Backup Documents 12/08/2015 Item #16D27 ORIGINAL DOCUMENTS CHECKLIST & ROUTING Sur6 ® 2 -7
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 Ini ' Is Date
1. Louise Pelletier Community and Human Services / 12/08/15
2. Jennifer Belpedio County Attorney Office
248 15
I
3. BCC Office Board of County Commissioners T1NC�
VAS /
4. Minutes and Records Clerk of Court's Office
121gliS 4:3 M
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 Louise Pelleti r CHS Phone Number 252-2696
Contact/ Department
Agenda Date Item was 12/08/15 Agenda Item Number 16.D.27 V
Approved by the BCC
Type of Document One Landlord Agreement: Number of Original 1
Attached 1. Claudia Tracy Documents Attached
PO number or account NA
number if document is to
be recorded
INSTRUCTIONS&CHECKLIST
Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is appropriate. Yes N/A(Not
(Initial) Applicable)
1. Does the document require the chairman's original signature? ti (::3‘/ _n'' ej
2. Does the document need to be sent to another agency for additional signature ? If yes,provide the NA
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 LP
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 Office and NA
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 LP
the final negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's signature and LP
initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip should NA
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_12/08/15 and all changes made during the LP
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 BCC,all LP ,�
changes directed by the BCC have been made,and the document is ready for the Chairman's 9/�J,,�r•�+'
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
Ann P. Jennejohn 16 D 27
From: Ann P.Jennejohn
Sent: Monday, December 14, 2015 8:28 AM
To: Pelletier, Louise
Subject: Item #16D17 (11-10-15) &Item #16D27 (12-08-15)
Attachments: Sierra Landlord Agreement.pdf;Tracy Landlord Agreement.pdf
Good Morning Louise,
There are two (2) signed landlord agreements attached for your records.
Item #161,17 w/Lillyan Sierra from the Board's November 10, 2.01-5 Meeting
and Item #16D27 from the December 8, 201-5 Meeting.
Thank you,
Have a great day!
Ann Jennejohn, Deputy Clerk
Clerk of the Circuit Court
Clerk to the Value Adjustment Board
Collier County Board Minutes & Records Dept
1602 ?
EMERGENCY SOLUTIONS GRANT
LANDLORD PAYMENT AGREEMENT
FOR TENANT BASED RENTAL ASSISTANCE
THIS AGREEMENT is entered into between Collier County Board of County Commissioners,
hereinafter referred to as the "agency", Claudia Tracy, 188 Furse Lakes Circle Apt. #1, Naples,
FL 34104, 239-777-6238, hereinafter referred to as the"landlord".
The undersigned landlord hereby agrees to the following conditions in order to receive landlord
payments from the agency under the Emergency Solutions Grant Program(ESG):
1. This agreement shall begin on December 8, 2015 and shall end upon 30-days written
notification from either party to the other, or if funding for this program is no longer
available.
2. The agency agrees to provide the lane lord with a list of names and contact information for all
agency personnel authorized to co it ESG funds. The landlord will only accept payment
commitment from authorized age 1 cy personnel. Changes (addition/deletions) to the
authorized personnel list must be ap Droved in writing by an authorized agency representative.
3. The landlord agrees to provide agency with contact information for authorized CHS
representative to resolve a crisis and/or apply benefit commitment on the client's behalf.
4. The landlord agrees to provide agency with copy of all leases and modifications or
amendments for each eligible ESG p ogram participant.
5. The agency agrees to provide payme is directly to the landlord on behalf of the eligible ESG
program participant and as long as the grantor agency and/or regulation does not prohibit
payment.
6. The landlord assures that no house old receiving ESG assistance will be treated adversely
because of such assistance under aIplicable provisions of federal, state or local regulatory
requirements. During the term of thi• agreement, landlord agrees to give the agency a copy of
any notice to the program particip. t to vacate the housing unit, or complaint used under
state or local law to commence an eve ction action against the program participant.
