose annual income
does not exceed 50% of the AMI as determined by HUD with adjustments for household
size.
Maximum Income Limit:
Low Income (LI) Household means individuals or families whose annual income does
not exceed 80% of the AMI as determined by HUD with adjustments for household size.
Maximum Income Limit:
Moderate Income (MI) Household means individuals or families whose annual income
does not exceed 120% of the AMI as determined by HUD with adjustments for household
size.
Maximum Income Limit:
121-140% Income Household means individuals or families whose annual income does
not exceed 140% of the AMI as determined by HUD with adjustments for household size.
Maximum Income Limit:
Based upon the
Income Limits for
(yea')
(MSA or County)
Signature of the SHIP Administrator or His/Her Designated Representative:
Signature
Name (print or type)
H. Household Data (to be completed by Head of Household only)
Date
Title
Household elects to not participate.
(Initials of Household Head)
Head of Household Data
By Race / Ethnici
By Age
White
Black
Hispanic
Asian
America
jLlndinn
Other
0 - 25
26 - 40
41 - 61
162 +
Household Members Data
Special Target / Special Needs Check all that apply to any member
Farm worker
Developmentally
Disabled
Homeless
Elderly
Special Needs
(define)
Special
Needs
NOTE: Information in this Section H is being gathered for statistical use only. No resident is required to give such
information.
SHIP H-RIC
Rev. 01 /2025
Page 44 of 47 CAO
mok. hoo 9 oN,dobl. _ 1' 1V1 lU4 11V U311 1' 111 SH%;V, 'UU1 FUI 4 LIU11
Florida Housing State Housing Initiatives Partnership
228 Noah 84197 - f x 85 48 5 8 0 • Tolloh orjd Florida 32301 (SHIP) Personal Property Asset `
850 488 41D7 •fox 850 488 D809 • wwv. Aoridahouung org D w
Calculation Worksheet 1 0
Applicant:
Part 11: HOTMA CALCULATION
Refer to the HOTMA Final Rule Implementing Sections 102 and 104 (Notice 88 FR 9600 dated 2.14.2023) and Implementation Guidance
included in Notice H 2O23-10 / PIH 2O23-27 for instructions regarding the calculation of assets and asset income.)
Assets Where Actual Income Can Be Calculated
If non -necessary personal property exceeds $51,600 (HUD Income Exclusions), list non -necessary personal property below, and list all
real property including actual income (remember that actual income for an asset can equal $0, such as a checking account that has
no rate of return).
Asset Cash Value Income Calculation Income
Total Net Valu Total Actual Income [A
Assets Where Actual Income Cannot Be Calculated
List assets, including real property, where no income could be calculated, including imputed income. NOTE: When the total net family
assets are less than or equal to the applicable Imputed Income Limitation, ($51,600 as of January 1, 2025) then only the actual income as
disclosed on the Asset Self -Certification is included on the Resident Income Certification (RIC).
Asset
Value
Total Value
Total [B] Multiply total value of assets by current HUD Passbook Rate* (0.45%)
Add the actual income from Cell [A] with the imputed income from Cell [B] to get the total asset income for the household:
SHIP H-RIC
Rev. 01/2025
Total Actual Income [A]
Total Imputed Income IBI
Total Income from Assets
Page 45 of 47 CAO
Collier County j 6 D,
Community & Human Services Division
EXHIBIT G
INCIDENT REPORT FORM
Organization Name:
Organization Address:
Project No:
Grant Coordinator:
Date of Incident
Time of Incident:
Report Submitted By:
ame & Phone
Description of Incident:
Location/Address of Incident:
Was Police Report Filed? ❑ Yes ❑ No
If Yes, Police Report
Number:
Jurisdiction:
Were there any warning signs that this type of Incident could occur? ❑ Yes ❑ No
If Yes, Explain:
What actions will be taken to prevent a recurrence of a similar incident?
I certify under penalty of perjury under F.S. 837.06 that the contents of this form 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 +CAO
Naples, FL 34112 Fax: (239) 252-2638
v
1 6D'6
EXHIBIT H
COLLIER COUNTY COMMUNITY & HUMAN SERVICES
WHISTLEBLOWER PROTECTIONS CERTIFICATION
SPONSOR Name:
SPONSOR Address:
Employee Name:
Project Name:
Project No:
In accordance with 2 CFR 200.217 and 41 U.S.C. § 4712, SPONSOR 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 SPONSOR, contractor, or subcontractor who has the
responsibility to investigate, discover, or address misconduct
SPONSOR 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 form, I certify that I have reviewed and understand my Whistleblower rights and
protections as provided above.
Name:
Signature:
Title:
Date:
Your typed name here represents your electronic signature
CAO