Backup Documents 09/09/2014 Item #16D 3 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SEN T
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR S l
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. Jennifer Belpedio County Attorney Office %049) cop``
4. BCC Office Board of County \--\'T -
Commissioners 1 v12VA
5. Minutes and Records Clerk of Court's Office 4-7m 9((_/14 3,`p2Pm
PRIMARY CONTACT INFORMATION �I
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 1 Phone Number 239-252-40
Contact/ Department
Agenda Date Item was 09/09/14 Agenda Item Number 16D3
Approved by the BCC
Type of Document Closeout Documents Number of Original s sear S
Attached Documents Attached
PO number or account -'+robe,.
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? NB ✓
2. Does the document need to be sent to another agency for additional signatures? If yes, NB 1,
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 NB ✓
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 911111111111111111e 6 IA
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 V
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip r T\) �
should be provided to the County Attorney Office at the time the item is input into SIRE. I'
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 and all changes made during NB Ve
the meeting have been incorporated in the attached ocument. The County
Attorney's Office has reviewed the changes,if applicable. .7 9 j —`�
9. Initials of attorney verifying that the attached document is the version approved by the NB
BCC,all changes directed by the BCC have been made,and the document is ready for e • •
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
1603
MEMORANDUM
Date: September 16, 2014
To: Natali Betancur, Operations Analyst
Park & Recreation Department
From: Ann Jennejohn, Deputy Clerk
Minutes & Records Department
Re: HUD Grant #B-08-SP-FL-0168 Closeout Agreement, Certificate
of Project Completion and Federal Financial Report for the
Immokalee South Park Project
Attached for further processing are two original copies of the closeout agreements and
related documents referenced above, (Item #1603) approved by the Board of County
Commissioners on Tuesday, September 9, 2014.
The Board's Minutes and Records Department has maintained copies of all documents
for the Board's Official Record.
If you have any questions, please contact me at 252-8406.
Thank you.
Attachment
1603
PROJECT REIMBURSEMENT NARRATIVE
December 4, 2009 thru June 30, 2014
Immokalee South Park: Community Center Building Federal Grant# B-08-SP-FL-0168
The Community Center project consists of a one story building approximately 3,900 square feet. It
features a community meeting room, kitchen, class room, storage, HVAC/Mechanical room, rest rooms
and janitorial closets.
On December 4, 2009; a Purchase Order was issued to begin the design phase of the project.The Board
of County Commissioners approved the construction contract on December 11, 2012. Construction of
the building started in May of 2013. The narrative below outlines every major milestone in the project
funded by the EDI grant.
Pay Application/Invoice #4 (Period ending August 26th) -The contractor installed the trusses and roof
sheeting. Sub-contractor waterproofed the walls. Bluewater worked on water tie-in to meter and fire
hydrant. Zip Foam sprayed underside roof deck to beam. Florida Hydronic Solutions worked on HVAC
layout. Gulf Coast Power & Light started the electrical rough. All work for this period was paid through
different funding source.
Pay Application/Invoice#5 (Period ending September 30th) - Sub-contractors worked on HVAC rough,
framing and insulation. The store front which includes windows and doors were also installed. All work
for this period was paid through different funding source.
Pay Application/Invoice#6(Period ending October 28th)-Sub-contractors worked on installing drywall,
pouring concrete entrance slabs, insulating fire dampers, setting panels for the electrical room, building
the dumpster enclosure, painting the interior,and working on HVAC.
Pay Application/Invoice#7(Period ending November 27th)-Sub-contractors worked on finishing the
floor polish,electrical trim, HVAC,site work,sidewalks, stucco, restroom tile,fire alarm, parking lot,
gutters, ceiling tiles, lightning protection, dumpster enclosure, epoxy floors, restroom accessories,
shutters, and irrigation. Final electrical and plumbing inspections have been completed.
Pay Application/Invoice#8(Period ending December 29th)-Sub-contractors worked on finishing
landscaping, down spouts,doors, buffing and polishing floors,fire alarm system,fencing, restroom
partitions,wireless radio,and dumpster gates.
Pay Application/Invoice#9(Period ending December 29th)—Release of last 5%retainage.
1603
Please let us know if you have any questions or need additional information.
