Backup Documents 06/28/2016 Item #16D24 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO1 fl 2 4
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNAL
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. Michelle Rubbo CHS
2.Jennifer A.Belpedio County Attorney Office C 12 I 1(°
3. BCC CRA Office CRA Board Vf -i—4
4.BCC Office Board of County Commissioners V C ,/ \Za`
5.Minutes and Records Clerk of Court's Office ���/ r
PRIMARY CONTACT INFORMATION r t'
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 Phone Number
Contact/ Department Lisa Oien 252-6141
Please call for pick up
Agenda Date Item was 2016Agenda Item Number
Approved by the BCC �Z� 16D21
Type of Document First Amendment to Agreement in triplicate Number of Original 3 Amendment documents
Attached (between Collier County and Bayshore CRA) 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,which pprop ' te. Yes N/A(Not
(Initial) Applicable)
1. Does the document require the chairman's original signatyrof?STAMPED SIGNATURE IS ok n/a
2. Does the document need to be sent to another agency for additional-signatures? If yes,provide the no
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 yes
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 Office and N/A
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 document or No,as
the final negotiated contract date whichever is applicable. u nts
are outed
b o
ppro al
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's signature and yes
initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip should N/A
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) ,,-;/ness
8. The document was approved by the BCC ori- /2016 and all changes made during the yes
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 BCC,all ap
changes directed by the BCC have been made,and the document is ready for the 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
1 602 4
MEMORANDUM
Date: July 1, 2016
To: Lisa Oien, Grants Coordinator
Community & Human Services
From: Ann Jennejohn, Deputy Clerk
Minutes & Records Department
Re: First Amendment to the agreement between Collier County
and the Bayshore CRA for the Pineland Avenue Drainage
Improvement Project
Attached, please find two original copies of the amendment referenced above,
(Item #16D24) approved by the Board of County Commissioners June 28, 2016.
The third original amendment document will be held in the Minutes and Records
Department for the Board's Official Record.
If you have any questions, please feel free to call me at 252-8406.
Thank you
Attachments (2)
16024
Grant# B-13-UC-12-0016
CFDA/CSFA# 14.218
Subrecipient Bayshore Gateway Triangle
Community Redevelopment
Agency
FAIN B-13-UC-12-0016
DUNS# 76997790
FEIN# 59-6000558
Fiscal Year End 9/30
Monitor End: 8/2021
FIRST AMENDMENT TO AGREEMENT BETWEEN COLLIER COUNTY
AND
BAYSHORE GATEWAY TRIANGLE COMMUNITY REDEVELOPMENT AGENCY
This Amendment is made and entered into this oc 0 day of 2016, by and between Collier County
Community Redevelopment Agency - Bayshore Gateway Triangle Area (CRA)", a community
redevelopment agency, hereinafter referred to as "SUBRECIPIENT" and Collier County, Florida
hereinafter to be referred to as "County", collectively stated as the "PARTIES".
RECITALS
WHEREAS, on September 8, 2015, the COUNTY entered into an Agreement awarding
Community Development Block Grant Program funds to be used for Pineland Avenue Drainage
Improvements (hereinafter referred to as the "Agreement");
WHEREAS, the parties desire to amend the agreement to increase the amount of project funds,
clarify the inclusion of permitting fees and construction inspection services and adjust performance
deliverables; and
WHEREAS, in accordance with HUD regulations and the Collier County Consolidated Plan
concerning the preparation various Annual Action Plans, the County advertised a substantial
amendment on May 28, 2016 with a 30 day Citizen Comment period from May 28, 2016 to June 27,
2016.
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:
Bayshore Gateway Triangle CRA
B-13-UC-12-0016
CD 14-16
First Amendent
Pineland Avenue Drainage Improvements 1 _
1 6024
Words S#r-u4TThr-ough are Deleted;Words Underlined are added
PART I
SCOPE OF WORK
The Subrecipient shall, in a satisfactory and proper manner and consistent with any standards required
as a condition of providing CDBG assistance, as determined by Collier County Community and Human
Services (CHS) Division,to perform the tasks necessary to conduct the program as follows:
CHS, as an administrator of the CDBG program, will make available CDBG funds up to the
gross amount of 00 $103,050 to the Bayshore Gateway Triangle CRA for
construction costs and all related activities including permitting fees and construction
inspection services, for the removal and improved replacement of an existing drainage
system with miscellaneous structures, swales, culverts and the necessary site restoration on
Pineland Avenue in Naples, Florida.
