Seventh-Day Adventists
ORIGINAL DOCUMENTS CHECKLIST & ROUTING SL%9
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARJ) OF COUNTY COMMISSIONERS OFFICE FOR SIGNA B 5
Print on pink paper. Attach to original document. Original documents should be hand delivered to the Board Office. The completed routing slip and original
documents are to be forwarded to the Board Office only * the Board has taken action on the item.)
ROUTING SLIP
Complete ronting lines #1 through #4 as appropriate for additional signatures, dates, and/or information needed. If the document is already complete with the
exceotion of the Chairman's sipature, draw a line throullil routing lines #1 throullh #4, -.- the checklist, and forward to Sue Filson (line #5).
Route to Addressee(s) OfrICe Initials Date
(List in rontin2 order)
1. Sue Filson, Executive Manager Board of County Commissioners
2. Minutes and Records Clerk of Court's Office
3. ...
4.
PRIMARY CONTACT INFORMATION
(The primary contact is the holder of the original document pending Bce approval. Normally the primary contact is the person who createdlpreplll'<!d.the executive
summary. Primary contact information is needed in the event one of the addressees above, including Sue FiisQD, need to contact staff for additional or missing
information. All original documents needing the Bec Chairman's signature are to be delivered to the Bce office only after the Bee has acted to approve the
item.
Name of Primary Staff Claudia Piotrowicz
Contact
Agenda Date Item was 6/22/04
A roved b the BCC
Type of Document
Attached
Phone Number
Agenda Item Number
Number of Original
Docwnents Attached
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark "NI A" in the Not Applicable column, whichever is
ro riate.
1. Original document has been signed/initialed for legal sufficiency. (All documents to be
signed by the Chairman, with the exception of most letters, must be revie",ed and signed
by the Office of the County Attorney. This includes signature pages from ordinances,
resolutions, etc. signed by the County Attorney's Office and signature pages from
contracts, agreements, etc. that have been fully executed by all parties except the BCC
Chairman and Clerk to the Board and 'bl State Officials.)
2. All handwritten strike-through and revisions have been initialed by the County Attorney's
Office and all other arties exce t the BeC Chairman and the Clerk to the Board
3. The Chairman's signature line date bas been entered as the date of Bce approval of the X
document or the final ne otiated contract date whichever is a licable.
4. "Sign here" tabs are placed on the appropriate pages indicating where the Chairman's X
si ature and initials are r uired.
5. In most cases (some contraOOi.are an exception), the original document and this routing slip
should be provided to Sue Filson in the BCC office within 24 hours of BCC approval.
Some documents are time sensitive and require forwarding to Tallahassee within a certain
time frame or the BCC's actions are nullified. Be aware of our deadlines!
6. The d~ument was approved by the BCC on (enter clate) &lid aU cbaDges
made during the meeting have been incorporated in the attached documeat. The
Co Attorne '8 0fI'ke bas reviewed the if a lieable.
239-985-1057
16B5
1
I: Forms! County Forms! BCC Forms! Original Documents Routing Slip WWS Original 9.03.04. Revised 1.26.05, Revised 2.24.05
This Instrument Prepared by:
Frank McMillan, Esquire
Attorney-at-Law
655 N. Wymore Rd.
Winter Park, Florida 32789
4109373 OR: 4313 PG: 3752
RBCORDBD in OPPICIAL RBCORDS of COLLIBR COUNTY, PL
12/20/2007 at 11:28AH DWIGHT B. BROCK, CLBRK
RBC PBB 52.50
DOC-.70 .70
COPIBS 6.00
MISC 1.50
Retn:
CLBRK TO THB BOARD 1 6
INTBROPPICB 4TH PLOOR .1:1 JC)
BIT 7240 -
CONSERVATION EASEMENT
TillS DEED OF CONSERVATION EASEMENT is given this 5th day of September,
2007, by the FLORIDA CONFERENCE ASSOCIATION OF SEVENTH-DAY ADVENTISTS,
whose address is: P. O. Box 2626, Winter Park, Florida, 32790-8223, ("Grantor") to Collier
County, Florida, a political subdivision of the State of Florida (hereinafter "Collier County" or
"Grantee"). Grantor and Grantee may hereafter be collectively referred to as the "parties".
WHEREAS, FLORIDA CONFERENCE ASSOCIATION OF SEVENTH-DAY
ADVENTISTS is the owner of that certain tract ofland located in Collier County, Florida described
as Exhibit "A" attached hereto (hereinafter referred to as the "property"); and
WHEREAS, Collier County is requiring that this Conservation Easement ("Easement") be
entered into and recorded in the land records of Collier County to bind FLORIDA CONFERENCE
ASSOCIATION OF SEVENTH-DAY ADVENTISTS; and
WHEREAS, the parties wish to establish their respective rights and responsibilities relative
to the use and maintenance of the conservation area described in the attached Composite Exhibit
"B" (the Easement Property).
NOW, THEREFORE, Grantor herby conveys a Conservation Easement to Collier County
as follows:
1. FLORIDA CONFERENCE ASSOCIATION OF SEVENTH-DAY ADVENTISTS,
its successors, heirs, assigns and/or transferees, herby grants an non-exclusive
easement to Collier County over and across the property described in Exhibit "A"
for the purpose of conservation. Collier County shall have no responsibility for
maintenance of the conservation easement.
2. No buildings, structures or impediments of any nature may be constructed, placed or
permitted on, over or across the Easement Property. No dumping or placing of soil
or other substances such as trash or unsightly or offensive materials shall be
permitted on the Easement Property. There shall be no removal or destruction of
trees, shrubs or other vegetation with the exception of exotic/nuisance vegetation
removal. Excavation, dredging or removal of soil material, peat, rock or other
material substance in such a manner as to affect the surface shall be prohibited on
the Easement Property. No dikes or fencing shall be permitted on the Easement
Property. There shall be no other activities detrimental to drainage, flood control,
water conservation, erosion control or fish and wildlife habitat conservation or
10f4
OR: 4313 PG: 3753
16H5
preservation permitted on the Easement Property. The Easement Property shall be
in no way altered from its natural or permitted state.
3. FLORIDA CONFERENCE ASSOCIATION OF SEVENTH-DAY ADVENTISTS,
its heirs, successors or assigns shall bear the responsibility for maintaining the
Easement Property, including, but not limited to, regular maintenance as may be
required by any governmental agency having jurisdiction relative thereto. The
Easement Property shall at all times be maintained in accordance with applicable
requirements of the Collier County Land Development Code.
4. No right of access by the general public to any part of the Easement Property is
being conveyed. Collier County shall; have the right to access and use the Easement
property for the purpose of making inspections; however, Collier County shall have
no obligation to maintain the Easement Property, nor shall Collier County have the
right to use the Easement Property for any purpose inconsistent with the terms of
this Conservation Easement.
5. Grantor reserves all rights as owner of the Easement Property, including the right to
engage in uses of the Easement Property that are not prohibited herein and which are
not inconsistent with any County ordinance, regulation or development permit, and
the intent and purposes of this Conservation Easement.
6. Grantor shall pay any and all real property taxes and assessments levied by
competent authority on the property.
7. Grantor shall insert the terms and restrictions of this Conservation Easement in any
subsequent deed or other legal instrument by which Grantor divests itself of any
interest in the property.
8. All notices, consents, approvals or other communications hereunder shall be in
writing and shall be deemed properly given if sent by United States Certified Mail,
Return Receipt Requested, addressed to the appropriate party or successor in
interest.
