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Backup Documents 06/14/2016 Item #16D 5 OUTING 5 ORIGINAL AC ACCOMPANY ALL ORIGINAL DOCUMENTS TS SENT TO LIp 16 D 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 Attomey Office. Route to Addressee(s) (List in routing order) Office Initials Date 1. Michelle Rubbo Community & Human Services (CHS) Division 0314? 2. County Attorney Office County Attorney Office 3. BCC Office Board of County OF b Commissioners J}-N its I `Qy -� -itp 4. Minutes and Records Clerk of Court's Office (-7PRIMARY CONTACT INFORMATION N (o/l 4.� o 2r(rn- 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 Rosa Munoz,CHS Phone Number 252-5713 Contact/ Department / Agenda Date Item was June 14,2016 V Agenda Item Number 16D5 Approved by the BCC Type of Document Amendment#1 Boys&Girls Club of Number of Original /1"-- Attached Collier County Agreement(Bus / Documents Attached Transportation Services 2015) PO number or account j� 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 signat ignature ok RM 2. Does the document need to be sent to another agency for additional signatures? If yes, N/A 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 RM 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 N/A 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 RM 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 RM signature and initials are required. 7. In most cases(some contracts are an exception),the original document and this routing slip „Nit 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 06/14/16 and all changes made RM .:,.::,•:,.,,,,° during the meeting have been incorporated in the attached document. The County 0, + .0a Attorney's Office has reviewed the changes,if applicable. 3.2 _ 9. Initials of attorney verifying that the attached document is the version approved by the BCC, all changes directed by the BCC have been made,and the document is ready for the Chairman's signature. ;i- 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 As...\ 1 60 5 MEMORANDUM Date: June 15, 2016 To: Rosa Munoz, Grants Coordinator Housing, Human & Veteran Services From: Martha Vergara, Deputy Clerk Minutes & Records Department Re: Amendment #1 to Grant #B-15-UC-12-0016 Agreement between Collier County and The Boys & Girls Club of Collier County, FL, Inc. Attached is an original copy of the document referenced above, (Item #165) approved by the Board of County Commissioners on Tuesday, June 14, 2016. The second original will be kept in the Minutes and Records Department for the Board's Official Record. If you have any questions, please contact me at 252-7240. Thank you. Attachment 1 6 0 5 MEMORANDUM Date: June 15, 2016 To: The Boys & Girls Club of Collier County, Inc. 7500 Davis Blvd. Naples, FL 34104 Cc: Rosa Munoz, Grants Coordinator Housing, Human & Veteran Services From: Martha Vergara, Deputy Clerk Minutes & Records Department Re: Amendment #1 to Grant #B-15-UC-12-0016 Agreement between Collier County and The Boys & Girls Club of Collier County, FL, Inc. Attached is an original copy of the document referenced above, (Item #165) approved by the Board of County Commissioners on Tuesday, June 14, 2016. The second original will be kept in the Minutes and Records Department for the Board's Official Record. If you have any questions, please contact me at 252-7240. Thank you. 160 5 FAIN # B-15-UC-12-0016 B-16-UC-12-0016 Federal Award Date Est. 10/2015 Federal Award Agency HUD CFDA Name Community Development Block Grant CFDA/CSFA# 14.218 Total Amount of Federal $25,000 FY 2015/2016& Funds Awarded $25,000 FY 2016/2017 Subrecipient Name The Boys&Girls Club of Collier County, FL, Inc. DUNS# 018696208 FEIN# 65-0279110 R& D No Indirect Cost Rate No Period of Performance FY 15/16: 10/01/2015-09/30/2016 FY 16/17: 10/01/2016-09/30/2017 Fiscal Year End 5/31 Monitor End: 09/2017 FIRST AMENDMENT TO AGREEMENT BETWEEN COLLIER COUNTY AND THE BOYS&GIRLS CLUB OF COLLIER COUNTY, FL, INC. ��i1.