Thank/you/ f-
Natali Betancur
Operations Analyst
Collier County Parks & Recreation
1 5000 Livingston Road N.
Naples, Florida 34109
Tel. #(239)252-4059
0 3
JUL 0 8 2014 , !;
U.S.DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT
( 1Iiit1* WASHINGTON,D.C.20410-1000 rtecreation
OFFICE OF COMMUNITY PLANNING
AND DEVELOPMENT
June 26, 2014
Mr. Natali Betancur
Operations Supervisor
County of Collier
15000 Livingstone Road
Naples, FL 34119
Dear Mr. Betancur:
In order that we may administratively close-out the 2008 Economic Development
Initiative(EDI) - Special Project Grant B-08-SP-FL-0168 for County of Collier, Naples, FL,
this letter transmits the Certificate of Project Completion and the Grant Close-out Agreement.
Also, please refer to ARTICLE V Project Close-out, in your Grant Agreement for specific
information on how to proceed with project completion and what additional records must be
submitted. Specifically, in addition to the Certificate of Project Completion and the Grant
Close-out Agreement, you must submit a Federal Finacial Report Form SF-425, and a final
performance report as required by the Grant Agreement. You are requested to complete and
sign the Certificate of Project Completion and the Grant Close-out Agreement and return the
completed forms along with other pertinent close-out information within ninety(90) days from
the date of this request. The information should be submitted to the following address:
U. S. Department of Housing and Urban Development
Community Planning and Development
Congressional Grants Division, Room 7146
451 7th St., SW
Washington, DC 20410
If you have any questions regarding these documents and procedures, please contact Laura
Stillwell of my staff on 202-708-3773 ext. 7037
Sin er-1
t
Holly A. K. ,
Acting Di -ctor
Congressional Grants Divison
Attachments
1603
`oy�
CO A,
MEMORANDUM
Parks f3t
Recreation
Play, Connect er Discover
To: Holy A Kelly, Acting Director, Congressional Grants Division
From: Natali Betancur, Operations Analyst, Parks and Recreation
Date: September 9, 2014
Subject: Immokalee South Park - HUD EDI Special Project Grant #B-08-SP-FL-0168
We are transmitting two packets of original closeout documents and requesting one fully executed
original be returned to the following address:
Collier County Parks and Recreation
Administration
15000 Livingston Road
Naples, FL 34109
We have enclosed a FedEx envelope with our account information for your convenience.
Should additional information be needed; please contact me at 239-252-4059.
Thank you.
Cc: Barry Williams, Director, Parks and Recreation Department
Ilonka Washburn, Operations Manager, Parks and Rec.
Therese Stanley, Senior Budget Analyst, Grant Management
16D3
U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT
GRANT CLOSEOUT AGREEMENT
FOR
2008 EDI-SPECIAL PROJECT GRANT NO. B-08-SP-FL-0168
This Agreement, enter into by and between County of Collier, Naples, FL hereinafter referred to
as "Grantee") and the U.S. Department of Housing and Urban Development(hereinafter
referred to as "HUD").
1. Whereas, the Grantee undertook activities with financial assistance in the amount of
$147,000 from HUD provided pursuant to the authority of Title II of Public Law 110-161 for
B os sP F�o�ss project no. hereinafter referred to as "project
2 Whereas, the Grantee and HUD entered into a Grant Agreement dated
January 26,2009, as revised by N!A amendments, hereinafter referred to as the
"Grant Agreement", and;
3. Whereas, the authorized and specified activities which comprise the project have
been completed by the Grantee and/or other participating parties, as required by the Grant
Agreement, and;
4. Whereas, the Grant Agreement requires compliance with 24 CFR Part 84 or 85, as
applicable, which includes requirements continuing after Project completion related to
use and disposition of real or personal property purchased with Federal funds,retention
of and access to records after close-out dis-allowances of Grant payments, and collection
of amounts due;
5. Whereas, the parties hereto desire to close-out the project in reliance upon: 1)
Grantee's final progress/performance report including financial data and a
performance/narrative report; and 2) the Grantee's Certificate of Project Completion.