9. This Conservation Easement may be amended, altered, released or revoked only by
written agreement between the parties hereto or their heirs, successors or assigns,
which shall be file din the public records of Collier County.
10. This Conservation Easement shall run with the land and shall be binding upon and
inure to the benefit of all present and future owners of any portion of the property
and their successors and/or assigns, it being the intention of the Grantor that this
Conservation Easement be perpetual.
11. If any provisions of the Conservation Easement or the application thereof to any
person or circumstances is found to be invalid, the remainder of the provisions of
20f4
OR: 4313 PG: 3754
1685
this Conservation Easement shall not be affected thereby, as long as the purpose of
the Conservation Easement is preserved.
12. Enforcement of the terms, provisions and restrictions of this Conservation Easement
shall be at the reasonable discretion of Grantee, and any forbearance on behalf of
Grantee to exercise its rights hereunder in the event of any breach hereof by Grantor,
shall not be deemed or construed to be a waiver of Grantee's rights hereunder.
13. The terms and conditions of this Conservation Easement may be enforced by the
Grantee by injunctive relief and other appropriate available remedies, and Grantor
consents that venue of such enforcement actions shall lie exclusively in the Circuit
Court of the Twentieth Judicial Circuit in and for Collier County, Florida. In any
enforcement action in which the Grantee prevails, Grantee shall be entitled to
recover reasonable attorney's fees and costs in the trial and appellate courts in
addition to the cost of restoring the land to the natural vegetative and hydrologic
condition existing at the time of execution of this Conservation Easement or to the
natural vegetative state required for a development permit. These remedies are in
addition to any other remedy, fine or penalty, which may be applicable under
Chapters 373 and 403, Florida Statues.
IN WITNESS WHEREOF, Grantor has hereunder set its hand and seal the day and year
first above written.
Signed, sealed and delivered
in our presence as witness:
BY:
FLORIDA CONFERENCE ASSOCIATION OF
SEVENTH-DAY ADVENTISTS, A Florida
Corporation
By: ~~ G~
Print Name: Glenn Carter
.$~l-r...-7I'?'--
Print Name Cynthia Duncanson
Title:
Vice President
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Attest By:
Wesley Quale, Assistant Secretary
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OR: 4313 PG: 3755
1685
STATE OF FLORIDA
) ss:
COUNTY OF ORANGE
On this ~ /t..- day of ~ R.fd I- . ,2007 before me, the undersigned notary
public, personally appeared Glenn Carter and Weslev Ouale , personally known to me to be
the persons who subscribed to the foregoing instrument and did not take an oath, as the Vice
President and Assistant Secretary, respectively, of Florida Conference Association of Seventh-day
Adventists, a Florida corporation, and acknowledged that they executed the same on behalf of said
corporation and that they were duly authorized to do so.
IN WITNESS WHEREOF, I hereunto set my hand and official seal.
NOTARY PUBLIC, STATE OF FLORIDA
~~.~
Print Name: yn la uncanson
My Commission Expires:
,,"':.l!~'~""" C. DUNCAN
~' '- NolaIY Public. S.... 01 FIoridI
. 5My CommIIIlon Expns Oct 18. 200ll
~ CommIIIlon. D0464I49
Bonded Br NIlIollII NoeIry..
MY COMMISSION EXPIRES:
acceptance by grantgee:
A TTESTL;);.p;j>.. .',~.;',c,"
DWIGHT E'~,;$ii~~(~Rl<
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~OARD OF COUNTY COMMISSIONERS
COLLIER COUNTY, FLORIDA
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gAMES COLETTA, CHAIRMAN
APPROVED AS TO FORM AND
LEGAL SUFFICIENCY:
ATTORNEY
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EXHIBIT "B"
CONSERVATION EASEMENT
*** OR: 4313 PG: 3757 ***
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DESCRIPTION OF CONSERVATION fASEMENT
A PARCEL Of LAND LYING AND Il[JNG IN '!HE SOUlHEAST ONE-QUARTER (1/4).
Of '!HE SOUlHEAST ONE-ClUARTER (1/4). Of' SEClIDN 23, 10WNSHIP 47 SOUlH,
RANGE 27 EAST, COWER COUNTY. fI.ORIDA. 8ElNG MORE PAR11CUlARlY
DESCRIBED AS FlllOWS:
CONNENaNG AT '!HE SOUlHEAST CORNER Of' SEClIDN 23, 10WNSHIP 47 SOUlH,
RANGE 27 EAST,
COWER COUNTY, F1.0R1DA; lHENCE Al.DNG lliE EASTERlY UN[ Of SAID
SOUlliEAST ONE-QUARTER (1/4) Of SAID SEC1IDN 23, RUN H 00'56'51" W, A
DlSTAllCE Of' 930.99 FEET TO TO A PaNT; 1llENCE IES1ERl.Y, lEAWlG SAID
EASTERY lINE Of' SEC110N 23, RUN S 89"01'39" W,A DISTANCE Of' 438.01 FEET
TO tHE POINT Of BEGlNNlNO Of A CONSERVA'RON EASEMENT HEREIN DESCRIBED;
lliENCE CON'RNUE ALONG '!HE FOlJ..OWNG 30 COURSES AND DISTANCES AS
FOllOWS;
UHE 1) S 84"02'54" W, FOR 16.64 mT;
UHE 2) N 52'56'23" W, FOR 14.10 FEET;
lINE 3) H 5416'12" W. FOR 26.17 FEET;
lINE 4) H 57'22'01" W, FOR 2l.60 FEET:
lINE 5) H 61'45'44" W, FOR 17.85 FEET;
lINE 6) H 54'4715" W, FOR 15.72 FEET;
UHE 7) H 16'4J'lr W. FOR 13.23 FEET;
UHE 8) H 22"55'44" W, FOR 8. 55 FEET;
lINE 9) H 40'24'24" W, FOR 9.22 FEET;
UHE 10) H 1810'32" W, FOR 9.69 FFE;
lINE 11) H JJ'J9'.w' E. FOR 11.22 FEET:
UHE 12) H 64'43' 4J" E, FOR 11.07 FEET;
UHE 13) S 87'58'02" E. FOR 14.86 FEET;
lINE 14) S 83'4758" E. FOR 18.19 FEET;
lINE 15) S 62'58'10" E. FOR 14.83 FEET;
UHE 16) S 58'20'22" E. FOR 11.62 FEET;
UHE 17) H 87"02' 4r E. FOR 15.61 FEET;
lINE 18) S 86'44'J6" E. FOR 16.22 FEET;
UHE 19) H 73'54'lr E. FOR 13.18 FEET:
UHE 20) H 69'43'04" E. FOR 10.42 FEET;
UHE 21) H 27'53'09" E. FOR 14.26 FEET;
lINE 22) H 78"05'31" E. FOR 11.59 FEET;
lINE 23) S 33"05'29" E. FOR 11.12 FEET;
lINE 24) S 06'32'19" E. FOR 12.43 FEET;
UHE 25) S 0210'14" E. FOR 25.92 FEET;
lINE 26) S 32'50'34" W, FOR 10.42 FEET;
lINE 2n S 35'24'22" W. FOR 10.75 FEET;
lINE 26) S 49"26'01"W, FOR :17.49 FEET;
lINE 20) 5 39"21'06" _Yl, .FOIr2;3.Q() FEET:
LINE 30) S 04"58'13" W, FOR 14"-7 fEET TO. '!HE POINT Of' IIEGlNNING.
