Backup Documents 09/27/2016 Item #16D15 1 6 D 1
COMMUNITY AND HUMAN SE1?IVCES
INTEROFFICE MEMORANDUM
TO: Board Minutes and Records
FROM: Lisa N. Carr, Grants Coordinator,CHS
DATE: September 29,2016
RE: Agreements between Area Agency on Aging for Southwest Florida, Inc and
Collier County
Please find attached a fully executed document that was approved by the BCC on the day listed
below for recording in Minutes and Records. Feel free to contact me if you have any questions.
BCC Approved on September 27,2016 Item 161)13, 16D14 and 16D15.
Thank you for your assistance.
.
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July 2016 to June 2017 E 63.001 5
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC.
COMMUNITY CARE FOR THE ELDERLY'PROGRAM
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
THIS AMENDMENT is entered into between the Area Agency on Aging for Southwest Florida, Inc. ("Agency") and
Collier County Board of County Commissioners ("Contractor"), amends agreement CCE 203.16.
The purpose of this amendment is to change language in ATTACHMENT I,E Reports,#2 Service Cost Reports.
ATTACHMENT I
E. Reports
2. Service Cost Reports
a. The Agency shall require the Contractor to submit Annual Service Cost Reports, which reflect actual costs of
providing each service by program. Service Cost Reports for all contracts are due by February 15, 2017 for the
prior calendar year.
b. Unit Cost Methodology worksheets must be submitted by August 1 of each year, if a rate increase is being
requested for any contract in the next calendar year.
All provisions in the contract and any attachments thereto in conflict with this Amendment shall be and are
hereby changed to conform to this Amendment.
All provisions not in conflict with this Amendment are still in effect and are to be performed at the level
specified in the contract.
This Amendment and all its attachments are hereby made part of the contract.
IN WITNESS THEREOF, the Parties hereto have caused this 1 page amendment, to be executed by their
undersigned officials as duly authorized; and agree to abide by the terms, conditions and provisions of this
CCE contract as amended. This Amendment is effective on the last date the Amendment has been signed by
both Parties.
Contractor: COLLIER COUNTY BOARD AREA AGENCY ON AGING FOR
OF COUNTY COMMISSIONERS SOUTHWEST LORIDA,INC.
SIGNED BY: SIGNED BY:
NAME: STEVE CARNELL NAME: MARIANNE G LORINI
TITLE: PUBLIC SERVICES DEPARTMENT HEAD TITLE: PRESIDENT/CEO
DATE:
gIi1-1110 DATE: pi a /16
Federal Tax ID: 59-600055 8
Fiscal Year Ending Date: 09/30
Approved as to form and legality
Assistant County Attorney , fr'
0
1 6 0 15
Revised August 2007
Attestation Statement
Agreement/Contract Number CCE 203.16
Amendment Number 001
I, Steve Carnell ,attest that no changes or revisions have been made to the
(Recipient/Contractor representative)
content of the above referenced agreement/contract or amendment between the Area Agency on Aging for
Southwest Florida and
Collier County Board of County Commissioners
(Recipient/Contractor name)
The only exception to this statement would be for changes in page formatting,due to the differences in
electronic data processing media,which has no affect on the agreement/contract content.
! /
Signature f Recipient/Contractor representative Date
Approved as to form and legality
Assistant County Attorney �l0
a\
Revised August 2007
0
July 2016 to June 2017 ADI 203.16.001 16 0 1 5
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC.
ALZHEIMER'S DISEASE INITIATIVE PROGRAM
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
THIS AMENDMENT is entered into between the Area Agency on Aging for Southwest Florida, Inc. ("Agency") and
Collier County Board of County Commissioners("Contractor"), amends agreement ADI 203.16.
The purpose of this amendment is to change language in ATTACHMENT I,MANNER OF SERVICE PROVISION,E
Reports,Service Cost Reports.
ATTACHMENT I
MANNER OF SERVICE PROVISION
E. Reports
The Contractor shall respond to additional routine or special requests for information and reports required by the
Agency in a timely manner as determined by the Contract Manager. The Contractor shall establish reporting due
dates for Subcontractors that permit the Contractor to meet the Agency's reporting requirements.
Service Cost Reports
a. The Agency shall require the Contractor to submit Annual Service Cost Reports, which reflect actual costs of
providing each service by program. Service Cost Reports for all contracts are due by February 15, 2017 for the
prior calendar year.
b. Unit Cost Methodology worksheets must be submitted by August 1 of each year, if a rate increase is being
requested for any contract in the next calendar year.
All provisions in the contract and any attachments thereto in conflict with this Amendment shall be and are
hereby changed to conform to this Amendment.
All provisions not in conflict with this Amendment are still in effect and are to be performed at the level
specified in the contract.
This Amendment and all its attachments are hereby made part of the contract.
N WITNESS THEREOF, the Parties hereto have caused this 1 page amendment, to be executed by their
undersigned officials as duly authorized; and agree to abide by the terms, conditions and provisions of this
ADI contract as amended. This Amendment is effective on the last date the Amendment has been signed by
both Parties.
Contractor: COLLIER COUNTY BOARD AREA AGENCY ON AGING FOR
OF COUNTY` i 1141 SSIONE?? SOUTHWEST FLORIDA,INC.