* * *
1.2 PROJECT DETAILS
A. Project Description/Project Budget
Pineland Avenue Drainage Improvements Federal Amount
Project Component: construction costs and all related activities including permitting $98,050$103,050
fees and construction inspection services, for the removal and improved
replacement of an existing drainage system with miscellaneous structures, swales,
culverts and the necessary site restoration on Pineland Avenue in Naples, Florida.
Total Federal Funds: $98,050$103,050
Bayshore Gateway Triangle CRA
B-13-UC-12-0016
CD 14-16
First Amendent
Pineland Avenue Drainage Improvements 2
1 6D2 4
D. Performance Deliverables
Program Deliverable Deliverable Supporting Submission Schedule
Documentation
Special Grant Condition Policies Policies as stated in this Within thirty (30) days of
(Section 1.1) agreement agreement execution
Insurance Insurance Certificate Annually within thirty (30)days
of renewal
Detailed project Schedule Project Schedule Within thirty(30) days of
agreement execution
Project Plans and Specifications Site Plans and Specifications Prior to Invitation to Bid
Submission of Progress Report Exhibit C Quarterly reports Until the
project's final close out
compliance notification has been
issued by CHS.
Financial and Compliance Audit Exhibit E Annually one hundred eighty
{180)days 9 months after FY end
until 2021
Continued Use Certification Continued Use Affidavit, if Annually until 2021
applicable
Revenue Plan for maintenance Plan approved by the County Initial Plan due after completion
and Capital Reserve of rehabilitation and annually
thereafter until 2029
E. Payment Deliverables
Payment Deliverable Payment Supporting Documentation Submission Schedule
Project Component: • Construction: Submission of • Monthly invoices
construction costs and all supporting documents must be
related activities, including provided as back up as
permitting fees and evidenced by, but not limited to,
construction inspection services signed AIA G702-1992 form
for the removal and improved (attached as Exhibit "G") or
replacement of an existing equivalent document
drainage system with accompanied by the
miscellaneous structures, contractor's Schedule of Values,
Bayshore Gateway Triangle CRA
B-13-UC-12-0016
CD 14-16
First Amendent
Pineland Avenue Drainage Improvements 3
1 6 0 2 4
swales, culverts and the proof of payment and
necessary site restoration on associated photos. Exhibits "B"
Pineland Avenue in Naples, and "C" if applicable.
Florida. • Detailed time sheets
documenting all of the specific
employee(s) activities for each
week that includes CEI
inspections for this project and
the associated activity log(s).
Invoices for construction
inspections services with
payment amount reflected in • Submit request
Exhibit "B". after final close
• Proof of payment and the out monitoring
Exhibit "B". clearance
• 10% Retainage will be withheld
with each request for payment
and will be released upon
completion of activities and final
close out monitoring
Final 10% (an estimated $9,805$10,305) of retainage held will be released upon documentation that a
CDBG National Objective has been met. Failure on behalf of the subrecipient in achieving the national
objective under this agreement will require repayment of the CDBG investment under this agreement.
1.4 AGREEMENT AMOUNT
The COUNTY agrees to make available Ninety Eight Thousand and Fifty One Hundred Three
Thousand and Fifty Dollars ($98,050.00 $103,050) for the use by the SUBRECIPIENT during the
term of the agreement (hereinafter, the aforestated amount including, without limitation, any
additional amounts included thereto as a result of a subsequent amendment(s) to the
agreement, shall be referred to as the "Funds").