SU8.ECT TO EASDIEMlS AND RtSTnleTIORSLOf.RECORO.
BEARING CONFIlBtA TO tHE EASlERL Y lilli: Of' lllE SOUlHEAST ONE-ClUARlER
(1/4) Of' SEC'RON 23. T. 47 5.. R. 'J:1 E.. 8ElNG H 00'56'51" W,
:2~:;;?J19'
Dennis M. Portella, Sr. PLS #4504
Not valid unless sIgned and sealed
with embossed seal.
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-23- -24-
-26- -25-
NORTHER.!:! R/W UNE
SOUTH LINE OF SECTION 23
---
Immokalee Road
NOT A BOUNDARY SURVEY
REVISIONS
SKETCH TO ACCOMPANY DESCRIPTION
PllEPARBD mR; IlE'l'llESDA SDA CHURCH
POIn'1!:U.A "ASSOCIATES, u.c lBf73M
2JII4 ..-xlll INE. fWlI.5. FL 34112
~ I". 100' o.r.TE: MAY 25, 2007
(239) 775-6511
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days of receiving notification from the funding source and submit a cost allocation plan for
approval by the Housing and Grants Section or designee within forty-five (45) days of said
official notification.
B. COMPLIANCE WITH LOCAL AND FEDERAL RULES. REGULATIONS AND LAWS
During the performance of the Agreement, the SUBRECIPIENT agrees to comply with any
applicable laws, regulations and orders listed below which by reference are incorporated and
made a part hereof. The SUB RECIPIENT further agrees to abide by all other applicable laws,
1. 24 CFR Part 570, as amended - The regulations governing the expenditure of
Emergency Shelter Grant funds.
2. 24 CFR Part 58 - The regulations prescribing the Environmental Review
procedure.
3. 36 CFR Part 800 - The regulations outlining the procedures for the protection of
historic and cultural properties.
4. 24 CFR Part 1 - The regulations promulgated pursuant to Title VI of the 1984
Civil Rights Act.
5. 24 CFR Part 107 - The regulations issued pursuant to Executive Order 11063
which prohibits discrimination and promotes equal opportunity in housing.
6. Executive Order 11246, as amended by Executive Orders 11375 and 12086 -
which establishes hiring goals for minorities and women on projects assisted
with federal funds.
7. Title VII of the 1968 Civil Rights Act as amended by the Equal Employment
Opportunity Act of 1972 - which prohibits discrimination in employment.
8. 24 CFR 135 - Regulations outlining requirements of Section 3 of the Housing
and Urban Development Act of 1968, as amended.
9. Age Discrimination Act of 1973
10. National Flood Insurance Act of 1968
11. 24 CFR Part 130 - Regulations that prohibit discrimination in employment in
federally assisted construction contracts.
12. 40 CFR Part 15 - Regulations relating to the applicability of the Clean Air and
Water Pollution Acts.
13. Contract Work - Hours and Safety Standards Act
SHELTER FOR ABUSED WOMEN & CHILDREN
Page 4 of27
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14. Lead Based Paint Poisoning Preventive Act
15. Section 504 of the Rehabilitation Act of 1973
16. Uniform Relocation Assistance and Real Property Acquisition Policies Act
of 1970
17. 29 CFR Parts 3, 5 and Sa - Regulations which prescribe the payment of
prevailing wages and the use of apprentices and trainees on federally assisted
projects as mandated by the Davis-Bacon Act. HUD Form 4010, which
describes the Davis-Bacon Act, is included as part of this agreement and must be
included in all construction contracts funded by CDBG. See attachment A-3.
18. Revised Order Number 4 - Regulations that establish guidelines for the
implementation of Executive Order 11246 as amended by Executive Orders
11375 and 12086.
19. Executive Order 11914 - Prohibits discrimination with respect to the
handicapped in federally assisted projects.
20. Executive Order 11625 and U.s. Department of Housing and Urban
Development Circular Letter 79-45 - which prescribes goal percentages for
participation of minority businesses in Community Development Block Grant
Contracts.
21. 29 CFR Part 3 - The Copeland Anti-Kickback Act (i 8 U.S.c. 874 and 40
U.S.c. 276c), which deals with employee forfeiture of compensation by force.
22. Florida Statutes, Chapter 112 - which deals with conflict of interest.
23. HUD - required reports, circulars, and procedures, such as the Grantee
Performance Report.
24. Public Law 100-430 - the Fair Housing Amendments Act of 1988.
25. 24 CFR 570, Subpart J - regulations covering standard Granted Administration
Procedures. These replace OMB Circular A-I 02. This subpart includes 24 CFR
570.502.
26.0MB Circular A-133 - concerning annual audits.
27.0MB Circular A-122 - which identifies cost principles.
28. Section 109, Public Law 100-202 - which restricts the awarding of public works
contracts to firms from foreign countries with unfair trade practices.
SHELTER FOR ABUSED WOMEN & CHILDREN
Page 5 of27
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29. 24 CFR Part 84 - OMB Circular A-lID Codified in the Uniform Administrative
Requirements for Grants and Agreements With Institutions of Higher Education,
Hospitals and Other Non-Profit Organizations.
30. 24 CFR Part 85- OMB Circular A-102 Codified in the Uniform Administrative
Requirements for Grants and Agreements to State and Local Governments.
C. SUBCONTRACTS
Any work or services subcontracted by the SUBRECIPIENT shall be specifically by written
contract or agreement, and such subcontracts shall be subject to each provision of this
Agreement and applicable County, State, and Federal guidelines and regulations. Prior to
execution by the SUBRECIPIENT of any subcontract hereunder, such subcontracts must be
submitted by the SUBRECIPIENT to Housing and Grants Section for its review and
approval, which will specifically include a determination of compliance with the terms of the
attached Work Program set forth in Exhibit "A."
This review also includes ensuring that all consultant contracts and fee schedules meet the
minimum standards as established by the Collier County Purchasing Department and HUD.
Subcontracts for architecture, engineering, survey, and planning shall be negotiated fixed fee
contracts. All additional services shall have prior written approval with support
documentation detailing categories of persons performing work plus hourly rates including
benefits, number of drawings required, and all items that justify the "Fixed Fee Contract."
Reimbursements for such services will be made at SUBRECIPIENT cost.
None of the work or services covered by this Agreement, including but not limited to
consultant work or services, shall be subcontracted by the SUBRECIPIENT or reimbursed by
the County without prior written approval of the Housing and Grants Department or his
designee.
D. AMENDMENTS
The County may, at its discretion, amend this Agreement to conform to changes required by
Federal, State, County, or HUD guidelines, directives, and objectives. Such amendments shall
be incorporated by written amendment as a part of this Agreement and shall be subject to
approval of Collier County. Except as otherwise provided herein, no amendment to this
Agreement shall be binding on either party unless in writing, approved by the County and
signed by each Party's authorized representatives.
E. INDEMNIFICATION
The SUBRECIPIENT shall protect, defend, reimburse, indemnify and hold the County, its
agents, its employees and elected officers harmless from and against any and all claims,
liability, expense, loss, cost, damages or causes of action of every kind or character, including
attorney's fees and costs, whether at trial or appellate levels or otherwise, arising during the
performance of the terms of this Agreement, or due to the acts or omissions of the
SUBRECIPIENT.
