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Backup Documents 10/27/2015 Item #16A13 ORIGINAL DOCUMENTS CHECKLIST &ROUTING SLIP 1 6 A 13 TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE 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. 2. 3. County Attorney Office County Attorney Officela-/ '14 4. BCC Office Board of County Commissioners \(J k ZEA\\5 5. Minutes and Records Clerk of Court's Office Please return copy to Diane Lynch �J I 9' ,�-7�� y� in Road Maintenance l I�[y f I� 6 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 Diane Lynch-Road Maintenance Phone Number 252-5820 Contact/ Department Agenda Date Item was 10/27/15 Agenda Item Number -14A-1-2--- d Approved by the BCC /,A I Type of Document Adopt-a-Road Agreement-First Number of Original 1 Attached Congregational Church Documents Attached PO number or account number if document is to be recorded Please return an executed copy to Diane Lynch in Road Maintenance. Thank you 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? '`jam C? _ "S 2. Does the document need to be sent to another agency for additional signatures? If yes, NA provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet. 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 dl by the Office of the County Attorney. 4. All handwritten strike-through and revisions have been initialed by the County Attorney's dl 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 dl document or the final negotiated contract date whichever is applicable. 6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's dl signature and initials are required. 7. In most cases(some contracts are an exception),the original document and this routing slip dl 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 time frame or the BCC's actions are nullified. Be aware of your deadlines! 8. The document was approved by the BCC on 10/27/15 and all changes made during dl the meeting have been incorporated in the 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 •-rt1 BCC,all changes directed by the BCC have been made,and the document is ready for e Chairman's signature. S I: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 /5`-r e frt - ca- 1 6 A 13 MEMORANDUM Date: December 7, 2015 To: Diane Lynch, Operations Supervisor Road Maintenance Division From: Martha Vergara, Deputy Clerk Minutes & Records Department Re: Adopt-a-Road Agreement First Congregational Church Attached is a scanned copy of the document referenced above, (Item #16A13) approved by the Board of County Commissioners on Tuesday, October 27, 2015. The original will be held on file 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 1 6 A 13 COLLIER COUNTY ADOPT-A-ROAD PROGRAM AGREEMENT Terms and Conditions THIS COLLIER COUNTY ADOPT-A-ROAD AGREEMENT entered into this a7thday of Oc,-k-obe.c , 2015, by and between Collier County (hereinafter the "COUNTY"), and the volunteer group, First Congregational Church of Naples, Inc. (hereinafter the "GROUP") whose address is 6330 Immokalee Rd,Naples FL 34119 WITNESSETH: WHEREAS, the COUNTY and the GROUP recognize the need and desire for litter-free roads, and enter this Agreement to permit the GROUP to contribute toward the effort of safely maintaining a litter-free Collier County; and WHEREAS, by signature below, the GROUP agrees to adopt the segment of roadway known as Immokalee Road from Logan Boulevard North to Ibis Cove, and acknowledges the hazardous nature of picking up litter, and agrees to the following terms and conditions: A. THE GROUP SHALL: 1. Obey and abide by all laws and regulations relating to safety on the Adopted Roadway. 2. Perform litter removal on the Adopted Roadway in accordance with the Florida Department of Transportation's Accident Prevention Manual, Safe Field Practices, the Florida Manual on Uniform Traffic Control Devices (MUTCD), and the Florida Department of Transportation Design Roadway and Standard Index 601 and 602, all of which by this reference are incorporated herein. 3. Only allow such persons to participate as are determined by the GROUP to be responsible enough to safely participate in litter removal activities. Participants must be at least 14 years of age and the GROUP shall provide at least one adult supervisor for every 5 minors participating in the litter removal. There shall at all times be at least one person 18 years of age or older who is on site and responsible for supervising all litter removal activities, with no one at the site under the age of 14 for any reason. 0 1 6 x 1 3 4. Conduct at least two safety procedure meetings per year for its participating members. Participants must sign the hold harmless agreement provided by the COUNTY, and attend a safety meeting conducted by the GROUP before participating in a cleanup activity pursuant to this Agreement. 5. Call the Collier County Adopt-A-Road contact and set up dates and times for their safety meetings. 