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Backup Documents 05/13/2014 Item #16D20 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP THE BOARD ACCMPANY ALL ORIGINAL OF COUNTY COMMISSIONERS O DOCUMENTS ICE FOR SIG TO TURK 6 El 2 0 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#1 through#2 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#1 through#2,complete the checklist,and forward to the County Attorney Office. Route to Addressee(s) (List in routing order) Office Initials Date 1. Jennifer A. Belpedio, ACA County Attorney Office ' of 4,1A5114.. 2. BCC Office Board of County —Tgb Commissioners W / 6\7..4k'4 3. Minutes and Records Clerk of Court's Office PRIMARY CONTACT INFORMATION 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,may need to contact staff for additional or missing information. Name of Primary Staff Priscilla Doria,HHVS Phone Number 239-252-5312 Contact/ Department Agenda Date Item was May 13,2014 Agenda Item Number 16.D.20 Approved by the BCC VVVV Type of Document Second Amendment to Agreement between Number of Original 2 Attached Collier County and CASL Documents Attached PO number or account number if document is to be recorded INSTRUCTIONS & CHECKLIST 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? 2. Does the document need to be sent to another agency for additional signatures? If yes, NIA-I provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet. /v A 3. 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 reviewed and signed T• b. by the Office of the County Attorney. 4. All handwritten strike-through and revisions have been initialed by the County Attorney's NIA 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 document or the final negotiated contract date whichever is applicable. Po. 6.----"Sign here"tabs are placed on the appropriate pages indicating where the Chairman's signature and initials are required. OD 7. In most cases(some contracts are an exception),the original document and this routing slip 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 PD. time frame or the BCC's actions are nullified. Be aware of your deadlines! 8. The document was approved by the BCC on r/1 3 hi and all changes made during the meeting have been incorporated in(he attached document. The County Attorney's Office has reviewed the changes,if applicable. 9. Initials of attorney verifying that the attached document is the version approved by the BCC, all changes directed by the BCC have been made,and the document is ready for t Chairman's signature. 1:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05;Revised 11/30/12 16020 MEMORANDUM Date: June 27, 2014 To: Priscilla Doria, Grants Coordinator Housing, Human & Veteran Services From: Teresa Cannon, Deputy Clerk Minutes & Records Department Re: Amendment #2 to Agreement with Community Assisted and Supportive Living, Inc. (CASL) Attached is an original copy of the document referenced above, (Item #16D20) approved by the Board of County Commissioners on Tuesday, May 13, 2014. The second original amendment document will be held in the Minutes and Records Department for the Board's Official Record. If you have questions, please feel free to contact me at 252-8411. Thank you Attachment 16020 Grant# - M-03-M-08-UC-12-00217 Grant# - M-04-M-08-UC-12-00217 Grant# - M-05-114-08-UC-12-00217 Grant# - M-06-M-08-UC-12-00217 Grant# - M-07-M-08-UC-12-00217 Grant# - M-08-M-08-UC-12-00217 CFDA/CSFA#- 14.239 Subrecipient—CASL DUNS#- 940621519 IDIS #454 FETI#- 65-0869993 FY End 12/31 Monitoring Deadline 9-30-2018 SECOND AMENDMENT TO AGREEMENT BETWEEN COLLIER COUNTY AND COMMUNITY ASSISTED AND SUPPORTIVE LIVING, INC. (CASL) This Amendment, is entered into this /9411 day of 0 , 2014, by and between "RENAISSANCE Manor, Inc. d/b/a Community Assisted and Su portive Living, Inc." (CASL) 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 CASL allowing HOME Investment Partnerships (HOME) Program funds to be used for a Multi Family Property Acquisition Project(hereinafter referred to as the "Agreement"); and WHEREAS, on January 14, 2013, Item 16D10, the COUNTY approved the first amendment to this agreement; and WHEREAS,the Parties desire to amend the Agreement to include language consistent with the Collier County Consolidated Plan One-Year Action Plan and update department contact information. 