SUBRECIPIENT's aforesaid indemnity and hold harmless obligation, or portion or
SHELTER FOR ABUSED WOMEN & CHILDREN
Page 6 of27
j 8 L
applications thereof, shall apply to the fullest extent permitted by law. The SUBRECIPIENT
will hold the County harmless and will indemnify the County for funds, which the County is
obligated to refund the Federal Government arising out of the conduct of activities and
administration of SUBRECIPIENT.
F. GRANTEE RECOGNITION
All facilities purchased or constructed pursuant to this Agreement shall be clearly identified as
to funding source. The SUBRECIPIENT will include a reference to the financial support
herein provided by the Housing and Grants Section in all publications and publicity. In
addition, the SUB RECIPIENT will make a good faith effort to recognize the Housing and
Grants Section support for all activities made possible with funds made available under this
Agreement.
G. TERMINATION
In event of termination for any of the following reasons, all finished or unfinished documents,
data studies, surveys, drawings, maps, models, photographs, reports prepared, and capital
equipment secured by the SUBRECIPIENT with funds under this Agreement shall be
returned to the Housing and Grants Section or the County. In the event of termination, the
SUBRECIPIENT shall not be relieved of liability to the County for damages sustained by the
County by virtue of any breach of the Contract by the SUBRECIPIENT, and the County may
withhold any payment to the SUBRECIPIENT for set-off purposes until such time as the
exact amount of damages due to the County from the SUBRECIPIENT is determined.
1. TERMINATION FOR CAUSE
If through any cause either party shall fail to fulfill in timely and proper manner its
obligations under this Agreement, or if either party shall violate any of the covenants,
agreements, or stipulations of this Agreement, either party shall thereupon have the right to
terminate this Agreement in whole or part by giving written notice of such termination to the
other party and specifying therein the effective date of termination.
2. TERMINATION FOR CONVENIENCE
At any time during the term of this Agreement, either party may, at its option and for any
reason, terminate this Agreement upon ten (10) working days written notice to the other
party. Upon termination, the County shall pay the SUBRECIPIENT for services rendered
pursuant to this Agreement through and including the date of termination.
3. TERMINATION DUE TO CESSATION
In the event the grant to the County under Title I of the Housing and Community
Development Act of 1974 (as amended) is suspended or terminated, this Agreement shall be
suspended or terminated effective on the date that HUD specifies.
H. INSURANCE
SHELTER FOR ABUSED WOMEN & CHILDREN
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8D
The SUBRECIPIENT agrees this coverage shall be provided on a primary basis.
1. COMMERCIAL GENERAL LIABILITY
The SUBRECIPIENT shall agree to maintain Commercial General Liability at a limit of
liability not less than $100,000 per person and $200,000 per accident/occurrence per Florida
Statutes S 768.28 and $2,000,000 per accident for federal and outside Florida litigation per
Florida Statutes S 768.28. Coverage shall not contain any endorsement excluding Contractual
Liability or Cross Liability unless granted by the County's Risk Management Department.
The SUBRECIPIENT agrees this coverage shall be provided on a primary basis.
2. BUSINESS AUTOMOBILE LIABILITY
The SUBRECIPIENT shall agree to maintain Business Automobile Liability at a limit of
liability not less than $100,000 per person and $200,000 per accident/occurrence per Florida
Statutes S 768.28 and $2,000,000 per accident for federal and outside Florida litigation per
Florida Statutes S 768.28 for all owned, non-owned and hired automobiles. The
SUBRECIPIENT shall agree to maintain physical damage coverage for a period not less than
10 years with deductibles not exceeding $1000 for Comprehensive and Collision. Collier
County Board of County Commissioners shall be endorsed to the policy as a Loss Payee. The
SUBRECIPIENT shall agree to be fully responsible for any deductibles, self-insured
retention or uncovered losses. The SUB RECIPIENT agrees this coverage shall be provided
on a primary basis.
3. ADDITIONAL INSURED
The SUBRECIPIENT shall agree to endorse the County as an Additional Insured with a CG
2026 Additional Insured - Designated Person or Organization endorsement, or its equivalent,
to the Commercial General Liability. The Additional Insured endorsement shall read "Collier
Countv Board of County Commissioners. a Political Subdivision of the State of Florida. its
Officers. Employees. and Agents. c/o Operations Support and Housing Section". The
SUBRECIPIENT shall agree the Additional Insured endorsements provide coverage on a
primary basis.
4. CERTIFICATE OF INSURANCE
The SUBRECIPIENT shall agree to deliver to the County a certificate(s) of insurance
evidencing the required insurance is in full force and effect within thirty (30) calendar days
prior to the execution of this Agreement by the County. A minimum thirty (30) day endeavor
to notify due to cancellation or non-renewal of coverage shall be included on the
certificate( s).
5. RIGHT TO REVIEW AND ADJUST
The SUBRECIPIENT agrees that the County, by and through its Purchasing or Risk
Management Department, in cooperation with the Housing and Grants Section reserves the
SHELTER FOR ABUSED WOMEN & CHILDREN
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D
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right to periodically review, modify, reject or accept any required policies of insurance,
including limits, coverage's, or endorsements, herein from time to time throughout the life of
this Agreement. The County reserves the right, but not the obligation, to review and reject
any insurer providing coverage because of its poor financial condition or failure to operate
legally.
1. INDEPENDENT AGENT AND EMPLOYEES
The SUBRECIPIENT agrees that, in all matters relating to this Agreement, it will be acting as
an independent agent and that its employees are not Collier County employees and are not
subject to the County provisions of the law applicable to County employees relative to
employment, hours of work, rates of compensation, leave, unemployment compensation and
employee benefits.
VIII. ADMINISTRATIVE REQUIREMENTS
A. FINANCIAL MANAGEMENT
The SUBRECIPIENT agrees to comply with OMB Circular A-II 0 (Uniform Administrative
Requirements for Grants and Agreements with Institutions of Higher Education, Hospitals
and other Non-Profit Organizations) and agrees to adhere to the accounting principles and
procedures required therein, utilize adequate internal controls, and maintain necessary source
documentation for all costs incurred.
B. DOCUMENTATION AND RECORD-KEEPING
1. The SUBRECIPIENT shall maintain all records required by the ESG Regulations.
2. All reports, plans, surveys, information, documents, maps, and other data procedures
developed, prepared, assembled, or completed by the SUBRECIPIENT for the
purpose of this Agreement shall be made available to the County by the
SUBRECIPIENT at any time upon request by the County or the Housing and Grants
Section. Upon completion of all work contemplated under this Agreement copies of all
documents and records relating to this Agreement shall be surrendered to the Housing
and Grants Department if requested. In any event the SUBRECIPIENT shall keep all
documents and records for three (3) years after expiration of this Agreement.
3. The SUBRECIPIENT shall submit reports as required to assist the COUNTY in the
preparation of HUD Labor Relations, WBE/MBE, Equal Opportunity Employment,
and HUD Section 3 reports, pursuant to 24 CFR 570.502, 507, and 92 (3)(vi).
4. SUBRECIPIENT shall submit monthly beneficiary reports to the Housing and Grants
Section using Exhibit "C".
5. The SUBRECIPIENT shall maintain records showing compliance with the Davis-
Bacon Law, including files containing contractor payrolls, employee interviews,
Davis-Bacon wage rates, and administrative cross-referencing. SUBRECIPIENT shall
SHELTER FOR ABUSED WOMEN & CHILDREN
Page 9 of 27
8D
maintain records showing contractor compliance with the Contract Work Hours and
Work Safety Law. Similarly, the SUBRECIPIENT shall maintain records showing
compliance with federal purchasing requirements and with other federal requirements
for grant implementation.
