Backup Documents 12/08/2015 Item #16D20 1ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANYTHE BOARD OF COUNTYCOMMISSIONERSALL
O DOCUMENTS
FOR SIGN
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.
3. Colleen Greene County Attorney Office LS
On&
4. BCC Office Board of County 714 b
Commissioners 1r`J,/Z7 t2A I<A S
5. Minutes and Records Clerk of Court's Office -Q'��,
�i616 I.�'`i7�' -I
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 Natali Betancur Phone Number 239-252-4059
Contact/ Department
Agenda Date Item was 12/08/15 Agenda Item Number 16D20
Approved by the BCC
Type of Document Agreement Number of Original 2
Attached 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? ,:s � a G
2. Does the document need to be sent to another agency for additional signals? If yes, N/A
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
by the Office of the County Attorney.
4. All handwritten strike-through and revisions have been initialed by the County Attorney's N/A
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 NB
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 NB
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip N/A
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 11/10/15 and all changes made during NB
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 B
BCC,all changes directed by the BCC have been made,and the document is ready for the iyl
Chairman's signature.
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
16 020
MEMORANDUM
Date: December 11, 2015
To: Natali Betancur, Operations Analyst
Collier County Park & Recreation Department
From: Ann Jennejohn, Deputy Clerk
Minutes & Records Department
Re: An agreement between Collier County and FDEP using TDC
Category "A" grant funds for a project that will provide mobile toll
booths at the entrance to Delnor-Wiggins State Park
Attached for your use is an original copy of the agreement referenced above,
,
(Item #16D20) approved by the Board of County Commissioners December 8, 2015.
The second original will be held in the Minutes and Records Department for the
Board's Official Record.
If I can be of any further assistance, please feel free to contact me at 252-8406.
Thank you.
Attachment
16D20
2015 TOURISM AGREEMENT BETWEEN COLLIER COUNTY
AND THE STATE OF FLORIDA, DEPARTMENT OF
ENVIRONMENTAL PROTECTION, FOR FY 15 CATEGORY "A"
BEACH PARK FACILITY PROJECTS
THIS AGREEMENT is made and entered into this 8th day of December, 2015, by and
between the State of Florida, Department of Environmental Protection, hereinafter referred to as
"GRANTEE" and Collier County, a political subdivision of the State of Florida, hereinafter
referred to as "COUNTY".
RECITALS:
WHEREAS, GRANTEE submitted a grant application for Category "A" Tourist
Development Tax Funds in the aggregate amount of seven thousand two-hundred dollars($7,200)
for the purchase of two mobile toll booths for fiscal year 2015-2016, as described in Exhibit"A,"
for use in the Delnor-Wiggins Pass State Park. This approval authorizes seven thousand two-
hundred ($7,200) for this Agreement, for the Beach Park Facility Project- Mobile Toll Booths,
hereinafter the "Project"; and
WHEREAS, the Board of County Commissioners desires to fund the Project as it serves
valid and worthwhile public purposes and finds that the project expenditures promote tourism.
NOW, THEREFORE, BASED UPON THE MUTUAL COVENANTS AND PREMISES
PROVIDED HEREIN AND OTHER VALUABLE CONSIDERATION, IT IS MUTUALLY
AGREED AS FOLLOWS:
1. SCOPE OF WORK. GRANTEE prepared detailed applications and proposals outlining
the Project to be accomplished, along with a project budget, as part of its request, hereinafter
referred to as "Scope of Work," attached as Exhibit "A-1". GRANTEE shall provide the project
activities outlined in the Scope of Work within the budgeted amounts provided in Exhibit "A".
GRANTEE shall not be reimbursed for any expenditure not included in the Scope of Work nor be
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reimbursed for amounts in excess of those provided in Exhibit "A" unless an amendment to this
Agreement is entered into by GRANTEE and COUNTY.
2. PAYMENT AND REIMBURSEMENT. The aggregate maximum reimbursement under
this Agreement shall be seven thousand two-hundred dollars ($7,200). GRANTEE shall be paid
in accordance with the fiscal procedures of COUNTY upon submittal of invoices and upon
verification that the services described in the invoice are completed or that goods have been
received.