Signature Page to Follow
Bayshore Gateway Triangle CRA
B-13-UC-12-0016
CD 14-16
First Amendent
Pineland Avenue Drainage Improvements 4
16024
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
DWIGHT E. BROCK, CLERK OF COL ER COUNTY, FLORIDA
Bf- '►# - By:
; ne., y Clerk DONNA FIALA, CHAIRMAN
Attest •
signature only. CQ Vi' \I Co
Date:
Bayshore Gateway Triangle Community
Redevelopment Agency
Approved as to form and
legality:
Tim Nance, CHAIRMAN
Jennifer A. Belpedio
Assistant County Atto'Imey _,P / 1
car �.4 Date: (ko \�do
C9-
Item# I(I `
Agenda (iyali_
Date 11v
Date Lo •
Deputy :1 V
Bayshore Gateway Triangle CRA
B-13-UC-12-0016
CD 14-16
First Amendent
Pineland Avenue Drainage Improvements 5
ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT T
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGN T 2 4
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. Michelle Rubbo CHS
2. Jennifer A. Belpedio County Attorney Office - (� /2 1/0
3. BCC Office Board of County
Commissioners - ///
4. Minutes and Records Clerk of Court's Office 14416
u 2-4fM
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 Phone Number
Contact/ Department Lisa Oien 252-6141
Please call for pick
Agenda Date Item was 2016 Agenda Item Number ,a�
Approved by the BCC 16Dl -1)1
Type of Document First Amendment to Agreement i : '= ut- umber of Original 3 Amendment
Attached (between Collier County an• th Haven ►,ocuments Attached documents
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 signatur-?STAMPED SIGNATURE ISo n/a
2. Does the document need to be sent to another agency for adds • . gnatures? If yes, no
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 yes
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 No,as
document or the final negotiated contract date whichever is applicable. doc nts
are uted
or
proval
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's yes
signature and initials are required. �
7. In most cases(some contracts are an exception),the original document and this routing slip C J`"j N/A
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 oria-.)/2016 and all changes made yes
during 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
BCC,all changes directed by the BCC have been made, and the document is ready for the 0,53
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
1 602 4
MEMORANDUM
Date: July 5, 2016
To: Lisa Oien, Grants Coordinator
Community & Human Services
From: Ann Jennejohn, Deputy Clerk
Minutes & Records Department
Re: First Amendment to the agreement between Collier County
and Youth Haven, Inc. for the "Shelter & Transitional Living
Home for Collier County Youth Project"
Attached, please find two original copies of the amendment referenced above,
(Item #16D24) approved by the Board of County Commissioners June 28, 2016.
The third original amendment document will be held in the Minutes and Records
Department for the Board's Official Record.
If you have any questions, please feel free to call me at 252-8406.
Thank you
Attachments (2)
160 2 4
FAIN# B-15-UC-12-0016
B-12-UC-12-0016
B-11-UC-12-0016
I I
Federal Award Est.10/15
Date(s)
Federal Award HUD
Agency
CFDA Name CDBG
CFDA/CSFA# 14.218
Total Amount of FY 2011$34,067
Federal Funds FY 2012$61,087
Awarded FY 2015$489,821
Subrecipient Youth Haven, Inc.
Name
R&D No
DUNS# 077283349
Indirect Cost No
Rate 1(
FEIN# 23-7065187
Period of From execution of
Performance agreement to March 31,
2018
Fiscal Year End 06/30
Monitor End: 03/31/2023
FIRST AMENDMENT TO AGREEMENT BETWEEN COLLIER COUNTY
AND
YOUTH HAVEN,INC.
SHELTER AND TRANSITIONAL LIVING HOME FOR COLLIER COUNTY YOUTH PROJECT
This Amendment is entered into thisc_day of%-t 2016, by and between Youth
Haven, 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,"
RECITALS
WHEREAS, on October 27, 2015, the COUNTY entered into an Agreement for awarding
Community Development Block Grant Program funds to be used for the Shelter and Transitional Living
Home for Collier County Youth Project(hereinafter referred to as the"Agreement");and
Youth Haven Inc.
CDBG CD15-04 IDIS#517—First Amendment
Shelter and Transitional Living Home for
Collier County Youth Project Page 1 of 5
1 6 0 24
WHEREAS, the Parties desire to amend the Agreement to increase the amount of project funds,
include environmental mitigation activities, remove design activity, clarify project management as an
activity and adjust performance deliverables;and
WHEREAS, in accordance with HUD regulations and the Collier County Consolidated Plan
concerning the preparation various Annual Action Plans, the County advertised a substantial
amendment on May 28, 2016 with a 30 day Citizen Comment period from May 28, 2016 to
June 27,2016.