C. PURCHASING
All purchasing for services and goods, including capital equipment, shall be made by
purchase order or by a written contract and in conformity with the procedures prescribed by
the Federal Management Circulars A-llO, A-122, 24 CFR Part 84, and 24 CFR Part 85,
which are incorporated herein by reference.
D. REPORTS. AUDITS. AND EVALUATIONS
Reimbursement will be contingent on the timely receipt of complete and accurate reports
required by this Agreement, and on the resolution of monitoring or audit findings identified
pursuant to this Agreement.
E. ADDITIONAL HOUSING AND GRANTS SECTION. COUNTY. AND HUD
REQUIREMENTS
The Housing and Grants Section shall have the right under this Agreement to suspend or
terminate reimbursement until the SUBRECIPIENT complies with any additional conditions
that may be imposed by the Housing and Grants Section, the County, or HUD at any time.
F. PRIOR WRITTEN APPROVALS-SUMMARY
The following activities require the prior written approval of the Housing and Grants Section
or designee in order to be eligible for reimbursement.
(a) All subcontracts and agreements proposed to be entered into by the SUBRECIPIENT
pursuant to this Agreement;
(b) All capital equipment expenditures of $1 ,000 or more;
( c) All change orders; and
(d) All requests to utilize uncommitted funds after the expiration of this agreement for
programs described in Exhibit A, and
( e) All rates of pay and pay increases paid out of ESG funds, whether for merit or cost of
living.
G. AUDITS AND INSPECTIONS
At any time during normal business hours and as often as the Housing and Grants Section, the
County, HUD, or the Comptroller General of the United States may deem necessary, there
shall be made available by the SUBRECIPIENT to Housing and Grants Section, the County,
HUD, or the Comptroller General for examination all its records with respect to all matters
covered by this Agreement.
SHELTER FOR ABUSED WOMEN & CHILDREN
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8 D f':
The SUBRECIPIENT agrees to comply with the provisions of the Single Audit Act of 1984,
as amended, as it pertains to this Agreement and any subcontracts entered into under this
Agreement. This will require the SUBRECIPIENT to submit a single audit, including any
management letter, made in accordance with the general program requirements of OMB
Circulars A-II0 (Uniform Administrative Requirement for Federal Grants), A-122 (Cost
Principles for Non-Profit Organizations), A-B3 (Audits of State, Local Governments, and
Non-Profit Organizations), and other applicable regulations within one hundred and eighty
(180) days after the end of any fiscal year covered by this agreement in which Federal funds
from all sources are expended. Said audit shall be made by a Certified Public Accountant of
the SUBRECIPIENT's choosing. The SUBRECIPIENT shall provide such audit to the
Housing and Grants Section. In the event the SUB RECIPIENT anticipates a delay in
producing such audit or audited financial statements, the SUBRECIPIENT shall request an
extension in advance of the deadline. The cost of said audit shall be borne by the
SUBRECIPIENT. In the event the SUBRECIPIENT is exempt from having an audit
conducted under A-B3 (Audits of State, Local Governments, and Non-Profit Organizations),
the County reserves the right to require submission of audited financial statements and/or to
conduct a "limited scope audit" of the SUBRECIPIENT as defined in A-B3. The County will
be responsible for providing technical assistance to the SUBRECIPIENT, as deemed
necessary by the County.
H. PROGRAM-GENERATED INCOME
All income earned by the SUB RECIPIENT from activities financed in whole or in part by
funds provided hereunder must be reported to the Housing and Grants Section. Such income
would include, but not be limited to, income from service fees, sale of commodities, and
rental or usage fees. The SUBRECIPIENT shall report its plan to utilize such income to the
Housing and Grants Section, and said plan shall require the prior written approval of the
Housing and Grants Section or designee. Accounting and disbursement of such income shall
comply with OMB Circular A-II0 (Uniform Administrative Requirement for Federal Grants)
and other applicable regulations incorporated herein by reference.
In addition to the foregoing, Program Income, as defined by 24 CFR 570.500(a) for ESG
funds may be retained by the Agency. Program Income shall be utilized to undertake
activities specified in "Exhibit A" of this Agreement, and all provisions of this Agreement
shall apply to stated activities. Any Program Income on hand at or received by the
SUBRECIPIENT or its sub-contractors after the expiration of this Agreement shall be
returned to the County no later than thirty (30) days after such expiration, subject to any
SUBRECIPIENT requests to utilize uncommitted funds.
1. GRANT CLOSEOUT PROCEDURES
SUBRECIPIENT obligation to the COUNTY shall not end until all closeout requirements are
completed. Activities during this closeout period shall include, but not limited to; making
final payments, disposing of program assets (including the return of all unused materials,
equipment, unspent cash advances, program income balances, and receivable accounts to the
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~.,..'.
c
COUNTY), and determining the custodianship of records.
IX. OTHER PROGRAM REOUIREMENTS
A. OPPORTUNITIES FOR RESIDENTS AND CIVIL RIGHTS COMPLIANCE
The SUBRECIPIENT agrees that no person shall on the ground of race, color, disability,
national origin, religion, age, familial status, or sex be excluded from the benefits of, or be
subjected to, discrimination under any activity carried out by the performance of this
Agreement. Upon receipt of evidence of such discrimination, the County shall have the right
to terminate this Agreement.
To the greatest extent feasible, lower-income residents of the project areas shall be given
opportunities for training and employment; and to the greatest feasible extent eligible business
concerns located in or owned in substantial part by persons residing in the project areas shall
be awarded contracts in connection with the project. The SUBRECIPIENT shall comply with
the Section 3 Clause of the Housing and Community Development Act of 1968.
B. OPPORTUNITIES FOR SMALL AND MINORITY/WOMEN-OWNED BUSINESS
ENTERPRISES
In the procurement of supplies, equipment, construction, or services to implement this
Agreement, the SUBRECIPIENT shall make a positive effort to utilize small business and
minority/women-owned business enterprises of supplies and services, and provide these
sources the maximum feasible opportunity to compete for contracts to be performed pursuant
to this Agreement. To the maximum extent feasible these small business and
minority/women- owned business enterprises shall be located in or owned by residents of the
ESG areas designated by Collier County in the Annual Consolidated Plan approved by HUD.
C. PROGRAM BENEFICIARIES
At least fifty-one percent (51%) of the beneficiaries of a project funded through this
Agreement must be low- and moderate- income persons. If the project is located in an
entitlement city, as defined by HUD, or serves beneficiaries countywide, more than thirty
percent (30%) of the beneficiaries directly assisted through the use of funds under this
Agreement must reside in unincorporated Collier County or in municipalities participating in
the County's Urban County Qualification Program. The project funded under this Agreement
shall assist beneficiaries as defined above for the time period designated in Exhibit A of this
Agreement. The SUBRECIPIENT shall provide written verification of compliance to the
Housing and Grants Section upon the Housing and Grants Section's request.