2.1 GRANTEE shall determine that the goods and services have been properly provided
and shall submit invoices to the County Manager or his designee. The County Manager, or his
designee, shall determine that the invoice payments are authorized and the goods or services
covered by such invoice have been provided or performed in accordance with such authorization.
The budget for each project, attached as Exhibit "A," shall constitute authorization of the
expenditure described in the invoices provided that such expenditure is made in accordance with
this Agreement.
2.2 Each invoice submitted by GRANTEE shall be itemized in sufficient detail for audit
thereof and shall be supported by copies of corresponding vendor invoices and proof of receipt of
goods or performance of the services invoiced. GRANTEE shall certify in writing that all
subcontractors and vendors have been paid for work and materials from previous payments
received prior to receipt of any further payments. COUNTY shall not pay GRANTEE until the
Clerk of the Board of County Commissioners pre-audits payment invoices in accordance with the
law.
2.3 GRANTEE shall be paid for its actual cost not to exceed the maximum amount
budgeted pursuant to the attached Exhibit "A".
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3. ELIGIBLE EXPENDITURES. Only eligible expenditures described in the Scope of Work
will be paid by COUNTY. Any expenditures paid by COUNTY which are later deemed to be
ineligible expenditures shall be repaid to COUNTY within thirty(30) days of COUNTY'S written
request to repay said funds. COUNTY may request repayment of funds for a period of up to one
(1) year after termination of this Agreement or any extension or renewal thereof.
4. PAYMENT REQUESTS. Payment requests for interim draws and final payment must
be submitted to the COUNTY on the Request for Funds form attached to this Agreement as Exhibit
"B". All payments are on a reimbursement basis only after proof of paid invoices are presented to
the COUNTY. COUNTY may withhold any interim draw for failure to provide the interim status
report, and COUNTY shall withhold final payment until receipt of the final status report or other
final report acceptable to COUNTY. All invoices and requests for payment including the final
payment must be received within ninety(90)days of termination of this Agreement. Any invoices
and requests for payment not received in this time frame shall be returned to the GRANTEE and
rejected for payment.
5. INSURANCE. To the extent required by law,the GRANTEE will be self-insured against,
or will secure and maintain during the life of this Agreement, Workers' Compensation Insurance
for all of its employees connected with the work of this Project and, in case any work is
subcontracted, the GRANTEE shall require the subcontractor similarly to provide Workers'
Compensation Insurance for all of its employees unless such employees are covered by the
protection afforded by the GRANTEE. Such self-insurance program or insurance coverage shall
comply fully with the Florida Worker's Compensation law. In case any class of employees
engaged in hazardous work under this Agreement is not protected under Workers' Compensation
[04-CMG-00002/1218918/1] 3
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statutes,the GRANTEE shall provide,and cause each subcontractor to provide,adequate insurance
satisfactory to the Department for the protection of its employees not otherwise protected.
The GRANTEE warrants and represents that it is self-funded for liability insurance, appropriate
and allowable under Florida law, and that such self-insurance offers protection applicable to the
GRANTEE's officers, employees, servants, and agents while acting within the scope of their
employment with GRANTEE.
6. CHOICE OF VENDORS AND FAIR DEALING. GRANTEE may select vendors or
subcontractors to provide services as described in the Scope of Work. COUNTY shall not be
responsible for paying vendors and shall not be involved in the selection of subcontractors or
vendors. GRANTEE agrees to disclose any relationship between GRANTEE and subcontractors
and/or vendors, including, but not limited to, similar or related employees, agents, officers,
directors and/or shareholders. COUNTY may, in its discretion, object to the reasonableness of the
expenditures and require repayment if invoices have been paid under this Agreement for
unreasonable expenditures. The reasonableness of the expenditures shall be based on industry
standards.