7. The landlord assures that eligible households on whose behalf ESG assistance is received
will not be discriminated against.
8. The landlord understand that only eligible activities listed under 24 CFR 576.106, Short-term
and medium-term rental assistance, . e to be paid with ESG funds.
9. The landlord understand that only costs of Short-term and medium-term rental assistance in
accordance with the terms of the E.G program are allowed. No charges that result from
illegal activities such as bad checks or meter tampering will be paid with ESG funds.
10. The landlord understand that the E G benefit amount must pay for the complete charges
owed by the ESG program particip t and that acceptance of ESG benefit will be deemed as
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Landlord's acknowledgement and acceptance has become current on any and all payments
due to landlord as a result of the ESG payment.
11. The landlord agrees to assist the agency in verifying the ESG program participant's
information and to make timely commitments to resolve any crisis situation. Subject to the
landlord's privacy requirements, the landlord agrees to provide the agency with the following
detailed ESG program participant information: (1) current amount owed (broken down by
month) (2) due date/eviction dates in formal eviction notice / 3-day notice and (3) amount
necessary to resolve the situation.
12. In accordance with the Florida Local Government Prompt Payment Act, the agency agrees to
provide payment to the landlord as follows:
(a) Rental Arrears, Application Fees and/or Deposits: will be dispersed by the agency
within 60 days from the date of the agency's approval of the program participant's
eligibility if the rental assistance is a valid ESG program expenditure.
(b) Ongoing rental assistance: will be disbursed by the agency for eligible ESG recipients
in accordance with the rental agreement as issued by the landlord on behalf of the
program participant under the same terms and conditions (i.e., same payment due date,
grace period, and late penalty requirements).
(c) Payments beyond 60 days will require interest to be paid from non-ESG funds.
(d) Agency's promise to pay can only be issued after ESG participant has been certified as
Eligible under the ESG program.
13. This Landlord Agreement will be signed by agency, and landlord's authorized representative.
Documentation authorizing authority must be provided from landlord.
14. If an ESG payment to the landlord cannot be applied to a ESG program participant's account,
the funds will be returned to the agency.
15. The landlord, with the exception of municipal providers, must be in "active" status with the
State of Florida: http://sunbiz.org/search.html. The landlord's name must also be verified
against the System for Award Management website at http://www.sam.gov. The agency
agrees to maintain documentation of verification that the business name of the landlord on
this agreement is the same as the legal business name on the State of Florida System for
Award Management website.
16. Agency does not assume any responsibility for, or liability to, any person injured as a result
of landlord's action or failure to act in connection with the implementation of this agreement
or as a result of any other or failure to act by the landlord.
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17. Landlord is not the agent of agency and this agreement does not create any relationship
between agency and any lender to landlord or suppliers, employees, contractors or
subcontractors used by landlord in connection with this agreement.
18. Nothing in this agreement will be construed as creating any right of a program participant or
a third-party to enforce any provision of this agreement or to assess any claim against
agency, or landlord under this Rental Assistance Agreement.
IN WITNESS THEREOF, the parties hereto have caused this agreement to be executed by their
undersigned officials as duly authorized.
AGENCY LANDLORD
Collier County Government Claudia Tracy
Community and Human Services 188 Furse Lakes Circle Apt. #1
3339 Tamiami Trail East, Su 211 Naples, FL 34104
Naples, FL 34112
.......■ / yett--L.1./0---
BY: / e,,1 , BY: �[.:.1...�. ___
Tim Nance, Chairman Claudia Tracy
•
Date: 1-2./q115 Date: C8/ cA/i-S-'
ATTEST:
Approved as to form and legality DWIGHT E. BROCK, Clerk
a _ _ ' f .
Assistant County iA ' ey 411�1 ; \� Attest hal an's
` signature only.
(tern# 1022-1
Agenda 12:11c.
Date
Date h •�lc
Reed 'v-------
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