D. EVALUATION AND MONITORING
The SUBRECIPIENT agrees that the Housing and Grants Section will carry out periodic
monitoring and evaluation activities as determined necessary by the Housing and Grant
Section or the County and that the continuation of this Agreement is dependent upon
satisfactory evaluation conclusions based on the terms of this Agreement, comparisons of
planned versus actual progress relating to project scheduling, budgets, audit reports, and
SHELTER FOR ABUSED WOMEN & CHILDREN
Page 12 of27
8
-,
j
output measures. The SUBRECIPIENT agrees to furnish upon request to the Housing and
Grants Section, the County or the County's designees and make copies or transcriptions of
such records and information, as is determined necessary by Housing and Grants Section or
the County. The SUBRECIPIENT shall, upon the request of the Housing and Grants Section,
submit information and status reports required by the Housing and Grants Section, the County
or HUD on forms approved by the Housing and Grants Section to enable the Housing and
Grants Section to evaluate said progress and to allow for completion of reports required of the
Housing and Grants Section by HUD. The SUBRECIPIENT shall allow the Housing and
Grants Section or HUD to monitor the SUBRECIPIENT on site. Such site visits may be
scheduled or unscheduled as determined by the Housing and Grants Section or HUD.
E. CONFLICT OF INTEREST
The SUBRECIPIENT covenants that no person who presently exercises any functions or
responsibilities in connection with the Project, has any personal financial interest, direct or
indirect, in the target areas or any parcels therein, which would conflict in any manner or
degree with the performance of this Agreement and that no person having any conflict of
interest shall be employed by or subcontracted by the SUBRECIPIENT. Any possible conflict
of interest on the part of the SUBRECIPIENT or its employees shall be disclosed in writing to
the Housing and Grants Section 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 of and participation of low and moderate-income
residents of the project target area.
F. PUBLIC ENTITY CRIMES
As provided in F.S. 287.133 by entering into this Agreement or performing any work in
furtherance hereof, the SUBRECIPIENT 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 F.S. 287.133 (3) (a).
G. DRUG-FREE WORKPLACE REQUIREMENTS
The SUBRECIPIENT, as a condition of being awarded, must certify that they will provide
drug-free workplaces in accordance with the Drug-Free Workplace Act of 1988 (42 U.S.C.
701) and with HUD's rules at 24 CFR Part 24, subpart F.
H. CERTIFICATION REGARDING LOBBYING
The undersigned certifies, to the best of his or her knowledge and belief, that:
1. No Federal appropriated funds have been paid or will be paid, by or on behalf of the
undersigned, to any person for influencing or attempting to influence an officer or
employee of any agency, a Member of Congress, an officer or employee of Congress,
or an employee of a Member of Congress in connection with the awarding of any
Federal contract, the making of any Federal grant, the making of any Federal loan, the
SHELTER FOR ABUSED WOMEN & CHILDREN
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8D
.
;,t
entering into of any cooperative agreement, and the extension, continuation, renewal,
amendment, or modification of any Federal contract, grant, loan, or cooperative
agreement.
2. If any funds other than Federal appropriated funds have been paid or will be paid to
any person for influencing or attempting to influence an officer or employee of any
agency, a Member of Congress, an officer or employee of Congress, or an employee
of a Member of Congress in connection with this Federal contract, grant, loan, or
cooperative agreement, the undersigned shall complete and submit Standard Form-
LLL, "Disclosure Form to Report Lobbying", in accordance with its instructions.
3. The undersigned shall require that the language of this certification be included in the
award documents for all subawards at all tiers (including subcontracts, subgrants, and
contracts under grants, loans, and cooperative Agreements) and that all
SUBRECIPIENTS shall certify and disclose accordingly.
1. REAL PROPERTY
Any real property acquired by the SUB RECIPIENT for the purpose of carrying on the
projects stated herein, and approved by the COUNTY in accordance with the Uniform
Relocation Assistance and Real Property Acquisition Policies Act of 1970 and 49 CFR
24.101, shall be subject to the provisions of the ESG Regulations including, but not limited to,
the provisions on use and disposition of property. Any real property within the
SUBRECIPIENT control, which is acquired or improved in whole or part with ESG funds
must adhere to the ESG Regulations at 24 CFR 570.505.
x. ENVIRONMENTAL CONDITIONS
A. AIR AND WATER
The SUBRECIPIENT, as Subrecipient, agrees to comply with the following requirements
insofar as they apply to the performance of the Contract:
1. Clean Air Act, 41 U.S.C., 7401, et seq.
2. Federal Water Pollution Control Act, as amended, 33 U.S.C. 1251, et seq., as
amended, 1318 relating to inspection, monitoring, entry, reports, and
information, as well as other requirements specified in said Section 114 and
Section 308 (EPA) regulations pursuant to 40 C.F.R., Part 50, as amended.
B. FLOOD DISASTER PROTECTION
In accordance with the requirements of the Flood Disaster Protection Act of 1973 (42 USC
4001), the Subrecipient shall assure that for activities located in an area identified by 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). If appropriate, a letter of map amendment
(LOMA) may be obtained from FEMA, which would satisfy this requirement and/or reduce
the cost of said flood insurance.
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8D
C. LEAD-BASED PAINT
The Subrecipient agrees that any construction or rehabilitation of residential structures with
assistance provided under this contract shall be subject to HUD Lead-Based Paint Regulations
at 24 CFR 570.608, 24 CFR Part 25 and 24 CFR part 92.355. Such regulations pertain to all
HUD-assisted housing and require that all owners, prospective owners, and tenants of
properties constructed prior to 1978 be properly notified that such properties may include
lead-based paint. Such notification shall point out the hazards of lead-based paint and explain
the symptoms, treatment and precautions that should be taken when dealing with lead-based
paint poisoning and the advisability and availability of blood lead level screening for children
under seven. The notice should also point out that if lead-based paint is found on the
property, abatement measures might be undertaken.
D. HISTORIC PRESERVATION
The Subrecipient agrees to comply with the Historic Preservation requirements set forth in the
National Historic Preservation Act of 1966, as amended (16 U.S.c. 470) and the procedures
set forth in 36 CFR, Part 800, Advisory Council on Historic Preservation Procedures for
Protection of Historical Properties, insofar as they apply to the performance of the Contract.
In general, concurrence from the State Historic Preservation Officer is required for all
rehabilitation and demolition of historic properties that are fifty years old or older or that are
included, on a Federal, state, or local historic property list.
XI. SEVERABILITY OF PROVISIONS
If any provision of this Agreement is held invalid, the remainder of this Agreement shall not be
affected thereby if such remainder would then continue to conform to the terms and requirements of
applicable law.
XII. REVERSION OF ASSETS
Upon expiration of the Agreement, the SUBRECIPIENT shall transfer to the COUNTY any ESG
funds on hand at the time of expiration, any accounts receivable attributable to the use of ESG funds,
and any non-expendable personal property that was purchased with ESG funds. Any real property
under SUBRECIPIENT control that was acquired or improved in whole or in part with ESG funds
will be covered by the regulations 24 CFR Part 570.503(B)(8).
XIII. CONDITIONS FOR RELIGIOUS ORGANIZATIONS
ESG funds may not be used for religious activities or provided to primarily religious organizations.
24 CFR 570.2000) specifies the limitations on ESG funds, and is herein incorporated by reference.
XIV. COUNTERPARTS OF THE AGREEMENT
This Agreement, consisting of twenty-six (26) enumerated pages, which include the exhibits
referenced herein, shall be executed in two (2) counterparts, each of which shall be deemed to be an
SHELTER FOR ABUSED WOMEN & CHILDREN
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original, and such counterparts will constitute one and the same instrument.
8D
XV. ENTIRE UNDERSTANDING
This Agreement and its provisions merge any prior agreements, if any, between the parties hereto
and constitutes the entire understanding. The parties hereby acknowledge that there have been and
are no representations, warranties, covenants, or undertakings other than those expressly set forth
herein.