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 Struek-Thr-eugh are deleted;Words Underlined are added
* *
PART I
SCOPE OF WORK
The Subrecipient shall, in a satisfactory and proper manner and consistent with any standards required
as a condition of providing CDBG assistance, as determined by Collier County Community and Human
Services(CHS) Division,perform the tasks necessary to conduct the program as follows:
ICHS, as an administrator of the CDBG program, will make available CDBG funds up to the gross
amount of $584,975 $597,475 to Youth Haven, Inc. to fund design project management,
required environmental mitigation, permitting, and construction activities for the construction
of a youth facility to house homeless youth. I
* * *
1.1 PROJECT DETAILS
A. Project Description/Project Budget
Description Federal Amount
Project Component 1: Construction and applicable project fees to include but not $69,915
limited to;inspection/project management/application/permit
Project Component 2: Construction related activities including environmental S-51-57060
mitigation $527,560
Youth Haven Inc.
CDBG CD 15-04 IDIS#517—First Amendment
Shelter and Transitional Living Home for
Collier County Youth Project Page 2 of 5
0
1602 4
Total Federal Funds: $C84797-5,00
$597,475.00
• Details will be provided in the schedule of values
* * *
D. Performance Deliverables
Program Deliverable Deliverable Supporting Submission Schedule
Documentation
!Special Grant Condition Policies Policies as stated in this Within thirty(30)days of
(Section 1.1) I agreement I agreement execution
[Insurance ( 'Insurance Certificate I Annually within thirty(30)days
of renewal until 2023
'Detailed project Schedule I Project Schedule ] 'Within thirty(30)days of
agreement execution
sroject Plans and Specifications Site Plans and Specifications
ubmission of Progress Report Exhibit C Prior to Construction StartQuarterly reports.Annually after
closeout for the period of
continued use.
Financial and Compliance Audit I Exhibit E Annually 9 months after FY end
until 2023 ,
Continued Use Certification Continued Use Affidavit Annually until 2023
Reverie Plan for maintenance Plan approved by the County I Initial Plan due after completion
and Capital Reserve I of rehabilitation and annually
thereafter until 2023
Program Income Reuse Nan Plan Approved by the County I Due upon completion of
Certification I construction and annually
thereafter until 2023
* * *
E. Payment Deliverables
Payment Deliverable Payment Supporting Documentation Submission Schedule
Project Component 1: Submission of supporting documents must Submission of monthly
Construction and applicable be provided as backup as evidenced by, invoices.
project fees to include but not banking documents, invoices and any
limited to; inspection/protect additional documents as needed.
managment/application/permit
Project Component 2: Submission of supporting documents must Submission of monthly
Youth Haven Inc.
CDBG CD15-04 IDIS#517—First Amendment
Shelter and Transitional Living Home for
Collier County Youth Project Page 3 of 5
le,
16024
Construction and mitigation be provided as backup as evidenced by, invoices.
related activities banking documents, invoices and any
additional documents as needed.
Final 10% ($58,437.50$59,750)of retainage held will be released upon documentation of a certificate of
occupancy has been obtained and Youth Haven, Inc. and a beneficiary count of 100 homeless youth, in
order to meet a CDBG National Objective Failure on behalf of the subrecipient in achieving the National
Objective under this agreement will require repayment of the CDBG investment under this agreement
and aforementioned acquisition agreement.
D. AGREEMENT AMOUNT
The COUNTY agrees to make available ' -
Seventy—Five Five Hundred Ninety Seven Thousand Four Hundred Seventy Five Dollars
($CS4w$597,475) for the use by the SUBRECIPIENT during the term of the agreement
(hereinafter, the aforestated amount including, without limitation, any additional amounts
included thereto as a result of a subsequent amendment(s)to the agreement, shall be referred
to as the"Funds"). I
Signature Page to Follow
it
Youth Haven Inc.
CDBG CD 15-04 IDIS#517—First Amendment
Shelter and Transitional Living Flome for
Collier County Youth Project Page 4 of 5
1 6 0 2 4
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
DWIGHT E. BROCK,CLERK COUNTY, RIDA
By:nABy: k
4.4' ,0 C • Donna Fiala,CHAIRMAN
Attest as
signature Only Date: C2 a� \ c c
YOUTH HAVEN, INC. ) �l
f6721
�' r4/017
�BREND O'CONNOR, PRESIDENT
Date: lJi /4 —%(p
Approved as to form and legality:
Jennifer A. Belpedio
Assistant County Attorn 6\‘'D
Item# 11
Agenda �r-
Date
Date
•ted
Youth Haven Inc.
CDBG CD 15-04 IDIS#517—First Amendment AJ
Shelter and Transitional Living Home for 2p
Collier County Youth Project Page 5 of 5