Backup Documents 09/09/2014 Item #16D12 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SE T ' I 1 12
THE BOARD OF COUNTY COMMISSIONERS OFFICE FORS I e , I I
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. Jennifer A. Belpedio, ACA County Attorney Office (;tit 11/0))+-
2. BCC Office Board of County T\A
Commissioners ' t\kz
3. Minutes and Records Clerk of Court's Office
12(Y q I (1 C2: pM
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 Kr(641 Jdnntti 1 ,47 Phone Number d So?._ ( (p
Contact/ Department
Agenda Date Item was Sep v 6t.e - q, dp/t/ Agenda Item Number /10. b. /a
Approved by the BCC L r
Type of Document Ca)5 I P eLr'1)7�cOdj cns Number of Original a
Attached Documents Attached
PO number or account 'CA/(:;
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. (IV ¢pplicable)
1. Does the document require the chairman's original signature? 1J
2. Does the document need to be sent to another agency for additional signatures? If yes,
provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet. ILI Fr Vg
3. Original document has been signed/initialed for legal sufficiency. (All documents to be 6/n/
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 r ✓
Office and all other parties except the BCC Chairman and the Clerk to the Board N iik 1/*
5. The Chairman's signature line date has been entered as the date of BCC approval of the 1''
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 1 g-1
signature and initials are required. f
7. In most cases(some contracts are an exception),the original document and this routing slip '//
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. v ;
The document was approved by the BCC on 9/4?// and all changes made 04 II .®,
•
during the meeting have been incorporated in the attached document. The County 1:
Attorney's Office has reviewed the changes,if applicable. If
9. Initials of attorney verifying that the attached document is the version approved by the I y,.
BCC,all changes directed by the BCC have been made,and the document is ready for he ■ +'/�)
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
16012
Ann P. Jennejohn
From: Ann P.Jennejohn
Sent: Friday, September 12, 2014 3:51 PM
To: Robinson, Erica
Subject: SHIP Certifications (9-9-14#16D12)
Attachments: SHIP Certifications (Item #16D12 9-9-14).pdf
Hi Erica,
Here are the signed SHIP Certifications you needed,
approved by the Board this past Tuesday, September 9th
as Agenda Item #16012.
Please let me know if you'd like me to do anything
else regarding the item.
Thank you!
Ann Jennejohn, Deputy Clerk
Clerk of the Circuit Court
Clerk of the Value Adjustment Board
Collier County Minutes & Records Dept.
239-252-8406
239-252-8408 (Fax)
16012
SHIP AR/2011-2012-Closeout
2011/2012 COLLIER COUNTY
SHIP CERTIFICATION
On behalf of Collier County ,I hereby certify that the information presented herein is true and
accurate as of the date of submission.
/ /
Date lip • Date 9111*
Witness Chief Elected O i ial
r,
Tom Henning, • airman
t .. rr�a AL %ateQ 4 �� `s '. _ Date 9 ill&
I
Wit ' CI unty/City Admin. trat.
Leo Ochs Jr., Co my anager
Or
1.,x- 5 li041,90
& . ∎% , • -pateQ It ') D14
Attest(, al) -411/°' 1:,,
Ghaitmaft �,
Attest a� w��`�
a �' Approved for form and legality:
signatur�:�niY� . . �,� .
, \
Jennifer A. Bel s-.o, Assistant County Attorney `\of
g
GENERAL INFORMATION
Name of Person to call regarding the Annual Report Form:
Kristi Sonntag, Manager Federal/State Grants
Housing, Human&Veteran Services Department
Telephone Number: (239) 252-4663
0
16012
SHIP 2011/2012-Annual Report Closeout
CERTIFICATION
For Implementation of
Regulatory Reform Activities
Required by S.H.I.P.
On behalf of COLLIER COUNTY, I hereby certify that the following information is true and accurate
as of the date of submission:
1) Permits as defined in s.163.3164(7) and (8)* for affordable housing projects are expedited to a
greater degree than other projects; and
2) There is an ongoing process for review of local policies, ordinances, regulations, and plan
provisions that increase the cost of housing prior to their adoption.
3) The cumulative cost per newly constructed housing per housing unit, from these actions for
**FY 13/14 is estimated to be $ 0 •
4) The cumulative cost per rehabilitated housing per housing unit, from these actions for
**FY 13/14 is estimated to be $ Q .
Date i /__., . Date 10114
Witness Chief Elected Offici.
Tom Henning., Ch.l,rman
. �..� ate � �� Date ° jcIJI#:�
W A '
County/City Administra
Leo Ochs,Jr., County ger
t '1 ��® �/Datp<<� 4 Approved for form and legality:
Attest ( 'AL)
..Attes . � an s
signature 6nly.,` VAr7))16. ‘,As‘o-
Date li It
a,., Jennifer A. Belpedi& sistant County Attorney t
\\op� n
Note: This form will be utilized beginning with **FY 2003/2004
* 163.3164(7)of the Florida Statutes: "Development order"means any order granting,denying,or granting with conditions (1)an application for a development permit. 163.31 64(8)of the Florida Statutes: "Development permit"includes any building
permit,zoning permit,subdivision approval,rezoning,certification, special exception,variance,or any other official action
nf lnral nnvarnmant having th,•• ffart nf nnrrnittinn tha rinVAlnmmnnt of la,,.l