7. INDEMNIFICATION. Each party hereto agrees that it shall be solely responsible for the
negligent or wrongful acts of its employees and agents. However, nothing contained herein shall
constitute a waiver by either party of its sovereign immunity or the provisions of Section 768.28,
Florida Statutes. Further, nothing herein shall be construed as consent by a state agency or
subdivision of the State of Florida to be sued by third parties in any matter arising out of any
contract or this Agreement.
[04-CMG-00002/1218918/1] 4
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8. NOTICES. All notices from COUNTY to GRANTEE shall be in writing and deemed
duly served if mailed by registered or certified mail, or sent via electronic mail as reflected by an
electronic mail read receipt, to GRANTEE at the following address:
Mr. Robert Steiger, Park Manager
c/o Delnor-Wiggins Pass State Park
11135 Gulf Shore Dr.
Naples, FL 34108
Robert.Steiger @dep.state.fl.us
All notices from GRANTEE to COUNTY shall be in writing and deemed duly served if mailed
by registered or certified mail, or sent via electronic mail as reflected by an electronic mail read
receipt, to COUNTY at the following address:
Mr. Barry Williams, Director
Collier County Parks and Recreation
Collier County Government
15000 Livingston Road
Naples, FL 34109
barrywilliams @colliergov.net
GRANTEE and COUNTY may change their above mailing address at any time upon giving the
other party written notification pursuant to this section.
9. NO PARTNERSHIP. Nothing herein contained shall be construed as creating a
partnership between COUNTY and GRANTEE, or its vendor or subcontractor, or to constitute
GRANTEE, or its vendor or subcontractor, as an agent or employee of COUNTY.
10. TERMINATION. COUNTY or GRANTEE may cancel this Agreement with or without
cause by giving thirty(30) days advance written notice of such termination pursuant to Section 8
and specifying the effective date of termination. If COUNTY terminates this Agreement,
COUNTY will pay GRANTEE for all expenditures incurred, or contractual obligations incurred
with subcontractors and vendors,by GRANTEE up to the effective date of the termination so long
as such expenses are eligible.
[04-CMG-00002/1218918/1] 5
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11. GENERAL ACCOUNTING. GRANTEE is required to maintain complete and accurate
accounting records and keep tourism tourist development tax funds in a separate checking account.
All revenue related to the Agreement should be recorded, and all expenditures must be incurred
within the terms of this Agreement.
12. AVAILABILITY OF RECORDS. Records made or received in conjunction with this
Agreement are public records and subject to disclosure under Chapter 119, Florida Statutes and
Section 24(a), Article I, Florida Constitution. GRANTEE and COUNTY shall maintain records,
books, documents, papers and financial information pertaining to work performed under this
Agreement for a period of five (5) years. GRANTEE agrees that COUNTY, or any of its duly
authorized representatives, shall, until the expiration of three (3) years after final payment under
this Agreement, have access to, and the right to examine and photocopy any pertinent books,
documents, papers, and records of GRANTEE involving transactions related to this Agreement.
13. AVAILABILITY OF FUNDS: This agreement is subject to the availability of Tourist
Development Tax revenues. If for any reason tourist tax funds are not available to fund all or part
of this agreement, the COUNTY may upon written notice, at any time during the terms of this
agreement, and at its sole discretion,reduce or eliminate funding under this agreement.
14. PROHIBITION OF ASSIGNMENT. GRANTEE shall not assign, convey, or transfer in
whole or in part its interest in this Agreement without the prior written consent of COUNTY.
15. TERM. This Agreement shall become effective on December 8, 2015, and shall remain
effective until ninety (90) days after completion of the Project described in Exhibit "A", but no
later than April 30, 2016.
16. AMENDMENTS. This Agreement may only be amended in writing by mutual agreement
of the parties and after recommendation by the Tourist Development Council.
[04-CMG-00002/1218918/11 6
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17. REQUEST FOR EXTENSION. Any request for additional time to complete the project
described herein or any request for additional tourist development tax funds must be made in
writing and received by the County Manager or designee at least thirty(30) days prior to the end
date of this Agreement as provided in Section 15, TERM.
