Backup Documents 05/12/2015 Item #16D4 16134
COMMUNITY AND HUMAN SERIVCES
INTEROFFICE MEMORANDUM
TO: Board Minutes and Records
FROM: Lisa N. Carr, Grants Coordinator, CHS
DATE: May 22, 2015
RE: Community Care for the Elderly Amendment between Area Agency on Aging
for Southwest Florida, Inc and Collier County: CCE 203.14.003
Please find attached one (1) each fully executed documents that were approved by the BCC on
the day listed below for recording in Minutes and Records. Feel free to contact me if you have
any questions.
BCC Approved on May 12, 2015, Item: 16.D4
Recommendation to approve an after-the-fact Amendment and Attestation Statement with
Area Agency on Aging for Southwest Florida, Inc. for the Community Care for the Elderly
program and budget amendment to ensure continuous funding for FY 2014/2015.
Thank you for your assistance.
Amendment 003 July 2014 to June 2015 CCE 203.14.003
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA INC. 16134
COMMUNITY CARE FOR THE ELDERLY PROGRAM
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
THIS AMENDMENT is entered into between the Area Agency on Aging for Southwest Florida, Inc. ("Agency") and
Collier County Board of County Commissioners,("Contractor"), amends agreement CCE 203.14.
The purpose of this amendment is to increase the allocation by$25,000 and revise ATTACHMENT III and
ATTACHMENT VII,ANNUAL BUDGET SUMMARY.
Line denotes completion of above summary
This amendment shall be effective April 1, 2015. All provisions in the agreement and any attachments thereto in conflict
with this amendment shall be and are hereby changed to conform with this amendment
All provisions not in conflict with this amendment are still in effect and are to be performed at the level specified in the
agreement.
This amendment and all of its attachments are hereby made a part of this agreement.
IN WITNESS WHEREOF, the parties hereto have caused this 3 page amendment to be executed by their officials there
unto duly authorized.
Recipient: COLLIER COUNTY BOARD OF AREA AGENCY ON AGING FOR SOUTHWEST
COUNTY COMMISSIONERS FLORIDA,INC.
SIGNED BY: e 101; 1 C4 SIGNED B
NAME: Stephen Y. Carnell NAME: MARIANNE G LORINI
TITLE: Public Services Administrator TITLE: PRESIDENT/CEO
DATE: April 9, 2015
DATE: 5 �/ /�
Federal Tax ID: 59-6000558
Fiscal Year Ending Date: 09/30
Approved as to form add �lePty
1 '$tam Conn
ttorney
Amendment 003 July 2014 to June 2015 CI 203.6003
•
ATTACHMENT III
1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO
THIS CONTRACT CONSIST OF THE FOLLOWING:
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL FEDERAL AWARD
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES
AWARDED PURSUANT TO THIS CONTRACT ARE AS FOLLOWS: N/A
2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS
CONTRACT CONSIST OF THE FOLLOWING:
MATCHING RESOURCES FOR FEDERAL PROGRAMS
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
$0
STATE FINANCIAL ASSISTANCE SUBJECT TO Sec. 215.97,F.S.
PROGRAM TITLE FUNDING SOURCE CSFA AMOUNT
Community Care for the Elderly General Revenue -Collier 65010 $ 775,634.00
TOTAL AWARD $ 775,634.00
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED
PURSUANT TO THIS CONTRACT ARE AS FOLLOWS:
STATE FINANCIAL ASSISTANCE
Section 215.97,Fla. Stat.
Chapter 691-5,Fla. Admin.
Code
2
Amendment 003 2014 to June 2015 CCE 203.14.003
m July
16D4
ATTACHMENT VII
ISI
COMMUNITY CARE FOR THE ELDERLY PROGRAM
ANNUAL BUDGET SUMMARY
for
Collier County Board of County Commissioners
Collier
CCE Services Allocations $ 775,634.00
3
Revised August 2007
1 6 D 4
Attestation Statement
Agreement/Contract Number: CCE 203.14
Amendment Number 003
1, Stephen Y. Carnell ,attest that no changes or revisions have been made to the
(Recipient/Contractor representative)
content of the above referenced agreement/contract or amendment between the Area Agency on Aging for
Southwest Florida and
Public Services Administrator
(Recipient/Contractor name)
The only exception to this statement would be for changes in page formatting,due to the differences in
electronic data processing media,which has no affect on the agreement/contract content.
4-9-15
Signature of Recipient/Contractor representative Date
Approved as to form and legality
Assistant County cy
Revised August 2007