Now therefore, in consideration of the mutual covenants, promises and
representations contained herein, the parties hereto agree as follows:
Section A. The Grantee shall continue to comply with the applicable
requirements of 24 CFR Part 84 or 85, as applicable, related to the use and disposition of
real or personal property purchased with Federal funds, retention of and access to
records, after close-out dis-allowances of grant payments, and collection of amounts due.
Section B. The Grantee agrees to the Total Grant Amount for the Project,
including any reduction in the grant amount caused by a decrease in cost; as indicated on
the Grantee's Certificate of Project Completion attached hereto and made a part hereof;
16133
Section C. Any excess grant funds drawn by the Grantee, in the amount
specified in Line 5 of the Certificate of Project Completion shall have been or shall be
returned immediately to HUD under the following repayment terms:
N/A
Section D. Any grant funds remaining in the Grantee's Line of Credit account
for the referenced Project have been reduced to zero(0) pending any final draw indicated
as a positive balance on line 6 of the Certificate of Project Completion. Grantee shall
draw down this balance within the following period N/A or Credit to
zero(0)and the Grantee shall have waived its rights to the remaining funding.
Section E. Execution of this Agreement shall constitute completion of the
Project activities and financial closeout of project costs, except for ongoing requirements
described in Section A of this Close-out Agreement. This Close-out Agreement shall be
followed as required by the Program directives cited therein and the following additional
post close-out requirements shall be followed as committed to in the approved application
which was incorporated in the Grant Agreement:
N/A
Section F. If any provision of this Agreement is held invalid, such holding
shall not affect the validity of the remainder of this Agreement.
Section G. If a default occurs under this Agreement or under the Grant
Agreement, HUD may at any time proceed to protect all rights available to HUD under
this Agreement or under default provisions of the Grant Agreement.
Section H. Special Conditions required by this Agreement are attached:
N/A
161) 3
This Grant Close-out Agreement is hereby executed and delivered by the parties hereto
on the dates set forth below their respective signatures and the Grantee agrees to abide by
all governing regulations as of the date executed by HUD.
Grantee's Authorized Official
Name. Signature:
•
Tom Henning
Tile:
Date. 4' 9' )
Chairman
HUD's Authorized Official
Name: Signature:
Holly A. Kelly
Title: Date:
Acting Director
ATTEST: Approved as to form and legality
DWIGHT E. BROCK;Clerk
BY i— � Asst County eY
Attest as �a '_
signature only.;
1603
U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT
CERTIFICATE OF PROJECT COMPLETION
FOR
EDI-SPECIAL PROJECT GRANT NO. B-08-SP-FL-0168
The Grantee, County of Collier, hereby certifies that: 1)the project as
described in the approved application has been performed/completed in accordance with
the terms and conditions of the executed Grant Agreement and applicable Grant award
statute; 2) all data provided below fairly reflect costs and sources of funds for the
project; 3) all data are taken from the HUD approved Financial Status Report and other
current related documents; and 4) the Grantee has complied with all the requirements of
the Grant Agreement.
Description Amounts $
000
1) Grant amount per Grant Agreement $147,
2) Grant amount that meets the allowable and allocable
requirements, including the necessary and reasonable $147 000
standard, of OMB Circular A-87 or A-122 QQ
3) Cumulative Grant funds drawn down. �P 147 ���
4) Balance available for drawdown. N/A
(line 2 minus line 3 if greater than zero)
5) Amount to be returned to HUD. N/A
(line 2 minus line 3 if less than zero)
6) Unused Grant amount to be canceled by HUD N/A
(line 1 minus line 3 minus line 4 if greater than zero)
/ /
Tom Henning, Chairman — c ) 9)4-
Name/Title of Grantee Official Signature of Authorizin. Grantee Official Date
(WARNING: Section 1001, Title 18 of U.S. Code (Criminal Code and Criminal
Procedure, 72 Stat. 967) applies to the above statements.)
