Backup Documents 01/14/2014 Item #16D 3 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP'. 1 J
•
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
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 after the Board has taken action on the item.)
ROUTING SLIP
Complete routing lines#1 through#4 as appropriate for additional signatures,dates,and/or information needed.If the document is already complete with the
exception of the Chairman's signature,draw a line through routing lines#I through#4,complete the checklist,and forward to Sue Filson(line#5).
Route to Addressee(s) Office Initials Date
(List in routing order)
1. Rosa Munoz, Grant Coordinator Housing,Human,Veterans Services RM 01/14/14
Department
2. Jennifer A. Belpedio,ACA Office located within Housing, Human,
Veterans Services Department (M.? 11 ,51m
3. County Attorney's Office County Attorney's Office
4. BCC Office Board of County Commissioners •
5. Minutes and Records Clerk of Court's Office (t t I(1'I1")"
PRIMARY CONTACT INFORMATION
(The primary contact is the holder of the original document pending BCC approval.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,including Sue Filson,need to contact staff for additional or missing
information.All original documents needing the CC Chairman's signature are to be delivered to the BCC office only after the BCC has acted to approve the
item.)
Name of Primary Staff Rosa Muno Grant Coordinator Phone Number 239-252-5713
Contact
Agenda Date Item was 01/14/14 Agenda Item Number .-C--P 6
Approved by the BCC \(o•D. 3
Type of Document Subrecipient Amendment -Community Number of Original 3 originals
Attached Assisted Supporting Living(CASL) Documents Attached
INSTRUCTIONS&CHECKLIST
Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is appropriate. Yes N/A(Not
(Initial Applicable)
1. Original document has been signed/initialed for legal sufficiency.(All documents to be signed by the RM
Chairman,with the exception of most letters,must be reviewed 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 possibly State
Officials.)
2. All handwritten strike-through and revisions have been initialed by the County Attorney's Office and N/A
all other parties except the BCC Chairman and the Clerk to the Board
3. The Chairman's signature line date has been entered as the date of BCC approval of the document or RM t/
the final negotiated contract date whichever is applicable.
4. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's signature and RM I/
initials are required.
5. In most cases(some contracts are an exception),the original document and this routing slip should be RM
provided to 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 your deadlines!
6. The document was approved by the BCC on 01/14/14 and all changes made during t RM n
meeting have been incorporated in the attached document. The County Attorney's Office as
reviewed the changes,if applicable.
I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05
«matter number»/«document_number»
16i 3
MEMORANDUM
Date: January 21, 2014
To: Rosa Munoz, Grants Coordinator
Housing, Human & Veteran Services
From: Martha Vergara, Deputy Clerk
Minutes & Records Department
Re: Subrecipient Amendment— Community Assisted Supporting Living
(CASL)
Attached are two (2) original of the document referenced above, (Agenda Item
#16D32) approved by the Board of County Commissioners on Tuesday, January 14,
2014.
An original has been kept in the Minutes and Records Department for the Board's
Official Record.
If you have any questions, please contact me at 252-7240.
Thank you.
Attachment
160 3 '' .1
. . . . 1I 11 - I 1
Grant#- M-03-M-08-UC-12-0017
I4 I : II
_Grant# - M-05-M-08-UC-12-0017
_Grant# - M-06-M-08-UC-12-0017
Grant# - M-07-M-08-UC-12-0017
Grant# - M-08-M-08-UC-12-0017
CFDA/CSFA#- 14.239
Subrecipient-CASL
DUNS #- 940621519
FETI #-65-0869993
FY End 12/31
Monitoring Deadline 9-30-2018
FIRST AMENDMENT TO AGREEMENT BETWEEN COLLIER COUNTY
AND
COMMUNITY ASSISTED AND SUPPORTIVE LIVING, INC.