WITNESS our Hands and Seals on this /d day of ~t
.20 07
SHELTER FOR ABUSED WOMEN & CHILDREN
(SUBRECIPIENT SEAL)
Optional
BY:
~
C TINO, CHIEF EXECUTIVE OFFICER
EL TE FOR ABUSED WOMEN & CHILDREN
BY:
Item# ~
SHELTER FOR ABUSED WOMEN & CHILDREN
Page 16 of27
8D
EXHIBIT "A"
SCOPE OF SERVICES
SHELTER FOR ABUSED WOMENT & CHILDREN
THE SUBRECIPIENT AGREES TO:
A. PROFESSIONAL SERVICES:
The procurement process of the consultant shall also incorporate any sub-consultants, which shall be
funded as reimbursable under the consultant's contract for services. Reimbursement for sub-
consultants shall be at cost. Such sub-consultants may include surveyors, testing services, or others as
deemed necessary for the nature of the project. Funds will be used for security and maintenance.
B. PROJECT SCOPE:
NARRATIVE OF WORK PLAN
The purpose of the activities pursuant to this Agreement is to provide assistance for Essential Services,
operational costs, and administration cost to benefit the emergency shelter clients at-risk of becoming
homeless.
NOTE 1: The SUBRECIPIENT shall submit its bid package and drawings/specifications to the
Housing and Grants Department and obtain a letter of approval prior to bidding the construction work.
NOTE 2: The SUBRECIPIENT shall prioritize the work in the Project, and shall bid such work in a
manner that would allow the receipt of itemized costs from bidders, which would then allow the award
of items that can be funded by the budget.
NOTE 3: The SUBRECIPIENT shall not award the construction contract for the Project until
sufficient funding is available to complete the established scope of work. All construction work shall
be included in one contract. The SUBRECIPIENT shall obtain the Housing and Grants Section
approval prior to awarding the construction contract to be funded through this agreement. After
awarding such contract the SUBRECIPIENT shall obtain the Housing and Grants Section's approval
prior to executing any change orders to such contract.
NOTE 4: The SUBRECIPIENT shall not request reimbursement from the Housing and Grants Section
for materials or equipment received and stored on the project site or elsewhere. The SUBRECIPIENT
shall only request reimbursement for materials and equipment that have been installed.
NOTE 5: The SUBRECIPIENT shall submit documentation showing the match funds that will be
provided along with ESG funds.
The SUBRECIPIENT further agrees that the Housing and Grants Section in consultation with any
parties the Housing and Grants Section deems necessary, shall be the final arbiter on the
SUBRECIPIENT's compliance with the above.
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8D J
c.
BUDGET:
Line Item:
ESG Funds
$96,119.00
Other
$96,119.00
Cleaning Service of Shelter, 100%
Maint & Sec Coordinator & benefits, 50%
Sonitol Security monitoring & maint, 100%
Fire System monitoring & maint, 100%
Fyr Fighter Kitchen Hood Ins&maint
Utilities,electric, H20,sewer,garbage, phone, 50%
Insurance, 50%
Shelter maintenance, electrician, plumber, carpet,
Furniture cleaning, floor polishing, duct & vent
Cleaning, window cleaning etc, 100%
$10,080.00
$10,100.00
$ 5,500.00
$ 1,375.00
$ 450.00
$17,500.00
$11,000.00
$40,1 14.00
TOTAL GRANT AMOUNT
$96,119.00
+
$96,119.00
Total Budget
$192,238.00
Any indirect costs charged must be consistent with the conditions of this Agreement. If indirect costs
are charged, the SUBRECIPIENT, as Subrecipient, will develop an indirect cost allocation plan for
determining the appropriate Subrecipient's share of administrative costs and shall submit such plan to
the Housing and Grants Section, on behalf of the County, as the Grantee, for the Housing and Grants
Section's approval, in a form specified by the Housing and Grants Section.
D. STAFFING: Provide list of staff and time commitments to be allocated to each activity specified in B
(Project Scope) and C (Budget) above, if applicable.
E. ASBESTOS REQUIREMENTS: The SUBRECIPIENT shall comply, and ensure its subcontractors'
compliance, with all applicable requirements for construction work in connection with the Project
funded through this Agreement.
F. DAVIS-BACON ACT: The SUBRECIPIENT shall request the County to obtain a Davis-Bacon wage
decision for the project prior to advertising the construction work. The SUBRECIPIENT shall
incorporate a copy of the Davis-Bacon wage decision and disclose the requirements of the Davis-
Bacon Act in its construction bid solicitation and sub-contract(s).
G. BONDING REQUIREMENTS: The SUBRECIPIENT shall comply with the requirements of OMB
Circular A-lIO (Uniform Administrative Requirement for Federal Grants) and 24 CFR Part 84 in
regard to any bid guarantees, performance bonds, and payment bonds.
H. CONSTRUCTION PAYMENT RET AINAGE: The SUBRECIPIENT shall apply a retainage of at
least 5% on all construction draws which retainages shall be released in conjunction with the final
draw upon satisfactory completion of the Project. The SUBRECIPIENT agrees not to release such
retainages until it has obtained approval from the County that the contractor and subcontractors have
SHELTER FOR ABUSED WOMEN & CHILDREN
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80
complied with the requirements of the Davis-Bacon Act.
1. FORMER PROJECTS: Failure to adequately maintain any former ESG funded project may result in
the delay of processing reimbursement requests for ongoing activities or in the forfeiture of future ESG
funds.
J. WORK SCHEDULE: The time frame for completion of the outlined activities shall be December 31,
2007.
Fifty percent (50%) ofthe funding must be expended by March 31,2007
One hundred percent (100%) ofthe funding must be expended by June 15,2007
Please note that if any of these activities exceed the timeline by two months a revised work schedule
must be submitted to the Housing and Grants Sections.
K. REPORTS: The SUBRECIPIENT shall submit detailed monthly progress reports to the Housing and
Grants Section outlining the status of specific activities under the project. Each report must account for
the total activity for which the SUBRECIPIENT is reimbursed with ESG funds, in part or in whole,
and which is required in fulfillment of their obligations regarding the Project. The progress reports
shall be submitted on the form "Exhibit C" which is due by the 1 oth of the following month. The
progress reports shall be used as an additional basis for the Housing and Grants Section's approval of
invoices, etc. for reimbursement.
*Please note that the provisions of the Davis Bacon Act (40 US.c. 276a-276a-5) do not apply to the ESG program.
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8D
4
1
EXHIBIT "B"
SHEL TER FOR ABUSED WOMEN & CHILDREN
REQUEST FOR PAYMENT
SECTION I: REQUEST
Subrecipient Name: SHELTER FOR ABUSED WOMEN & CHILDREN
Subrecipient Address: P.O. BOX 10102 Naples. FL 34101
Project Name: SHELTER FOR ABUSED WOMEN & CHILDREN
Project No: Payment Request #
Dollar Amount Requested: $
SECTION II: STATUS OF FUNDS
1. Grant Amount Awarded
$
96.119 .00
2. Sum of Past Claims Paid on this Account
$
3. Total Grant Amount Awarded Less Sum
Of Past Claims Paid on this Account
$
4. Amount of Previous Unpaid Requests
$
5. Amount ofToday's Request
$
6. Current Grant Balance (Initial Grant
Amount Awarded Less Sum of all
Requests)
$
7. If applicable amount held as retainage to
date by the County, if not retained by
the sub-recipient.