18. SEVERABILITY CLAUSE. This Agreement has been delivered in the State of Florida
and shall be construed in accordance with the laws of Florida. Wherever possible, each provision
of this Agreement shall be interpreted in such manner as to be effective and valid under applicable
law, but if any provision of this Agreement shall be prohibited or invalid under applicable law,
such provision shall be ineffective to the extent of such prohibition or invalidity, without
invalidating the remainder of such provision or the remaining provisions of this Agreement.
19. EXECUTION IN COUNTERPARTS. This Agreement may be executed in two or more
counterparts, each of which together shall be deemed an original, but all of which together shall
constitute one and the same instrument. In the event that any signature is delivered by facsimile
transmission or by e-mail delivery of a ".pdf' format data file, such signature shall create a valid
and binding obligation of the party executing(or on whose behalf such signature is executed)with
the same force and effect as if such facsimile or ".pdf' signature page were an original thereof
20. ENTIRE AGREEMENT. This Agreement represents the entire agreement of the parties.
Any alterations, variations, changes, modifications or waivers of provisions of this Agreement
shall only be valid when they have been reduced to writing, duly signed by each of the parties
hereto, and attached to the original of this Agreement, unless otherwise provided herein.
IN WITNESS WHEREOF, GRANTEE and COUNTY have each respectively, by an authorized
person or agent, hereunder set their hands and seals on the date and year first above written.
[04-CMG-00002/1218918/1] 7
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DATED: 1?-1 t 1 2015 BOARD OF COUNTY COMMISSIONERS
ATTEST: COLLIER COUNTY, FLORIDA
DWIGHT E. BROCK, Clerk
e;44eGne..
y Clerk Tim Nance, Chairman
Attest as t,
signature only:
Approved as to form and legality: GRANTEE: State of Florida, Department of
Environmental Protection
By: �•
Al •
Colleen M. Greene Valinda Subic, District 4 Bureau Chief
Assistant County Attorney
APPROVED AS TO
State of Florida FORM& LEG TY
County of r�cttQ pA ,/�
The foregoing instrument was acknowledged before me this te day
of ec i - , 20_5_, by *(t who is
personally known ✓ OR who produced identification . Type of
identification produced:
(Affix notary seal)
a Q „ LISA A.HARPER
40 MY COMMISSION S FF173248 Item# �I�1�'Y L`)
°' �,��rr�` EXPIRES:October 30,2018
Notary Public
Agenda lL$AS
A, kits xr Date
Notary Typed or Printed Name(or stamp) Date t-2,,0 -(�
Redd
I
My Commission Expires: 1 G 3C 1 ■ u W
The signee of this Affidavit guarantees, as evidenced by the sworn affidavit required herein, the
truth and accuracy of this affidavit to interrogatories hereinafter made.
[04-CMG-00002/1218918/1] 8
EXHIBIT A 16 Ii 2 0
Collier County Tourist Development Council
Category "A" Grant Application Page 2
(Project Title)
PROJECT BUDGET
PROGRAM ELEMENT AMOUNT
TDC Funds Requested $ __7,200.00
City/Taxing District Share $ 0
State of Florida Share $ 0
Federal Share $ 0
TOTAL $ 7,200.00
PROJECT EXPENSES:
(Engineering, Mobilization, Contractor,Monitoring etc)
2 booths 4'x6' $_3400.00
2 trailers 4'x6' $ 3000.00
2: 6k Btu air conditioners $ 400.00
20 traffic cones $ 400.00
TOTAL $ 7,200.00
I have read the Tourist Development Category "A" Beach Funding Policy covering
beach renourishment and pass maintenance and agree that my organization will
comply with all guidelines and criteria.
1
Sponsor Signature of S Organization's Chief Official Date
g P g
EXHIBIT A-1
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COLLIER COUNTY TOURIST DEVELUI'MENT COUNCIL
CATEGORY "A" GRANT APPLICATION
Beach Renourishment and Pass Maintenance
_Mobile Toll Booths (2)
(Project Title)
1. Name and Address of Project Sponsor Organization:
Delnor-Wiggins Pass State Park
11135 Gulfshore Dr.
Naples, Fl. 34108
2. Contact Person,Title and Phone Number:
Name:_Robert M. Steiger
Address: 11135 Gulfshore Dr.