THIS CERTICATE OF PROJECT COMPLETION IS HEREBY APPROVED:
Holly A. Kelly
Acting Director
Congressional Grants Divison
Name/Title of Authorizing , Signature of Authorizing HUD Official Date
HUD Program Official
5 ,1
ATI EST: Approved as to form and legality
DWIG 7 E. BROCK Clerk • ,.1 an's
Au- �� '�''�'� Aecicf Cnnnh, AHn
f 1613 3
FEDERAL FINANCIAL REPORT
(Follow form instructions)
1. Federal Agency and Organizational Element to Which 2.Federal Grant or Other Identifying Number Assigned by Federal Agency(To
Report is Submitted report multiple grants, use FFR Attachment) Page of
U.S. Department of Housing and Urban Development B-08-SP-FL-0168 1
I pages
3. Recipient Organization(Name and complete address including Zip code)
Collier County Parks and Recreation, 150000 Livingston Rd, Naples,34109-3808
4a. DUNS Number 4b. EIN 5. Recipient Account Number or Identifying 6. Report Type 7. Basis of Accounting
76997790 59-6000558 Number(To report multiple grants, use FFR ❑Quarterly I]Cash
Attachment) ❑Semi-Annual ❑Accrual
N/A ❑Annual
0 Final
8. Project/Grant Period(Month, Day,Year) 9. Reporting Period End Date(Month, Day,Year)
From: January 26,2009 ITo: October 30,2015 06/30/14
10.Transactions I Cumulative
(Use lines a-c for single or combined multiple grant reporting)
Federal Cash(To report multiple grants separately,also use FFR Attachment):
a.Cash Receipts $ 147,000.00
b.Cash Disbursements $ 147,000.00
c.Cash on Hand(line a minus b) $ -
(Use lines d-o for single grant reporting)
Federal Expenditures and Unobligated Balance:
d.Total Federal funds authorized $ 147,000.00
e. Federal share of expenditures $ 147,000.00
f. Federal share of unliquidated obligations
g.Total Federal share(sum of lines e and f) $ 147,000.00
h. Unobligated balance of Federal funds(line d minus g) _ $ -
Recipient Share:
i.Total recipient share required
j. Recipient share of expenditures
k. Remaining recipient share to be provided(line i minus j)
Program Income:
I.Total Federal share of program income earned
m. Program income expended in accordance with the deduction alternative
n. Program income expended in accordance with the addition alternative
o. Unexpended program income(line I minus line m or line n)
11. a.Type b. Rate c. Period ;Period To d. Base e.Amount Charged f. Federal Share
Indirect From i
Expense
�" ,4s ° :�•. .z,u,; 'c .:'',,: ,.,:. ,1;419.Totals: 0 0 0
12. Remarks:Attach any explanations deemed necessary or information required by Federal sponsoring agency in compliance with governing legislation:
13.Certification:By signing this report,I certify to the best of my knowledge and belief that the report is true,complete,and accurate,and the
expenditures,disbursements and cash receipts are for the purposes and intent set forth in the award documents. I am aware that any false,
fictitious,or fraudulent informatio ay subject me to criminal,civil,or administrative penalties.(U.S.Code,Title 18,Section 1001)
a. Typed or Printed Nam nd Title • Authorized Certifying Official c.Telephone(Area code, number,and extension)
Tom Henning,Chairma 239-252-4000
- d. Email Address
b. Signal a of Auth izof ed Certifying Official ' e. Date Report Submitted(Month, Day,Year)
�" TF.ST• R CK,Ctwk Approved as to form and legality ' '
DwiGHT E `8 .•� .ro..
'� Standard Form 425-Revised 10/11/2011
�l 70,f.",K g �-"- OMB Approval Number: 0348-0061
By: ,a+i airman Assistant County AM M Cy Expiration Date:2/28/2015
_A A-
Paperwo ; =Ii+';",'I :nt
According !WI,'. eduction Act,as amended,no persons are required to respond to a collection of information unless it displays a valid OMB Control Number The
valid OMB contro1Aumber for this infbrmation collection is 0348-0061.Public reporting burden for this collection of information is estimated to average 1.5 hours per response.
including time for reviewing instructions,searching existing data sources,gathering and maintaining the data needed,and completing and reviewing the collection of
information. Send comments regarding the burden estimate or any other aspect of this collection of information,including suggestions for reducing this burden,to the Office of
Management and Budget,Paperwork Reduction Project(0348-0061),Washington,DC 20503.
