Backup Documents 01/26/2016 Item #16D 4 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 A D )'
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 Office JAB op 1/25/16
4. BCC Office Board of County
�(F
��'N
Commissioners ! t\`6\\l0
5. Minutes and Records Clerk of Court's Office
OV 1 i2g(1(/) I I%Zf a u4
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 Rachel Brandhorst, Grants Coordinator,
Contact/ Department Community and Human services
Agenda Date Item was 1/26/16 1 Agenda Item Number 16.D.4
Approved by the BCC
Type of Document Resolution Number of Original One
Attached G i v 11 Documents Attached
PO number or account n/a
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 signatur STAMP OK JAB
2. Does the document need to be sent to another agency for additional signatures? If yes, JAB
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 JAB
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 JAB
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 JAB
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 JAB
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip JAB
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 1/26/16 and all changes made durin e JAB V',,',
meeting have been incorporated in the attached document. The County Attorne 's
Office has reviewed the changes,if applicable. W
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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
1604
Martha S. Vergara
From: Martha S. Vergara
Sent: Thursday,January 28, 2016 4:27 PM
To: BrandhorstRachel (RachelBrandhorst@colliergov.net)
Subject: Resolution 2016-17 - Retired &Senior Volunteer Program
Attachments: Resolution 2016-017.pdf
Hi Rachel,
Attached is a scanned copy of Resolution 2016-17 for your records.
Let me know if you need a paper/certified copy.
Thanks,
Martha Vergara, BMR Senior Clerk
Minutes and Records Dept.
Clerk of the Circuit Court
& Value Adjustment Board
Office: (239) 252-7240
Fax: (239) 252-8408
E-mail: martha.vergara@collierclerk.com
1
1 6 0 4
RESOLUTION No. 2016-1 7
A RESOLUTION OF THE BOARD OF COUNTY
COMMISSIONERS OF COLLIER COUNTY,
FLORIDA,AUTHORIZING THE COMMUNITY AND
HUMAN SERVICES DIVISION DIRECTOR TO SIGN
MEMORANDUMS OF UNDERSTANDING FOR THE
RETIRED AND SENIOR VOLUNTEER PROGRAM
VOLUNTEER STATIONS.
WHEREAS, Collier County is a recipient of the Retired and Senior Volunteer
Program(RSVP)grant which is used for the dual purpose of: engaging persons 55 and older
in volunteer service to meet critical community needs; and to provide a high quality
experience that will enrich the lives of volunteers; and
WHEREAS, 45 CFR 2553.23(c)(2) requires Collier County to enter into a
Memorandum of Understanding (MOU) that identifies project requirements, working
relationships and mutual responsibilities to ensure compliance with program regulations for
each RSVP volunteer station; and
WHEREAS, the Board of County Commissioners desires to set forth an
administrative process to ensure timely execution of MOU's to provide uninterrupted
operation of RSVP.
NOW, THEREFORE, BE IT RESOLVED BY THE BOARD OF COUNTY
COMMISSIONERS OF COLLIER COUNTY, FLORIDA that the Board of County
Commissioners hereby authorizes the Community and Human Services Division Director to
sign form Memorandums of Understanding, attached hereto as Exhibit A.
k THIS RESOLUTION ADOPTED after motion,second,and majority vote on this the
(o day ofghwaK.",y�016.
ATTEST: BOARD OF COUNTY COMMISSIONERS
DWIGHT E. BROCK, CLERK COLLIER CO/^ Y, FLORI A
Attest as to ChairmaPUT I L�'`'i'` CHA ' AN DONNA FIALA
signature-only._ : , DISTRICT 1 COMMISSIONER
Approval for form and legality:
Jennifer A. Belpedi
Assistant County A e
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EXHIBIT <��o R CPA
a
Co er County
RSVP
Memorandum of Understanding for the
Retired and Senior Volunteer Program
of Collier County and
Volunteer
Station:
Address:
City: State: Zip:
Phone: ( ) Fax:
E-Mail: Website:
Period Covered: to
This Memorandum of Understanding (MOU) contains basic provisions, which will guide the
working relationship between both parties. This MOU may be amended, in writing, at any time
with concurrence of both parties and must be renegotiated at least every three years.
A. Retired and Senior Volunteer Program will:
1. Do volunteer screening in compliance with County policies and ordinances.
2. Recruit, interview and enroll RSVP volunteers and refer volunteers to the volunteer
station.
3. Provide RSVP orientation and training to volunteer station staff prior to placement of
volunteers and at other times, as needed.