City_Naples ST FL. 34108
Phone: 239-597-6196 FAX: 239-597-8223
Other:
3. Organization's Chief Official and Title: Valinda Subic,
Chief—Bureau of Parks, District 4
4. Details of Project- Description and Location: Delnor-Wiggins Pass State Park,
11135 Gulfshore Dr., Naples, Florida 34108 entrance road by existing Ranger
Station
For many years, the intersection of Gulfshore Drive and Bluebill Avenue has been
congested during the height of tourist season, i.e., January thru May. During these times
during the hours of 10AM and 2PM, the intersection becomes clogged due to traffic into
Delnor Wiggins State Park. Recent construction of a circle driveway and bathroom facility
by Collier County Government have improved conditions; however, during these peak
times, entering the Park has caused traffic to stack from the entrance to the State Park on
Bluebill Ave.past the bridge that connects from Connor Park to Delnor Wiggins Pass State
Park (see Google Earth image below)
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Recently, a workgroup was established by the Collier County Deputy County Manager to
address this issue. The Collier County Sheriff's Office, State Park personnel, County
Transportation staff and County Parks and Recreation staff met to conceptualize solutions
to this issue. Ideas that were created from this workgroup included:
Traffic Safety issue created on Bluebill bridge by patrons attempting to enter Wiggins
State Park at Park opening and after Park reaches capacity. This proposal seeks to
address the problem of patrons entering the Park at opening and the workgroup will
continue to work on when the Park reaches capacity.
Utilizing two(2)Mobile Toll Booths that would be placed at the northern end of the
median where the current ranger station currently sits to allow two lanes of queuing
space. This would potentially result in an increased queuing space of 16 additional
vehicles. These booths would be manned by park staff during the morning"rush"to get
vehicles into the park faster.
The State Park would open the park a half hour to an hour earlier than currently but no
earlier than sunrise.
Construction of 2 mobile toll booths.These toll booths will be 4'x6'on the same size trailer
with 2 windows a door, electric outlets inside for a cash register and 6,000 Btu air-
conditioner.
These toll booths will be part of a project to increase speed at which we will service visitors
entering Delnor Wiggins Pass State Park. They will be moved behind the existing Ranger
Station approximately 175' into the Park to allow for more vehicles to get off of Bluebill
Avenue and into the park. This will increase visitor accessibility to the Park and be used
during its peak visitation days during Tourist Season and busy weekends and holidays.
1
6 D 20
Delnor-Wiggins Pass State Park is a tourist destination in Collier County, Florida. We
support the county's tourism in many ways. We have been listed in Dr. Beach 10 best
beaches in the United States three times and 2 times in last couple years.
Our visitation in FY 13/14 was 566,947 helping to produce an economic value to Collier
County of $42,613,602.00. This helped produce a collection of sales tax worth
$2,934,142.00 and helped support the creation of 597 jobs.
5. Estimated project start date: December 1,2015
6. Estimated project duration: 4 to 8 weeks
7. Total TDC Tax Funds Requested: $ 7,200.00
8. If the full amount requested cannot be awarded,can the program/project
be restructured to accommodate a smaller award?
Yes( ) No(x)
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Collier County Tourist Development Council
Category "A"Grant Application Page 2
(Project Title)
PROJECT BUDGET
PROGRAM ELEMENT AMOUNT
TDC Funds Requested $_7,200.00
City/Taxing District Share $ 0
State of Florida Share $ 0
Federal Share $ 0
TOTAL $ 7,200.00
PROJECT EXPENSES:
(Engineering, Mobilization,Contractor,Monitoring etc)
2 booths 4'x6' $ 3400.00
2 trailers 4'x6' $ 3000.00
2: 6k Btu air conditioners $ 400.00
20 traffic cones $ 400.00
$
TOTAL $ 7,200.00
I have read the Tourist Development Category "A" Beach Funding Policy covering
beach renourishment and pass maintenance and agree that my organization will
comply with all guidelines and criteria.