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QPP�MENTpF,y 16 0 3
°� 1 a,01 U.S.DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT
*IIIIii WASHINGTON,DC 20410-7000
FB4N DE.,
OFFICE OF COMMUNITY PLANNING
AND DEVELOPMENT
MAR 2 3 2015
Mr.Natali Betancur (C _ V
11
Operations Supervisor
County of Collier MAR 3 1 2015
15000 Livingstone Road
Naples, FL 34119 Parks and Recreation
RE: Fully Executed Grant Closeout Package for FY2008 Economic Development Initiative-
Special Project Grant B-08-SP-FL-0168
Dear Mr. Betancur:
This letter is to inform you that the FY2008 Economic Development Initiative-Special Project
grant(EDI-SP)has been countersigned by the Department of Housing and Urban Development and is
administratively closed out. Attached is a countersigned, fully executed copy of the closeout package
(Certificate of Project Completion and Grant Closeout Agreement)for this grant. You are advised to
retain this Closeout package in the grant award records. Further,please be advised that your organization
is required to adhere to the provisions contained within the Grant Closeout Agreement.
If you need further technical assistance for this project,please feel free to contact me via telephone
at(202)402-6324 or via email at Holly.A.Kelly(;hud.gov.
Thank you for participating in the Department's program.
Sincerely,
U
Hol . Kelly
Office of Policy Development and Coordination
Closeout Team
Attachment:
www.hud.gov espanol.hud.gov
1603
U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT
GRANT CLOSEOUT AGREEMENT
FOR
2008 EDI-SPECIAL PROJECT GRANT NO. B-08-SP-FL-0168
This Agreement, enter into by and between County of Collier,Naples,FL hereinafter referred to
as "Grantee") and the U.S. Department of Housing and Urban Development(hereinafter
referred to as "HUD").
1. Whereas,the Grantee undertook activities with financial assistance in the amount of
$147,000 from HUD provided pursuant to the authority of Title II of Public Law 110-161 for
project no.
B-08-SP-FL-0168 hereinafter referred to as "project".
2 Whereas, the Grantee and HUD entered into a Grant Agreement dated
January 26,2009,as revised by N/A amendments,hereinafter referred to as the
"Grant Agreement", and;
3. Whereas, the authorized and specified activities which comprise the project have
been completed by the Grantee and/or other participating parties, as required by the Grant
Agreement, and;
4. Whereas, the Grant Agreement requires compliance with 24 CFR Part 84 or 85, as
applicable, which includes requirements continuing after Project completion related to
use and disposition of real or personal property purchased with Federal funds,retention
of and access to records after close-out dis-allowances of Grant payments, and collection
of amounts due;
5. Whereas, the parties hereto desire to close-out the project in reliance upon: 1)
Grantee's final progress/performance report including financial data and a
performance/narrative report; and 2)the Grantee's Certificate of Project Completion.
Now therefore, in consideration of the mutual covenants,promises and
representations contained herein, the parties hereto agree as follows:
Section A. The Grantee shall continue to comply with the applicable
requirements of 24 CFR Part 84 or 85, as applicable, related to the use and disposition of
real or personal property purchased with Federal funds, retention of and access to
records, after close-out dis-allowances of grant payments, and collection of amounts due.
Section B. The Grantee agrees to the Total Grant Amount for the Project,
including any reduction in the grant amount caused by a decrease in cost; as indicated on
the Grantee's Certificate of Project Completion attached hereto and made a part hereof;
1603
Section C. Any excess grant funds drawn by the Grantee, in the amount
specified in Line 5 of the Certificate of Project Completion shall have been or shall be
returned immediately to HUD under the following repayment terms:
N/A
Section D. Any grant funds remaining in the Grantee's Line of Credit account
for the referenced Project have been reduced to zero(0)pending any final draw indicated
as a positive balance on line 6 of the Certificate of Project Completion. Grantee shall
draw down this balance within the following period N/A or Credit to
zero(0)and the Grantee shall have waived its rights to the remaining funding.
Section E. Execution of this Agreement shall constitute completion of the
Project activities and financial closeout of project costs, except for ongoing requirements
described in Section A of this Close-out Agreement. This Close-out Agreement shall be
followed as required by the Program directives cited therein and the following additional
post close-out requirements shall be followed as committed to in the approved application
which was incorporated in the Grant Agreement:
N/A
Section F. If any provision of this Agreement is held invalid, such holding
shall not affect the validity of the remainder of this Agreement.
