Backup Documents 12/09/2014 Item #16D17 16 017
ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
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 Init', s Date
1. Peggy Hager Community and Human
Services I /0/5///�
2. County Attorney Office County Attorney Office c _ C2 1Z /4114'-
3.
g.I143. BCC Office Board of County b `
CommissionersS> tl��
4. Minutes and Records Clerk of Court's Office
12\ VIII* 1V3 -
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 Gino Santabarbara Phone Number 239-252-239
Contact/ Department
Agenda Date Item was December 9,2014 Agenda Item Number 16D17
Approved by the BCC
Type of Document Amendment#2—Time extension for Number of Original 3 ✓
Attached Habitat for Humanity—Faith landing Documents Attached
Project
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' original si; ature? GS
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 GS
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
Office and all other parties except the BCC Chairman and the Clerk to the Board 1J IA
5. The Chairman's signature line date has been entered as the date of BCC approval of the GS I/
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 GS V
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip GS
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 December 9,2014 and all changes made tv
during the meeting have been incorporated in the attached document. The County 16. •
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
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
1601 7
MEMORANDUM
Date: December 11, 2014
To: Gino Santabarbara, Grant Coordinator
Housing, Human & Veteran Services
From: Martha Vergara, Deputy Clerk
Minutes & Records Department
Re: Amendment #2 for an Agreement between Collier County &
Habitat for Humanity
Faith Landing Infrastructure Improvements
Attached are two (2) originals of the item referenced above, (Item #16D17) approved
by the Board of County Commissioners on Tuesday, December 9, 2014.
The Minutes and Record's Department has held the third original copy of the
agreement amendment for the Board's Official Record.
If you have any questions, please feel free to call me at 252-7240.
Thank you.
Attachment
16017�
Grant#- B-13-UC-12-0016
4 CFDA/CSFA# - 14.218
Subrecipient — Habitat for Humanity of
Collier County, Inc.
DUNS #-080676690
FETI #-59-1834379
Fiscal Year End: 6/30
IDIS Project#467
Monitor End: 12/31/2019
SECOND AMENDMENT TO AGREEMENT BETWEEN COLLIER COUNTY
AND
HABITAT FOR HUMANITY OF COLLIER COUNTY, INC.
Faith Landing Infrastructure Improvements
This Amendment is entered into this 1+ti day of Pet ,.vc2014, by and between HABITAT FOR
HUMANITY OF COLLIER COUNTY, 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 January 28th 2014, the COUNTY entered into an Agreement for awarding Community
Development Block Grant Program funds to be used for Faith Landing Infrastructure Improvements
Project (hereinafter referred to as the"Agreement"); and
WHEREAS,the Parties desire to amend the Agreement to extend the project end date to June 30, 2015.
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 St-ruck-Through are deleted; Words Underlined are added
II. TIME OF PERFORMANCE
Services of the SUBRECIPIENT shall start on the 14th day of January, 2014 and end on the 3 -day
30`h day June, 2015. The term of this Agreement and the provisions herein may be
extended by amendment to cover any additional time period during which the SUBRECIPIENf remains in
control of CDBG funds or other CDBG assets, including program income.
I labitat for I lumanitp of Collier Count), Inc.
Amendment 42
2013-2014 CDBG(CD13G 13-03)
Page 1 of 2
16 017
[N WITNESS WHEREOF, the Subrecipient and the County, have each, respectively, by an authorized person
i or agent, hereunder set their hands and seals on the date first written above.
ATTEST, 'AR °', BOARD OF COUNTY COMMISSIONERS OF
DW I fT:2 o& CLERK COLLIER I,$UNT , FLORIDA
Depu;, I se 'HENN --6 -'adAIRMAN
Datedbe-r-e;41 '` t i Goi
,,,,,.d,.. —,:j.,)
Attest as td Chirman's
signature only.
HABITAT FOR HUMANITY OF COLLIER
COUNTY, INC.
Approved as to form and legality
�-✓�-� By: 4/...r ' I/. ��. �—
Assistant Co Acorn NICK KOULe't RAS
�Y
9 EXECUTIVE V.P. OF LAND DEVELOPMENT
V2•13114- FOR HABITAT FOR HUMANITY OF COLLIER
COUNTY, INC.
Habitat for Humanity of Collier County,Inc.
Amendment#2
2013-2014 CMG(CDI3GI3-03)
Page 2 of 2
0