Backup Documents 10/14/2014 Item #16D 5 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIj 60
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. Colleen Greene County Attorney Office /J1101101 ( l
4. BCC Office Board of County ` /1���U
1,
Commissioners iLg/s7
/v//7/V
5. Minutes and Records Clerk of Court's Office
Tir'n (0(M1t Z:35pn•
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 was10/14/1 Agenda Item Numbe 16D5
Approved by the BCC
Type of Document Agreement Number of Original 1
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? NB
2. Does the document need to be sent to another agency for additional signatures? If yes, _N ift--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 CrOK
by the Office of the County Attorney.
4. All handwritten strike-through and revisions have been initialed by the County Attorney's _t1.13---
Nr+
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 �d8
should be provided to the County Attorney Office at the time the item is input into SIRE. qtk-
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 10/14/14 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 NB
BCC,all changes directed by the BCC have been made,and the document is ready for the
Chairman's signature. p
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
160 5
Martha S. Vergara
From: Martha S.Vergara
Sent: Monday, October 20, 2014 3:16 PM
To: Betancur, Natali
Subject: Agreement - scanned copy
Attachments: Natali Bentancur.pdf
Natali,
Attached is a scanned copy for your records.
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(acollierclerk.com
160 5
AFTERSCHOOL MEALS PROGRAM
SPONSOR-SITE AGREEMENT FOR UNAFFILIATED SITES
This agreement is entered into between Southwest Florida Workforce Development Board, Inc. , hereinafter
Name of Sponsoring Organization
referred to as the "sponsor," and Collier County Government (Parks and Recreation) , hereinafter
referred to as the "site." Locations Include: East Naples Community Park, Golden Gate Community Park, Immokalee Sout
Park, Eagle Lakes Community Park
I. THE SPONSOR AGREES TO:
A. Instruct the site to comply with site requirements set forth in the Child Care Food Program (CCFP)
Procedure Manual for Afterschool Programs, as revised, and applicable CCFP policy memoranda.
B. Train site personnel on program requirements before the site begins participation in the Afterschool Meals
Program. The training will cover all required topics, including but not limited to information on meal pattern
requirements; recording and maintaining menus, meal counts, and attendance records; and civil rights
requirements.
C. Offer, at least annually, additional training sessions scheduled at times and places mutually convenient for
the sponsor and site.
D. Respond to the site's requests for technical assistance within two (2) days.
E. Distribute to the site all necessary CCFP Afterschool Meals Program record keeping forms.
F. Collect monthly, all necessary program records for claiming CCFP Afterschool Meals Program
reimbursement including, but not limited to, menus for each meal service claimed, Attendance Records,
and Meal Count Records including daily meal count documentation if meal counts were recorded on
another document and later transferred to the Monthly Meal Count Record form.
G. Review the site's Afterschool Meals Program operations to assess compliance with the meal pattern,
record keeping, and other program requirements. At least one review will occur during a new site's first
four weeks of CCFP participation. Unless otherwise approved by the Florida Department of Health (DOH),
reviews will be conducted at least three times within each 12-month period and not more than six months
will elapse between reviews, even if the reviews occur in different federal fiscal years.
H. Maintain records concerning the location and dates of all compliance reviews, problems noted, corrective
actions prescribed, and sanctions imposed.
I. Present photo identification when making visits to the site.
J. Hold site responsible for compliance with program policies and procedures, and disallow snacks and/or
meals not meeting U.S. Department of Agriculture (USDA) meal pattern requirements or not supported by
appropriate records.
K. Not discriminate against any child because of race, color, national origin, sex, age, or disability.
L. Determine the site's area eligibility to participate in the Afterschool Meals Program at least once every five
years, and maintain the site's eligibility documentation as directed in the Procedure Manual for Afterschool
Programs, as revised.
M. Provide snacks and/or prepared meals, and/or pay for catered snacks and/or meals delivered by a DOH
registered caterer, to the site at no cost to the site. However, if a site is responsible for the disallowance of
snacks and/or meals due to the site's failure to meet program requirements, the sponsor may charge the
site for the amount that the sponsor paid for the disallowed snacks and/or meals.