Section G. If a default occurs under this Agreement or under the Grant
Agreement, HUD may at any time proceed to protect all rights available to HUD under
this Agreement or under default provisions of the Grant Agreement.
Section H. Special Conditions required by this Agreement are attached:
N/A
1603
This Grant Close-out Agreement is hereby executed and delivered by the parties hereto
on the dates set forth below their respective signatures and the Grantee agrees to abide by
all governing regulations as of the date executed by HUD.
Grantee's Authorized Official
Name: Signature: / /
Tom Henning „ : . ire*.
Title: Date: 4h h I
Chairman
HUD's Authorized Official
Name: Si=�'' il,
Holly A. Kelly i��i►��/I i�
Title: Date to :or
Acting Director
n
ATTEST: r`. Approved as to form and legality
DWIGhT. E. 8ROCK.Clerk
By . i..aw / Aslant County ey iiik
- ttest.as a A ''_
signature-only.;
1
6D3
U.S. DEPARTMENT OF HOUSING AND URBAN DEVELOPMENT
CERTIFICATE OF PROJECT COMPLETION
FOR
EDI-SPECIAL PROJECT GRANT NO. B-08-SP-FL-0168
The Grantee, County of Collier,hereby certifies that: 1) the project as
described in the approved application has been performed/completed in accordance with
the terms and conditions of the executed Grant Agreement and applicable Grant award
statute; 2) all data provided below fairly reflect costs and sources of funds for the
project; 3) all data are taken from the HUD approved Financial Status Report and other
current related documents; and 4)the Grantee has complied with all the requirements of
the Grant Agreement.
Description Amounts $
1) Grant amount per Grant Agreement $147,000
2) Grant amount that meets the allowable and allocable
requirements, including the necessary and reasonable $147 000
standard, of OMB Circular A-87 or A-122
3) Cumulative Grant funds drawn down. $147,000
N/A
4) Balance available for drawdown.
(line 2 minus line 3 if greater than zero)
N/A
5) Amount to be returned to HUD.
(line 2 minus line 3 if less than zero)
6) Unused Grant amount to be canceled by HUD
N/A
(line 1 minus line 3 minus line 4 if greater than zero)
Tom Henning, Chairman _ f -
Name/Title of Grantee Official Signature of Authorizing_Grantee Official Date
(WARNING: Section 1001,Title 18 of U.S. Code(Criminal Code and Criminal
Procedure, 72 Stat. 967) applies to the above statements.)
THIS CERTICATE OF PROJECT COMPLETION IS HEREBY APPROVED:
Holly A. Kelly
Acting Director
Congressional Grants Divison `AI IP All
'140
fr
Name/Title of Authorizing 'ignature o A tho ' mg . Official Date
HUD Program Official
ATTEST: - Approved as to form and legality
DWiG T'1?r. 3ROCK Clark
Au. �� ��y •
.:.,:i •- • . 1 111 A A.
9
FEDERAL FINANCIAL REPORT 1 60 3
(Follow form instructions)
1. Federal Agency and Organizational Element to Which 2. Federal Grant or Other Identifying Number Assigned by Federal Agency(To
Report is Submitted report multiple grants,use FFR Attachment) Page of
U.S. Department of Housing and Urban Development B-08-SP-FL-0168 1
I pages
3. Recipient Organization(Name and complete address including Zip code)
Collier County Parks and Recreation, 150000 Livingston Rd, Naples,34109-3808
4a. DUNS Number 4b. EIN 5. Recipient Account Number or Identifying 6. Report Type 7. Basis of Accounting
76997790 59-6000558 Number(To report multiple grants, use FFR ❑Quarterly E Cash
Attachment) ❑Semi-Annual ❑Accrual
N/A El Annual
0 Final
8. Project/Grant Period(Month, Day,Year) 9. Reporting Period End Date(Month, Day,Year)
From January 26,2009 ITo: October 30,2015 06/30/14
10.Transactions I Cumulative
(Use lines a-c for single or combined multiple grant reporting)
Federal Cash(To report multiple grants separately,also use FFR Attachment):
a. Cash Receipts $ 147,000.00
b. Cash Disbursements $ 147,000.00
c. Cash on Hand(line a minus b) $
(Use lines d-o for single grant reporting)
Federal Expenditures and Unobliqated Balance:
