Backup Documents 10/13/2015 Item #16D 6 1606
COMMUNITY AND HUMAN SERIVCES
INTEROFFICE MEMORANDUM
TO: Board Minutes and Records
FROM: Lisa N. Carr, Grants Coordinator, CHS
DATE: October 14, 2015
RE: Area Agency on Aging for Southwest Florida,Inc amendments
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 October 13,2015; Item: 16.D.6
Recommendation to approve after-the-fact Amendments and Attestation Statements with Area
Agency on Aging for Southwest Florida.Inc.for the Community Care for the Elderly.Alzheimer's
Disease Initiative and Home Care for the Elderly programs and authorize Budget Amendments to
ensure continuous funding for FY 2014/2015.(Net Fiscal Impact$26.967.41)
BCC Approval on October 13,2015; Item: 16 D. 7
Recommendation to approve"after-the-fact"Amendments and Attestation Statements with Area
Agency on Aging for Southwest Florida.Inc.for the Community Care for the Elderly and Alzheimer's
Disease Initiative grant programs and budget amendments to ensure continuous funding for FY
2015/2016.
Thank you for your assistance.
Amendment 004 July 2014 to June 2015 ADI 203.14.004
1606
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC.
ALZHEIMER'S DISEASE INITIATIVE PROGRAM
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS,
This AMENDMENT,entered into between the Area Agency on Aging for Southwest Florida,hereinafter referred
to as the "Agency,"and Collier County Board of County Commissioners, hereinafter referred to as the"Contractor,"
amends contract ADI 203.14.
The purpose of this amendment is to amend 4. Contract Amount with the final allocation for the 2014-2015 contract
year,revise ATTACHMENT III and ATTACHMENT VIII,ANNUAL BUDGET SUMMARY.
Line denotes completion of above summary
4. Contract Amount:
The Agency agrees to pay for contracted services according to the terms and conditions of this contract in an amount
not to exceed$244,428.43,or the rate schedule, subject to the availability of funds. Any costs or services paid for
under any other contract or from any other source are not eligible for payment under this contract
This amendment shall be effective June 30,2015.
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,one page, is 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: fit/ `" , SIGNED BY: ‘726
NAME: Stephen Y. Carrell NAME: MARIANNE G LORINI
TITLE: Public Services Department Head TITLE: PRESIDENT/CEO
DATE: � ( — ( � DATE: /4-)f.f/l r—
Federal Tax ID: 59-6000558
Fiscal Year Ending Date: 09/30
Approved as to form and legality
1
Assistant Cn,,..,,, A a+nrneV
Cg)
Amendment 004 July 2014 to June 2015 ADI 203.14.004
ATT C N 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 CSF AMOUN
Alzheimer's Disease Initiative General Revenue/TSTF-Collier 65004 $ 244,428.43
TOTAL AWARD $ 244,428.43
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED
PURSUANT TO THIS CONTRACT ARE AS FOLLOWS:
STATE FINANCIAL ASSISTANCE
Section 215.97,Fla. Stat.
Chapter 69I-5, Fla.Admin.
Code
2
CD
Amendment 004 July 2014 to June 2015 ADI 203.14.004
1606
ATTACHMENT VIII
ALZHEIMER'S DISEASE INITIATIVE PROGRAM
ANNUAL BUDGET SUMMARY
For
Collier County Board of County Commissioners
Collier
ALLOCATION TOTAL $244,428.43
3
1606
Attestation Statement
Agreement/Contract Number ADI 203.14
Amendment Number 004
I, 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 Department Head
(Signature of 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.
•
41. I CIA41#1 15--
Signature of Recipien Contractor representative Date
Approved as to form and legality
Assistant County Attorney r
Amendment 004 July 2014 to June 2015 HCE 203.14.004
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC. 1 LI 6
HOME CARE FOR THE ELDERLY PROGRAM V
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
This AMENDMENT,entered into between the Area Agency on Aging for Southwest Florida, hereinafter referred to
as the "Agency,"and Collier County Board of County Commissioners, hereinafter referred to as the"Contractor,"
amends contract HCE 203.14.
The purpose of this amendment is to amend 4. Contract Amount with the final allocation for the 2014-2015 contract
year,revise ATTACHMENT III and ATTACHMENT VII,ANNUAL BUDGET SUMMARY.