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 Through are deleted; Words Underlined are added CASL(HM13-02) Multi Family Property Acquisition Amendment#2 Page 1 of 5 16020 SCOPE OF SERVICES * * * Project Component One: Fund building Aacquisition and environmental review of Multi- Family Rental Housing properties located at 3028 Santa Barbara Boulevard, Naples, FL in Section 28, township 49 South, Range 26 East, Collier County; the project will target eight (8) low and very low income adult individuals with disabilities. The project will consist of tiffit.s consist of four (4) 1,1415 square foot two bedroom market rate units with rents at the 2013 High Rent Limits for Collier County ($1,038). II. TIME OF PERFORMANCE Services of the SUBRECIPIENT shall start on the 8th day of October, 2013 and end on the 7th day of October, 2014 30th day of April, 2015. The term of this Agreement and the provisions herein may be extended by amendment to cover any additional time period during which the SUBRECIPIENT remains in control of HOME funds or other HOME assets, including program income III. AGREEMENT AMOUNT * * * The budget identified for the Property Acquisition Project shall be as follows: Line Item Description HOME Funds Project Component One: Acquisition of Multi-Family Rental $405,564.00 Housing Property and associated costs $404,064.00 Project Component Two: Environmental Review $1,500.00 TOTAL $ 405,564.00 * * * Words ruc k—Tit-Feu-0 are deleted; Words Underlined are added CASL(HM13-02) Multi Family Property Acquisition Amendment#2 Page 2 of 5 1620 The following table details the project payment deliverables and-payment-schedule: Deliverable Payment-Deliverable Submission Schedule Supporting Documents Project Component One: Exhibit B with documentation including At acquisition Acquisition of Multi- but not limited to HUD Settlement Family Rental Housing Statement(s), appraisal(s), closing Property and associated documents, deed restriction, note, costs mortgage and any additional supporting documentation as needed. Project Component Two; Supporting Documents: Canceled check, Upon successful Environmental Review bank statements, invoice, Exhibit B and clearance of any other additional supporting environmental by documentation certifying officer HOME Match Documentation of rehabilitation Qty Requirement - • - . . ... . - _ .. . for from non federal sources Income eligibility Client files Maintained-by SUBRECIPIENT and submitted 60 days prior Eight(s)persons with Exhibit D Quarterly special needs will benefit be low and moderate - clicntcle Exhibit D Quarterly Insurance Certificate N Annually Affirmative as modified 149S-Inspections Inspection Forms Annually Tenant Leases Signed Leases 30 days prior to occupancy Tenant Participation Plan Plan Document :! :: and annually thereafter Annual Audit • .-• ' -.. • - ' . --- - . - Exhibit E fiscal year Words Sk---T-11-Fough are deleted; Words Underlined are added CASL(HM13-02) Multi Family Property Acquisition Amendment#2 Page 3 of 5 CA 16020 The following details the program deliverables and schedule HOME Match Documentation of rehabilitation Quarterly as they occur Requirement expenditures and supportive services paid following acquisition for from non-federal sources Income eligibility Client files Maintained by SUBRECIPIENT and eligibility documentation submitted 60 days prior to tenant occupancy Eight(s)persons with Exhibit D Quarterly special needs will benefit from this funding and will be low- and moderate- income (LMI)presumed clientele Progress Report Exhibit D Quarterly Insurance Certificate N/A Annually Affirmative Plan Documents Within 30 days of Action/Marketing Plan contract execution and/or as modified HQS Inspections Inspection Forms Annually 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 Exhibit E fiscal year * * * IV. NOTICES COLLIER COUNTY ATTENTION: Rosa Munoz, Grant Coordinator 3339 E Tamiami Trail, Suite 211 Naples, Florida 31112 - ' a - 239 252 5713 ATTENTION: Priscilla Doria, Grant Coordinator 3339 E Tamiami Trail, Suite 211 Naples, Florida 34112 mailto:PriscillaDoria@,colliergov.net Phone: 239-252-5312 Words k Through are deleted; Words Underlined are added CASL(HM13-02) Multi Family Property Acquisition Amendment#2 Page 4 of 5 16P20 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 COMMISSIONERS OF COLLIER DW s T E. BROCK, CLERK COUNTY LO'Ali A . Ca-VULGA. By: �� , Deputy Clerk CTOM HENNING, C IRMAN S�! 31?-014 Dated: 1`( Attest as to;armaks signature only. Community Assisted& Supported Living, Inc. (CASL). By: Subr cipient Signature J. Scott Eller, CEO Subrecipient Name and Title Approved as to form and legality: JennifeN. Belpedio �j ,h Assistant County Attorney 0 t'\\�-�� Item# -1=_to Agenda a� 4 Date Date Re '. s ' Deputy Clerk Words Str-uck-T-h-Fough are deleted; Words Underlined are added CASL(HM13-02) Multi Family Property Acquisition Amendment#2 Page 5 of 5 GP