Signature of Sponsor Organization's Chief Official Date
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EXHIBIT A
Option#1 Maximize current operation by adding Annual Pass lane.
Open the park one half hour to 1 hour earlier. No earlier than sunrise so visitors can see
where they are going.That should help alleviate any back up outside of the front gate
occurring currently by 8:00am.
Remove wooden barrier posts. Put up cones instead (traffic cones for trial). Remove
current parking on east side of entry lane north of Ranger Station and turn that into an
Annual Pass/cash only lane with signage and temporary traffic cones to show lanes.
Extra OPS would staff 2 mobile toll booths.One additional staff would be posted at the
point where the one lane splits into 2 to tell drivers which lane to move to and help
reduce confusion due to changes taking place.The 2 lanes will create a queuing area for
approximately 16+vehicles.The regular lane would be for cash/credit cards and motor
homes, boats and trailers, regular vehicles.The second lane to the east would be for
annual passes/cash and cars, pickup trucks/and vans only to move them through
quickly.
The toll booths will be situated near the end of the existing island. (North approximately
175 feet north from where the one lane splits into 2). See diagram.
There will need to be 2: 4'x4'signs made.One on the left lane that says,"Credit Cards
or Cash, Boats&Trailers, Large trucks, regular vehicles".The right lane will say,"Annual
Pass or Cash, regular vehicles&Pick up trucks".
The Ranger Station door used for regular business will be closed and covered with the
hurricane roll down.A sign stating to"proceed to the toll booth"will be mounted here.
If annual passes want to be renewed ask them to purchase upon exiting or make a U-
turn at the end of the island and park in the exit parking area on the west side of the
Ranger Station.
The goal to get early morning traffic into the park so it can reach capacity quicker and
help eliminate the backup of vehicles trying to enter the park all at once. Once capacity
is reached then it is back to normal operation.C.C.S.O.will turn traffic outside of gate
on the intersection of Bluebill and Gulfshore Dr. until approximately 10%of the parking
spaces are empty to allow more to enter.
Since no permanent toll booth would be allowed per county review, a small mobile air
conditioned toll booth set up for a cash register and credit card machine would suffice.
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EXHIBIT "B"
REQUEST FOR FUNDS
COLLIER COUNTY TOURIST DEVELOPMENT COUNCIL
EVENT NAME
•
ORGANIZATION
ADDRESS
CONTACT PERSON TELEPHONE( )
REQUEST PERIOD FROM TO
REQUEST#
( )INTERIM REPORT ()FINAL REPORT
TOTAL CONTRACT AMOUNT$
EXPENSE BUDGET REIMBURSEMENT REQUESTED
TOTALS
NOTE:Reimbursement of funds must stay within the confines of the Project Expenses outlined in your application.
Copies of paid invoices,cancelled checks,tear sheets,printed samples or other backup information to substantiate
payment must accompany request for funds. The following will not be accepted for payments: statements in place
of invoices; checks or invoices not dated; tear sheets without date,company or organizations name. A tear sheet
is required for each ad for each day or month of publication. A proof of an ad will not be accepted.
Each additional request for payment subsequent to the first request,Grantee is required to submit verification in
writing that all subcontractors and vendors have been paid for work and materials previously performed or
received prior to receipt of any further payments.
If project budget has specific categories with set dollar limits,the Grantee is required to include a spreadsheet to
show which category each invoice is being paid from and total of category before payment can be made to Grantee.
Organizations receiving funding should take into consideration that it will take a maximum of 45 days for the
County to process a check.
Furnishing false information may constitute a violation of applicable State and Federal laws.
CERTIFICATION OF FINANCIAL OFFICER: I certify that the above information is correct based on our
official accounting system and records, consistently applied and maintained and that the cost shown have been
made for the purpose of and in accordance with, the terms of the contract. The funds requested are for
reimbursement of actual cost made during this time period.
SIGNATURE TITLE
[04-CMG-00002/1218918/1]