Line denotes completion of above summary
4. Contract Amount:
The Agency agrees to pay for contracted services according to the terms and conditions of this contract in an amount
not to exceed$31,167.17, or the rate schedule, subject to the availability of funds. Any costs or services paid for
under any other contract or from any other source are not eligible for payment under this contract
This amendment shall be effective June 30,2015.
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,one page, is 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: '� I ; SIGNED BY: 32f AAA:a,
NAME: Stephen Y. Carrell NAME: MARIANNE G LORINI
TITLE: Public Services Department Head TITLE: PRESIDENT/CEO
DATE: q— ( 0 DATE: /6/51/5'
Federal Tax ID: 59-6000558
Fiscal Year Ending Date: 09/30
Approved as to form and legality
1 Assistant County Attorney SI
1'
�`
Amendment 004 July 2014 to June 2015 HCE 203.14.004
I !
1606
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
Home Care for the Elderly General Revenue—Collier 65001 $ 31,167.17
TOTAL AWARD $ 31,167.17
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED
PURSUANT TO THIS CONTRACT ARE AS FOLLOWS:
STATE FINANCIAL ASSISTANCE
Section 215.97,Fla. Stat.
Chapter 69I-5,Fla.Admin.
Code
2
Amendment 004 July 2014 to June 2015 HCE 203.14.004
1606
ATTACHMENT VII
HOME CARE FOR THE ELDERLY PROGRAM
BUDGET SUMMARY
Collier County Board of County Commissioners
Collier
HCE Case Management/Case Aide $ 2,536.07
HCE Basic and Special Subsidies 28,631.10
Total $ 31,167.17
RATE SUMMARY
Collier County Board of County Commissioners
Collier
SERVICES REIMBURSEMENT RATE
Collier
Case Management $60.00
Case Aide $33.88
3
1606
Attestation Statement
Agreement/Contract Number HCE 203.14
Amendment Number 004
I, Stephen Y. Carvell ,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 Department Head
(Signature of 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.
9A ' ' Ci'— (S-1s
Signature of Recipien /Contractor representative Date
Approved as to form and legality
Assistant County Attorney
c c ,\\S
Ameidment,005 July 2014 to June 2015 CCE 203.14.005
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC. 16 Li 6
COMMUNITY CARE FOR THE ELDERLY PROGRAM
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
This AMENDMENT,entered into between the Area Agency on Aging for Southwest Florida,hereinafter referred
to as the "Agency,"and Collier County Board of County Commissioners, hereinafter referred to as the"Contractor,"
amends contract CCE 203.14.
The purpose of this amendment is to amend 4. Contract Amount with the final allocation for the 2014-2015 contract
year,revise ATTACHMENT III and ATTACHMENT VII,ANNUAL BUDGET SUMMARY.
Line denotes completion of above summary
4. Contract Amount:
The Agency agrees to pay for contracted services according to the terms and conditions of this contract in an amount
not to exceed$792,887.81,or the rate schedule, subject to the availability of funds. Any costs or services paid for
under any other contract or from any other source are not eligible for payment under this contract
This amendment shall be effective June 30,2015.
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,one page, is 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 I' � � SIGNED BY: ALV(tliat, y11 ienx;w
NAME: Stephen Y. Carnell NAME: MARIANNE G LORINI
TITLE: Public Services Department Head TITLE: PRESIDENT/CEO
DATE: S ( (f5c- DATE: 10/61/.,
Federal Tax ID: 59-6000558
Fiscal Year Ending Date: 09/30
Approved as to form and legality
1 ��`�`�
Assistant County Attorney
(
Amendment-005 July 2014 to June 2015 CCE 203.14.005
161:16
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 $ 792,887.81
TOTAL AWARD $ 792,887.81
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
Amerdmen+005 July 2014 to June 2015 CCE 203.14.005
16 0 6
ATTACHMENT VII
COMMUNITY CARE FOR THE ELDERLY PROGRAM
ANNUAL BUDGET SUMMARY
for
Collier County Board of County Commissioners
Collier
CCE Services Allocations $ 792,887.81
3
Revised August 2007 160 6
Attestation Statement
Agreement/Contract Number: CCE 203.14
Amendment Number 005
I, 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 Department Head .
(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.
Signature of -ecipient/C ractor representative Date
Approved as to form and legality
Assistant County Attorney
\``�
Revised August 2007
r` '2)