(CASL)
This Amendment, is entered into this 14 day of a „ 2014, by and between
"RENAISSANCE Manor, Inc. d/b/a Community Assisted and supportive L ing, Inc." a private not-
for-profit corporation existing under the laws of the State of Florida, herein after referred to as
SUBRECIPIENT and Collier County, Florida, herein after to be referred to as "COUNTY,"
collectively stated as the "Parties."
RECITALS
WHEREAS, on October 8, 2013, the COUNTY entered into an Agreement with the HOME
Investment Partnerships (HOME) Program funds to be used for a Multi Family Property Acquisition
Project(hereinafter referred to as the "Agreement"); and
WHEREAS, the Parties desire to amend the Agreement to include language allowing direct
payment of eligible expenditures via Wire Transfer.
NOW, THEREFORE, in consideration of foregoing Recitals, and other good and valuable
consideration, the receipt and sufficiency of which is hereby mutually acknowledged, the Parties agree
to amend the Agreement as follows:
Words Struck-Threugh are deleted; Words Underlined are added
I. SCOPE OF SERVICES
CASL
(HM 13-02)
Multi Family Property Acquisition
Amendment#1 Page 1 of 4
CD
1f l 3
FY2003 - FY20098 Amended Action Plans and identified and approved the project to
Community Assisted & Supportive Living (CASL) for the following:
III. AGREEMENT AMOUNT
X
The following table details the project deliverables and payment schedule:
PAYMENT DELIVERABLES
Deliverable Payment-Deliverable Submission Schedule
Supporting Documents
Project Component One: Exhibit B with documentation including but At acquisition
Acquisition of Multi-Family not limited to HUD Settlement Statement(s),
Rental Housing Property and appraisal(s), closing documents, deed
associated costs restriction, note, mortgage and any additional
supporting documentation as needed.
Payment(s)may be made via Wire Transfer(s)
PROGRAM DELIVERABLES
Deliverable Program—Deliverable Supporting Submission Schedule
Documents
Income°' ib ' t Client files Maintained by
Creation and maintenance of SUBRECIPIENT and
income eligibility files on eligibility documentation
clients served submitted 60 days prior to
tenant occupancy
Eight(s-8) persons with Exhibit D Quarterly
special needs will benefit
from this funding and will be
low-and moderate- income
(LMI) presumed clientele
Progress Quarterly Report Exhibit D Quarterly
Insurance Certificate Is.1744 Annually
Proof of Insurance Insurance Certificate Within 30 days of renewal
Affirmative Plan Documents Within 30 days of contract
Action/Affirmative execution and/or as
Housing Marketing Plan modified
HQS Inspections Inspection Forms Annually
CASL
(HM 13-02)
Multi Family Property Acquisition
Amendment#1 Page 2 of 4
C—)
160 3
Tenant Leases Signed Leases 30 days prior to occupancy
Tenant Participation Plan Plan Document 60 days prior to leasing and
annually thereafter
Annual Audit Audit Report with Management Letter and 180 days after end of fiscal
Exhibit E year
HOME Match Documentation of rehabilitation expenditures Ongoing
Documentation and supportive services paid for from non-
federal sources
X * X
REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
SIGNATURE PAGE TO FOLLOW
CASL
(HM 13-02)
Multi Family Property Acquisition
Amendment#1 Page 3 of 4
Cq
1603 3
IN WITNESS WHEREOF,the Parties have each, respectively, by an authorized person or
agent, hereunder set their hands and seals on the date first written above.
ATTEST: BOARD OF COUNTY OMMISSIONERS OF COLLIER
DWIGHT. BROCK;CLERK COUNTY, F RID;' /
1P1 By i� 1
Af.0-1 as tO,Chairman'$D ut "erk Tom Henning
signature`o" Y. Chairman
Dated. 1
(SE L)
Community Assisted& Supported Living, Inc. (CASL).
By:
Su ecipient Signature
J. Scott Eller, CEO
Subrecipient Name and Title
Approved as to form and legality:
JenniA.pedi
Assistant County Attorney
•\\
CASL
(HM 13-02)
Multi Family Property Acquisition
Amendment#1 Page 4 of 4