$
I certify that this request for payment has been drawn in accordance with the terms and conditions of the
Agreement between the County and us as the Sub-recipient. I also certify that the amount of the Request for
Payment is not in excess of current needs.
Signature
Date
Title
Authorizing Grant Coordinator
Supervisor
Director
(Signature needed if request is over $15,000.00)
SHELTER FOR ABUSED WOMEN & CHILDREN
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8D
ESG MONTHLY PROGRESS REPORT
Complete form for past month and submit to Housing and Grants Section staff by the 1 (jh of
the following month.
Status Report for Month of
Submittal Date:
Project Name
Project Number Activity Number
Subrecipient: SHELTER FOR ABUSED WOMEN & CHILDREN
Contact Person Marci Sanders
Telephone: 280-1350
Fax: 775-3061
E-mail:
msanders@naplesshelter.org
1. Activity Status/Milestones (describe any action taken, relating to this project,
during the past month):
2. What events/actions are scheduled for the next two months?
3. Describe any affirmative marketing you have implemented regarding this
project. Please list and attach any recent media coverage of your
organization relating to this project.
4. List any additional data relevant to the outcome measures listed on the
application for this project.
SHELTER FOR ABUSED WOMEN & CHILDREN
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8D
5. New contracts executed this month (if applicable):
Name of Contractor or Amount of Contractor Race Ethnicity
Subcontractor, Address & Phone Contract Federal ID (see (see
Number Number definitions defmitions
on page 3) on page 3)
6. For projects that serve a particular clientele, please complete the following
information by entering the appropriate number in the blank spaces and in the
chart below. Complete the below chart for NEW clients served this month.
DO NOT DUPLICATE clients served in previous months. You may provide
data by either households or persons served. However, if one person received
TWO services this counts as TWO SERVICE UNITS:
TOTAL BENEFICIARIES
This project benefits households or persons. Please circle one category
(either "households" or "persons"). Enter the number of beneficiaries in the blank space
and in box "1."
INCOME
Of the households or persons assisted, are extremely low-income income (0-
30%) of the current Median Family Income (MFI). Enter this number in box "2. "
Of the households or persons assisted, are very low-income (31-50%) of the
current Median Family Income (MFI). Enter this number in box "3. "
Of these households or persons assisted, are low income (51-80%) of the
current Median Family Income (MFI). Enter this number in box "4. "
NOTE: The total of boxes 2, 3 and 4 should equal the number in box 1.
SHELTER FOR ABUSED WOMEN & CHILDREN
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8D
FEMALE HEAD OF HOUSEHOLD
This project assisted Female Head of Households REGARDLESS of income.
Enter this number in box "5" below.
BOX I BOX 2 BOX 3 BOX 4 BOX 5
Total Number of Extremely Very Low Income Female Head of
Households or Persons Low Income Low Income (51-80%) Household
Assisted (0-30%) (31-50%)
ESG ProJ!ram Services
HOUSING AND SERflC~SAC~O~
Indicalte Pro2ram(s) and Service(s) with an "X"
Emergency Shelter Facilities
Vouchers For Shelters
Drop in Center
Food Pantry
Mental Health
Alcohol/Drug Program
Child Care
Transitional Housing
Outreach
Soup Kitchen/Meal Distribution
Health Care
HIV / AIDS Services
Employment
Homeless Prevention
Other *
*If yOU chose OTHER. type a description of the services (25 Characters)
SHELTER FOR ABUSED WOMEN & CHILDREN
Page 23 of 27
80
BENEFll;IARY(10UNT ESTIMATES:
Residential. Services . #. Total
.. .
AVERAGE NUMBER SERVED DAILY ADULTS -If shelter
provides overnight accommodations type in an estimate of the
average number of adults served daily.
AVERAGE NUMBER SERVED DAILY CHll,naRN- If shelter
provides overnight accommodations type in an estimate of the
average number of children served daily.
AVERAGE NUMBER SERVED YEARLY-If shelter provides
overnight accommodations type the average number of persons
served yearly. Base number on the persons served, not number of
visits.
Non-Residential Services # Total
AVERAGE NUMBER SERVED DAILY ADULTS -If your shelter
does not have overnight accommodations, type the average count of
non-resident persons served daily. If a person is served more than
once daily, include each visit in the count.
Subrecipient must indicate total beneficiaries for Race AND Ethnicitv
Definitions of Race:
1. White: A person having origins in any of the original peoples of Europe, the
Middle East, or North Africa.
2. Black or African-American: A person having origins in any of the black racial
groups of Africa. Asian: A person having origins in any of the original
peoples of the Far East, Southeast Asia, or the Indian subcontinent including,
for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the
Philippine Islands, Thailand, and Vietnam.
3. American Indian or Alaska Native: A person having origins in any of the
original peoples of North and South America (including Central America),
and who maintains tribal affiliation or community attachment.
4. Native Hawaiian or Other Pacific Islander: A person having origins in any of
the original people of Hawaii, Guam, Samoa, or other Pacific Islands.
SHELTER FOR ABUSED WOMEN & CHILDREN
Page 24 of 27
8D
Definitions of Ethnicity:
1. Hispanic or Latino: A person of Cuban, Mexican, Puerto Rican, South or
Central American, or other Spanish culture or origin, regardless of race.
Tabulation Table of Race and Ethnicitv Beneficiaries
RACIALlETHNlC CHAJlACtIBJS~
On this table you approximate the racial and ethnic background of residential persons
only that are served by your facility. You must enter racial and ethnic characteristics for
the same "Average Number Served ~y" that you entered on the previous table.
Race # Total # Hispanic
White
Black or African American
Asian
American Indian or Alaskan Native
Native Hawaiian or Other Pacific Islander
American Indian! Alaska Native and White
Asian and White
Black! African American and White
American Indian! Alaskan Native and Black! African American
Other Multi-Racial
TOT AL:
ES
Residential Services
Unaccompanied 18 and over?
%Male
% Female
Unaccompanied Under 18?
Single 18 and Over- Single parent families with children headed by
an adult 18 and over?
!41_~
SHELTER FOR ABUSED WOMEN & CHILDREN
Page 25 of27
8u
. %
...
Youth 18 and under-Single parent families with children headed by a
youth 18 and under.
Two Parents 18 and over-Two parent families with children headed
bv adults over 18 years.
Two Darents under 18- Two parent families with children headed by
youths under the age of 18
What is vour estimate Dercenta!!e of the DODulation served bv vour
residential shelter on an avera!!e dav. which are families with no
children?
~~~:::.~ ....rsona served on
On An Avera2e day % of the PODulation served who are %
Battered Spouse
Runaway/Throwaway Youth
Chronically Mentally III
Developmentally Disabled
HIV / AIDS
Alcohol Dependent Individuals
Drug Dependent Individuals
Elderly
Veterans
Physically/ Disabled
Other
~c!:i~t:":~~f:~=~::~~~so:sc~:sed ~
How many persons were housed in: Total
Barracks
Group/Large House
Scattered Site Apartment
Single Family Detached House
Single Room Occupancy
Mobile Home/Trailer
HoteVMotel
Other
SHELTER FOR ABUSED WOMEN & CHILDREN
Page 26 of 27
ao
shelter t
es this activit
I
.
.
What is the (ioUarampllutoffuJ).dsexpendedfromthe Totalof$ .
fonowin~ sources?
Other Federal
Local Government
Private
Fees
Other
SHELTER FOR ABUSED WOMEN & CHILDREN
Page 27 of27