d. Total Federal funds authorized $ 147,000.00
e. Federal share of expenditures $ 147,000.00
f. Federal share of unliquidated obligations
q. Total Federal share(sum of lines e and f) $ 147,000.00
h. Unobliqated balance of Federal funds(line d minus q) $
Recipient Share:
i. Total recipient share required
j. Recipient share of expenditures
k. Remaining recipient share to be provided(line i minus j)
Program Income:
I. Total Federal share of program income earned
m. Program income expended in accordance with the deduction alternative
—
n. Program income expended in accordance with the addition alternative
o. Unexpended program income(line I minus line m or line n)
11. a.Type b. Rate c. Period Period To d. Base e.Amount Charged f. Federal Share
Indirect From
Expense
q.Totals: 0 0 0
12. Remarks:Attach any explanations deemed necessary or information required by Federal sponsoring agency in compliance with governing legislation:
13.Certification: By signing this report,I certify to the best of my knowledge and belief that the report is true,complete,and accurate,and the
expenditures,disbursements and cash receipts are for the purposes and intent set forth in the award documents. I am aware that any false,
fictitious,or fraudulent informatio ay subject me to criminal,civil,or administrative penalties.(U.S.Code,Title 18,Section 1001)
a.Typed or Printed Nam9;and Title Authorized Certifying Official c.Telephone(Area code,number, and extension)
Tom Henning,Chairman' 239-252-4000
% ' d. Email Address
./
b. Signatur fe oo Auth !zed Certifying Official e. Date Report Submitted(Month, Day,Year)
ATTEST: Approved as to form and legality 14.Agency use only:
_ - ' ` Standard Form 425 Revised 10/11/2011
. 1 ..`t/,� > '�—y OMB Approval Number: 0348-0061
Attp.�. hii a rmap'S Assistant County A o Cy Expiration Date:2/28/2015
Paperwor .= .•t1(�f nt
According r ''...-,,dtlt.eduction Act;'as amended,no persons are required to respond to a collection of information unless it displays a valid OMB Control Number.The
valid OMB control number for this information collection is 0348-0061. Public reporting burden for this collection of information is estimated to average 1.5 hours per response,
including time for reviewing instructions,searching existing data sources,gathering and maintaining the data needed,and completing and reviewing the collection of
information.Send comments regarding the burden estimate or any other aspect of this collection of information,including suggestions for reducing this burden,to the Office of
Management and Budget,Paperwork Reduction Project(0348-0061),Washington,DC 20503.
1603•
Line of Credit Control System (A67) 'y ' �
Web Grant Detail
Front Page-► BO8SPFLO168
COLLIER COUNTY User: L. Stillwell
BO8SPFLO168 EDI Special Projects (EDSI)
General Budget oucherS
Region: 11 WASHINGTON CPD Authorized: 147,000.00 Actions
Office: 92 HEADQUARTERS Disbursed: 147,000.00 Contract Dates
Tax ID: 59-6000558 -► EDSI In Process: 0.00 Grant History
DUNS: 076997790 0 Balance: 0.00 PAS Project Detail
VRS No 46869-80001 Disbursement History
Semi-Annual Report Due covering 01-26-2014 to 07-25-2014, due 08- Letter History
30-2014 Budget Update
Business Partner Level Payment LOCCS Created: 02-02-2009 Update Thresholds
Information Effective Date: 01-26-2009 Discontinue Letters
0670-9171-9 Receipt of Outstanding
ABA No FIFTH THIRD BANK OF FLORIDA
Document
Account No.: 1138577 Checking Project Notes
Pymt Mthds: ACH Update Mailing Address
Contractual Organization Tax ID: 59-6000558 Suspend/Unsuspend
COLLIER COUNTY Revise Budget Disbursements
3301 E TAMIAMI TRAIL
NAPLES, FL 34112-
Payee Organization Tax ID: 59-6000558
- same as above -
Program Office Level Correspondence Mailing Address
COLLIER COUNTY/HOUSING DIRECTOR
3301 E. TAMIAMI TRAIL
BLDG. H
ROOM 211
NAPLES , FL 34112-0000
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