6. Remove litter during daylight hours only, in good weather conditions only. 7. Pick up litter on one side of the road at a time. 8. Not pick up litter at construction sites, in tunnels, on bridges or over-passes, and on medians, or where otherwise hazardous to do so. 9. Park all vehicles well clear of the Adopted Roadway, at least 20 feet from the edge of the pavement. 10. Remove litter a minimum of once monthly, and whenever the appearance of the Adopted Roadway is objectionable. 11. Obtain required supplies and material from the COUNTY. 12 Place traffic control signs supplied by the COUNTY during trash pickup. 13. Ensure that all participants wear COUNTY supplied or approved safety vests at all times during the litter removal activity. The local maintenance office should be contacted to obtain safety vests, traffic control signs and litter collection bags at least five (5) days prior to litter removal activity and return the same when activity is complete. 14. Not wear clothing that will hinder the sight of participants. 15. Coordinate pickup details with the County's project coordinator at least one week prior to a pickup. 16. Place filled trash bags at the site for pickup and disposal by the COUNTY. 17. After each pickup, the adopting GROUP coordinator will file a report detailing the number of people involved, number of bags of litter collected, composition and estimate of recyclable materials, and hours spent. Pre-printed forms will be furnished by the COUNTY for making the reports,and filed with the COUNTY project coordinator. 18. The GROUP is encouraged to separate recyclable materials. All proceeds from redemption of recyclable materials shall become the property of the Group. 2 16A13 19. Unused materials and supplies furnished by the COUNTY shall be returned to the COUNTY within two workdays following cleanup or, with COUNTY coordinator's permission, be retained by the GROUP during the term of this Agreement. B. THE COUNTY SHALL: 1. Provide safety vests,trash bags,pickup sticks, and traffic control signs. 2. Provide GROUP with an outline pertaining to safety regulations. 3. Remove the filled trash bags as soon as possible after the pickup. 4. Remove litter from the Adopted Roadways only under unusual circumstances, i.e., to remove large,heavy or hazardous items. 5. Construct and place a roadside sign stating that the GROUP is responsible for keeping the area free of litter. C. TERM OF AGREEMENT: This is a month-to-month, at-will agreement, terminable by either party, with or without cause, on 30 days written notice to the other party. This Agreement creates no rights or interest. If, in the sole judgment of the County Project Coordinator, it is found that the GROUP is not meeting the terms and conditions of this Agreement, the COUNTY may terminate this Agreement effective immediately. The COUNTY reserves the right to modify or cancel the program at any time. Upon the termination of this Agreement by either party, the GROUP will immediately return all County-owned materials to the County project coordinator. D. HOLD HARMLESS CLAUSE: The GROUP covenants and agrees that it will indemnify and hold harmless Collier County and its officers, agents and employees from any claim, loss, damage, cost, charge or expense arising out of any act, action, neglect or omission by the Group or by any person performing litter removal as part of the GROUP during the performance of the Agreement, whether direct or indirect, and whether to any person or property to which Collier County or said parties may be subject, except that neither GROUP nor any of its members shall be liable under this provision for damages arising out of injury or damage to persons or property directly caused or resulting from the sole negligence of Collier County, and its officers, employees or agents. 3 1 6 A 1 3 E. NO ASSIGNMENT: This Agreement is non-transferable and non-assignable in whole or in part without the prior written consent of Collier County. F. MISCELLANEOUS PROVISIONS: This Agreement is the full and complete agreement between the parties, and may not be modified except by a writing signed by both parties. Any and all prior understandings between the parties, either oral or written, with respect to the matters set forth above, have been incorporated and merged into this Agreement, and are otherwise of no further force or effect. This Agreement is for litter removal activities only. No beautification activities are authorized by this Agreement. IN WITNESS WHEREOF, the Parties have caused this Agreement to be executed as of the date written above. BOARD OF COUNTY COMMISSIONERS ATTEST: OF COLLIER COUNTY, FLORIDA DWIGHT E.:BROCI 'Clerk By: ` -° 1 �` i� By: / e& Deputy CI , ( Tim Nance, Chairman Attest as to Chairmani signature only, GROUP: First Congregational Church of Naples;,f I Rc j, By 4-1 / Name(priit): CU& v l Cee.' Title (print): AFRO Phone# (day): _ iLIW - c7-/0 Phone#(night): Approved as to form anct\legality: ._---h-----' .-4•:•---- ii 9 /aci/S Scott A. Stone, Assistant County Attorney 4 6