{-kr. THIS AGREEMENT is made and entered into this r7 day ou4.11Q2016, by and between the Boys & Girls Club of Collier County, Florida, Inc. a private not-for-profit corporation existing under the laws of the State of Florida, herein after referred to as SUBRECIPIENT and Collier County, Florida, hereinafter to be referred to as"COUNTY," collectively stated as the "Parties." WHEREAS, on October 27, 2015, the COUNTY entered into an Agreement for awarding Community Development Block Grant Program funds to be used for the Bus Transportation Services Project (hereinafter referred to as the "Agreement") ; and WHEREAS, the Parties desire to amend the Agreement to revise the National Objective in order to benefit Low Mod Income/Low Mod Clients(LMC) who are at least 51% Low Mod Income (LMI)and revise reporting Exhibit C. NOW, THEREFORE, in consideration of foregoing Recitals, and other good and valuable consideration, the receipt and sufficiency of which is hereby mutually acknowledged, the parties agree to amend the Agreement as follows: Words are deleted; Words Underlined are added Boys&Girls Club of Collier County CD15-07-IDIS#520-Amendement#1 Bus Transportation Services Page 1 160 5 PART I SCOPE OF WORK * * * 1.2 PROJECT DETAILS B. National Objective The CDBG program funds awarded to Collier County must benefit low-moderate income persons (LMI/lA LMC). As such the Subrecipient shall be responsible for ensuring that all activities and beneficiaries meet the definition of: E LMA Low/Mod Area Benefit LMC—Low/Mod Clientele Benefit or presumed Low Mod Clientele ❑ LMH—Low/Mod Housing Benefit ❑ LMJ—Low/Mod Job Benefit * * * REMAINDER OF PAGE INTENTIONALLY LEFT BLANK Boys&Girls Club of Collier County CD15-07-IDIS#520-Amendement#1 Bus Transportation Services Page 2 .160 5 EXHIBIT"C" QUARTERLY PERFORMANCE REPORT DATA GENERAL Grantee is required to submit to HUD, through the Integrated Disbursement and Information System ("IDIS") Performance Reports. The County reports information on a quarterly basis. To facilitate in the preparation of such reports, Subrecipient shall submit the information contained herein within ten (10) days of the end of each calendar quarter. QUARTERLY PROGRESS REPORT Sub-recipients: Please fill in the following shaded areas of the report Agency Name: The Boys& Girls Club of Collier County(BGCCC) Date: Project Title: Transportation Services Alternate Program Contact: Helen Gorman,Grant Writer Tiffany Heck Contact: Tiffany Heck Telephone Number: (239)239-325-1700 Activity Reporting Period Report Due Date October 1st-December31stJanuary 10th January 31st—March 31st April 10th April 1St—June 30th July 10th July 1st—September 30th October 10th Please take note: Each quarterly report needs to include cumulative data beginning from the start of the agreement date. Please list the outcome goal(s)from your approved application&sub-recipient agreement and indicate your progress in meeting 1. those goals since the beginning of the agreement. A.Outcome Goals: list the outcome goal(s)from your approved application&sub-recipient agreement. Outcome 1: A minimum of 120 youths each year for two years will benefit from bus transportation services (duplication of clients from year 1 to year two is permitted to allow for continuity of services. Outcome 2: Documentation of national objective achievement: LMI/(LMA LMC for yr 1 and 2), benefits clientele to be at least 51% LMI. Boys&Girls Club of Collier County CD15-07-IDIS#520-Amendement#1 Bus Transportation Services Page 3 160 5 B.Goal Progress: Indicate the progress to date in meeting each outcome goal. Is this project still in compliance with the original project schedule?If morethan2 months behind schedule,must submit a new 2. timeline for approval. Yes No If no, explain: 3. Since October 1,2015,of the persons assisted, how many.... a. ...now have new access(continuing)to this service or benefit? 