4. Develop publicity for RSVP such as radio, TV, print or verbal presentations
highlighting volunteers' service, accomplishments and impact on the community.
5. Furnish accident, personal liability and excess automobile insurance coverage as
required by program policies. Insurance is secondary coverage and is not primary
insurance.
6. Periodically monitor volunteer activities at volunteer station to assess and/or discuss
needs of volunteers and volunteer station.
7. Annually assess volunteer placements to ensure the safety of volunteers as follows:
Throughout the three year duration of this memorandum of understanding an annual
safety assessment will be conducted, including a required e-mail assurance of safety
from each volunteer station covered by this agreement.
B. The Volunteer Station Responsibilities will:
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RSVP
1. Implement orientation, in-service instruction or special training of volunteers.
2. Interview and make final decision on assignment of volunteers.
3. Furnish volunteers with materials required for assignment, as follows:
4. Furnish volunteers with transportation required during their assignments, as follows:
5. Provide supervision of volunteers on assignments.
6. Provide for adequate safety of volunteers and submit an annual assurance e-mail
upon request by the project sponsor.
7. Collect and validate appropriate volunteer reports for submission to RSVP office on a
monthly basis.
8. Investigate and report any accidents and injuries involving RSVP volunteers
immediately to the RSVP office. All reports will be submitted in writing.
C. Other Provisions:
1. Separation from volunteer service: The volunteer station may request the
removal of an RSVP volunteer at anytime. The RSVP volunteer may withdraw
from service at the Volunteer Station or from RSVP at anytime. Discussion of
individual separations will occur among RSVP staff, Volunteer Station staff and
the volunteer to clarify the reasons, resolve conflicts, or take remedial action,
including placement with another Volunteer Station.
2. Letters of Agreement: When in-home assignments of volunteers are made, a
letter of agreement will be signed by the parties involved. The document will
authorize volunteer service in the home and identify specific volunteer activities,
periods and conditions of service.
3. Religious Activities: The Volunteer Station will not request or assign RSVP
volunteers to conduct or engage in religious, sectarian or political activities.
4. Displacement of Employees: The Volunteer Station will not assign RSVP
volunteers to any assignment which would displace employed workers or impair
existing contracts for service.
5. Accessibility and Reasonable Accommodation: The Volunteer Station will
maintain the programs and activities to which RSVP volunteers are assigned
accessible to persons with disabilities (including mobility, hearing, vision, mental
and cognitive impairments or addictions and diseases) and/or limited English
language proficiency and provide reasonable accommodation to allow persons
with disabilities to participate in programs and activities.
6. Prohibition of Discrimination: The Volunteer Station will not discriminate against
RSVP volunteers or in the operation of its programs on the basis of race, color,
national origin, including limited English proficiency; sex, age, political affiliation,
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sexual orientation, religion, or on the basis of disability, if the volunteer is a
qualified individual with a disability.
7. Specify, either by written information or verbally, that RSVP volunteers are
participants in the Volunteer Station's program in all publicity featuring such
volunteers, whether it be radio, TV, print or verbal presentation. Display an RSVP
placard where it may be viewed by the public.
8. For impact-based assignments, supply data measuring volunteer impact on
community needs to Collier County RSVP.
9. Conditions of this Memorandum of Understanding may be amended or
terminated in writing at anytime at the request of either party. It will be reviewed
every three years to permit needed changes.
10. Term. Either party may terminate this Agreement for any reason with thirty (30)
days written notice to the other party.
11. This Agreement is subject to the availability of funds. If funds are not available,
the County will provide notice in writing to the Volunteer Station at least thirty
days prior to the termination of the Agreement.
12. This Memorandum of Understanding contains all the terms and conditions
agreed upon by the contracting parties. No other understanding, oral or
otherwise, shall be deemed to exist or to bind any of the parties hereto.
13. This Memorandum of Understanding will be in effect upon dated signature of the
Volunteer Station's Representative and the RSVP Project Director.
14. The total number of RSVP volunteer assignments projected to be available with
the Volunteer Station on an annual basis is . It is projected that these
assignments will be at the following locations, in approximately the following
numbers:
The Volunteer Station representative who will serve as liaison with RSVP and who will be
responsible for volunteer orientation and supervision is:
Name (Please Print):
Title:
Phone:
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RSVP
By signing this MOU, the Volunteer Station Representative certifies that the station is a
public or nonprofit private organization, or a proprietary health care agency.
SIGNATURE:
Each part to this MOU has caused it to be executed effective this day of
20
Kimberley Grant Date
Director
Community and Human Services Division
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