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160 5
N. Not charge the site a fee for the sponsor's program services.
II. THE SITE AGREES TO:
A. Prepare and/or serve age specific snacks and/or meals that meet program meal pattern requirements.
B. Record meal counts within one hour of the end of each snack and/or meal service.
C. Claim only those meal types approved by the sponsor for reimbursement.
D. Claim reimbursement for no more than one snack and one meal per child per day.
E. Maintain copies of all Child Care Food Program (CCFP) Afterschool Meals Program records such as
menus, Meal Count Records, Attendance Records, etc. for the current fiscal year and three subsequent
fiscal years. Records for the current month and the previous 12 months shall be maintained at the site.
Records older than 13 months may be maintained off-site or stored electronically, but these records shall
be made available to staff of the sponsor, the Florida Department of Health (DOH), the U.S. Department of
Agriculture (USDA), the Florida Department of Law Enforcement (FDLE), the Florida Department of
Financial Services, Division of Public Assistance Fraud, and Early Learning Coalitions upon presentation
of proper photo identification.
F. Send the previous month's claim documentation (Attendance Records, Monthly Meal Count Records and
daily meal count sheets, menus) to the sponsor by the fifth (5th) day of each month. If the fifth (5th) day of
the month falls on a weekend or holiday, these records must be received by the sponsor on the first
business day following the weekend/holiday.
G. Attend training sessions as required by the sponsor.
H. Allow representatives of the sponsor, DOH, USDA, FDLE, the Florida Department of Financial Services,
Division of Public Assistance Fraud, and Early Learning Coalitions access to the site during operating
hours for the purpose of reviewing CCFP Afterschool Meals Program meal services and/or records. The
site will allow such access upon presentation of photo identification whether the review is announced or
unannounced.
I. Allow representatives of the sponsor, DOH, USDA, FDLE, the Florida Department of Financial Services,
Division of Public Assistance Fraud, and Early Learning Coalitions to conduct parental/household contacts
regarding the CCFP Afterschool Meals Program.
J. If licensed or accredited, maintain a current child care license/accreditation and notify the sponsor of any
changes (e.g., capacity, hours/days of operation, expiration, revocation, etc.) within two (2) days of a
change.
K. Maintain current food service inspection documentation (satisfactory inspection report or valid
permit/certificate) and notify the sponsor of any food service changes (e.g., food service method, permit
expiration or revocation, etc.) within two (2) days of a change.
L. Report a change of address or ownership, site closure, and any permanent changes in meal service times
to the sponsor immediately.
M. Report to the sponsor any pending sale of the site prior to the sale closing date. (Note: This agreement
is not transferable to a new owner.)
N. Provide all eligible children the same snacks and/or meals at no separate cost to the parent or guardian.
O. When requested by the sponsor, distribute to parents copies of CCFP Afterschool Meals Program
materials.
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16D 5
P. Not discriminate against any child because of race, color, national origin, sex, age, or disability.
Q. The site agrees to use the U.S. Department of Homeland Security's E-Verify system,
https://e-verify.uscis.gov/emp, to verify the employment eligibility of:
1. All persons employed during the agreement term by the site to perform employment duties within
Florida;
2. All persons (including subcontractors) assigned by the site to perform work pursuant to this
agreement.
III. THE SPONSOR AND SITE MUTUALLY AGREE:
A. Effective Date
This agreement shall begin on the latest date on which both parties have signed the agreement.
B. Termination
1. Termination at Will
This agreement may be terminated by either party or the Florida Department of Health without cause upon
no less than thirty (30) days notice in writing to the other party, unless a lesser time is mutually agreed
upon in writing by the parties. Said notice shall be delivered by certified mail, return receipt requested, or
in person with proof of delivery.
2. Termination Because of Lack of Funds
In the event funds to finance this agreement become unavailable and the Florida Department of Health
terminates the sponsor's contract, the sponsor may terminate this agreement upon no less than twenty-
four (24) hour notice in writing to the site. Said notice shall be delivered by certified mail, return receipt
requested, or in person with proof of delivery.
I have read the above agreement and I understand each section and paragraph.
IN WITNESS THEREOF, the parties have caused this three (3) page agreement to be executed by
their undersigned officials as duly authorized.
Site Owner/Director Tort Henning, Chairman, Collier County Board of Commissioners
Mailing Address ' 32991 Tarniami Trail, Ste. 303, Naples, FL 34112
Signature ,ice . _ Date i Date of Birth
Sponsor Representative Joe Paterno
Title Executive Director
Signature /COL Date 10-8-14
•v-4 as to form and gali•y
Sponsor must ensure that both signature boxes are c
T`i EST' (/ I l ) /' % lea12,
DWI HT E. BRCCK, Clerk I Assistant County ttorney
141.--,
By:
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