0 b. ...now has improved access to this service or benefit? 0 c. ...now receive a service or benefit that is no longer substandard? 0 TOTAL: 0 4. What funding sources are applied for this peri©d',program-year?.. Other Consolidated Plan Funds CDBG Other Federal Funds ESG State/Local Funds HOME Total Entitlement Total Other Funds $ 0.00 Funds $ 0.00 Boys&Girls Club of Collier County CD15-07-IDIS#520-Amendement#1 Bus Transportation Services Page 4 1 60 5 5. What is the total number of UNDUPLICATED clients served this quarter,if applicable? a. Total No.of adult females served: 0 Total No.of females served under 18: 0 b. Total No.of adult males served: 0 Total No.of males served under 18: 0 TOTAL: 0 TOTAL: 0 c. Total No.of families served: Total No.of female head of household: 0 6. What is the total number of UNDUPLICATED clients served since October,if applicable? a. Total No. of adult females served: 0 Total No. of females served under 18: 0 b. Total No.of adult males served: 0 Total No.of males served under 18: 0 TOTAL: 0 TOTAL: 0 c. Total No.of families served: 0 Total No.of female head of household: 0 Complete EITHER question#7 OR#8. Complete question#7 if your program only serves clients in one or more of the listed HUD Presumed Benefit categories. Complete question#8 if any client in your program does not fall into a Presumed Benefit category. DO NOT COMPLETE BOTH QUESTION 7 AND 8 7. PRESUMED BENEFICIARY DATA: 8. j OTHER BENEFICIARY DATA: INCOME RANGE Indicate the total number of UNDUPLICATED persons served Indicate the total number of UNDUPLICATED persons served since October 1 who fall into each presumed benefit category since October 1 who fall into each income category(the total (the total should equal the total in question#6) should equal the total in question#6) REPORT AS: REPORT AS: O Abused Children Homeless 0 Extremely low Income(0-30%) 0 Person Battered 0 Low Income(31-50%) 0 Battered Spouses 0 Moderate Income(51-80%) O Persons w/HIV/AIDS 0 Above Moderate Income(>80%) O Elderly Persons O Veterans O Chronically/Mentally III 0 Physically Disabled Adults 0 Other-Youth TOTAL: 0 TOTAL: 0 9. Racial&Ethnic Data: (if applicable) Please indicate how many UNDUPLICATED clients served since October fall into each race category.In addition to each race category,please indicate how many persons in each race category consider themselves Hispanic(Total Race column should equal the total cell). RACE ETHNICITY White 0 ;of whom,how many are Hispanic? 0 Black/African American 0 ;of whom,how many are Hispanic? 0 Asian 0 ;of whom,how many are Hispanic? 0 American Indian/Alaska Native 0 ;of whom,how many are Hispanic? 0 Native Hawaiian/Other Pacific Islander 0 ;of whom,how many are Hispanic? 0 American Indian/Alaskan Native&white 0 ,of whom,how many are Hispanic? 0 Black/African American&White 0 ;of whom,how many are Hispanic? 0 Am.Indian/Alaska Native&Black/African Am. 0 ;of whom,how many are Hispanic? 0 Other Multi-racial 0 ;of whom,how many are Hispanic? 0 TOTAL: o TOTAL:HISPANIC p Name: Signature: Your Typed name here represents your electronic signature Title Boys&Girls Club of Collier County CD15-07-IDIS#520-Amendement#1 Page 5 Bus Transportation Services 1 6 0 5 IN WITNESS WHEREOF, the Subrecipient and the County, have each respectively, by an authorized person or agent, hereunder set their hands and seals on the date first written above. ATTEST: BOARD OF COUNTY COMMISSIONERS OF COLLIER 'WIGHT E. BROCK,CLERK COUN FLORIDA Air 1,714.740 s. b'. - By: Depu ' rk DONNA FIALA,CHAIRMAN A est as to Chairman's signature only. II4 ) Date: � G LAE- THE BOYS)GIRLS CLUB OF COLLIER COUNTY, FL, INC. Dated: LLQ` co (SEAL) I By. Theresa Shaw, P • '•-nt&CEO Date: 5"-c25 '012"dll, Approved as to form and legality: U` • Jenni e A. Belpedio Assistant County Atto 037 Z (.p Boys&Girls Club of Collier County CD15-07-IDIS#520-Aniendement#1 Bus Transportation Services Page 6 ,