SIGNED BY: i SIGNED BY: )<
NAME: STEVE CARNELL NAME: MARIANNE G LORINI
TITLE: PUBLIC SERVICES DEPARTMENT HEAD TITLE: PRESIDENT/CEO
DATE: v 1 Pio DATE: 0 d5
Federal Tax ID: 59-6000558 Approved as to form and legality
Fiscal Year Ending Date: 09/30
Assistant County Attorney
r 1601 5
Revised August 2007
Attestation Statement
Agreement/Contract Number ADI 203.16
Amendment Number 001
I, Steve Camel! ,attest that no changes or revisions have been made to the
(Recipient/Contractor representative)
content of the above referenced agreement/contract or amendment between the Area Agency on Aging for
Southwest Florida and
Collier County Board of County Commissioners
(Recipient/Contractor name)
The only exception to this statement would be for changes in page formatting,due to the differences in
electronic data processing media,which has no affect on the agreement/contract content.
r
f14 4
_
(046
Signature i f Recipient/Contractor rep esentative Date
Approved as to form and legality
Assistant County Attorney
Revised August 2007
July 2016 to June 2017 HCE 203.16.1
161J15
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC.
HOME CARE FOR THE ELDERLY PROGRAM
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
THIS AMENDMENT is entered into between the Area Agency on Aging for Southwest Florida, Inc. ("Agency") and
Collier County Board of County Commissioners ("Contractor"), amends agreement HCE 203.16.
The purpose of this amendment is to amend AMENDMENT VII by adding due dates for the Utilization Report and the
billing for Basics and Subsidies and change language in ATTACHMENT I,E Reports,#2 Service Cost Reports.
ATTACHMENT I
E. Reports
2. Service Cost Reports
a. The Agency shall require the Contractor to submit Annual Service Cost Reports, which reflect actual costs of
providing each service by program. Service Cost Reports for all contracts are due by February 15, 2017 for the
prior calendar year.
b. Unit Cost Methodology worksheets must be submitted by August 1 of each year, if a rate increase is being
requested for any contract in the next calendar year.
All provisions in the contract and any attachments thereto in conflict with this Amendment shall be and are
hereby changed to conform to this Amendment.
All provisions not in conflict with this Amendment are still in effect and are to be performed at the level
specified in the contract.
This Amendment and all its attachments are hereby made part of the contract.
IN WITNESS THEREOF, the Parties hereto have caused this 2 page amendment, to be executed by their
undersigned officials as duly authorized; and agree to abide by the terms, conditions and provisions of this
HCE contract as amended. This Amendment is effective on the last date the Amendment has been signed by
both Parties.
Contractor: COLLIER COUNTY BOARD AREA AGENCY ON AGING FOR
OF COUNTY 42I .IONERS SOUTHWEST FLORIDA,INC.
SIGNED BY: At71 f'�n �-C!"" SIGNED BY:Wlevuevit )& O •lam
NAME: STEVE CARNELL NAME: MARIANNE G LORINI
TITLE: PUBLIC SERVICES DEPARTMENT HEAD TITLE: PRESIDENT/CEO
DATE: Vir? /(" DATE: g/.231/6.
Federal Tax ID: 59-6000558
Fiscal Year Ending Date: 09/30 Approved as to form and legality
nOt1/4‘49
1 Assistant County Attorney
��4
1 D15
July2016 to June 2017 HCE 20116
ATTACHMENT VII
HOME CARE FOR THE ELDERLY
INVOICE REPORT SCHEDULE
Report Number Based On Submit to Agency on this Date
1 July Advance* July 1
2 August Advance* July 1
Monthly Utilization Report (7/1-7/15) July 20
3 July Expenditure Reports (105 & 106) August 9
Monthly Utilization Report(7/16-8/15) August 20
4 August Expenditure Report (105 & 106) September 9
Monthly Utilization Report (8/16-9/15) September 20
5 September Expenditure Report (105 & 106) October 9
Monthly Utilization Report(9/16-10/15) October 20
6 October Expenditure Report (105 & 106) November 9
Monthly Utilization Report(10/16-11/15) November 20
7 November Expenditure Report(105 & 106) December 9
Monthly Utilization Report(11/16-12/15 December 20
8 December Expenditure Report(105 & 106) January 9
Monthly Utilization Report(12/16-1/15) January 20
9 January Expenditure Report (105 & 106) February 9
Monthly Utilization Report(1/16-2/15) February 20
10 February Expenditure Report (105 & 106) March 9
Monthly Utilization Report(2/16-3/15) March 20
11 March Expenditure Report(105 & 106) April 9
Monthly Utilization Report(3/16-4/15) April 20
12 April Expenditure Report(105 & 106) May 9
Monthly Utilization Report(4/16-5/15) May 20
13 May Expenditure Report(105 & 106) June 9
Monthly Utilization Report (5/16-6/15) June 20
14 June Expenditure Report(105 & 106) July 9
Monthly Utilization Report(6/15-6/30) July 20
15 Final Expenditure Report(105 & 106) July 25
16 Closeout Report(105 & 106) August 1
Legend: * Advance based on projected cash need.
Note# 1: Report #1 for Advance Basis Contracts cannot be submitted to the Area Agency on Aging for
Southwest Florida,Inc.prior to July 1 or until the contract with the Agency has been executed and
a copy sent to the Agency on Aging for Southwest Florida,Inc.Actual submission of the vouchers
to the Agency is dependent on the of the expenditure report.
Note#2: All advance payments made to the Contractor shall be returned to the Agency as follows: one—
tenth of the advance payment received shall be reported as an advance recoupment on each request
for payment,starting with report number five.The adjustment shall be recorded in Part C,Line 1 of
the report(ATTACHMENT VIII). Report numbers 5 through 14 shall reflect an adjustment of
one-tenth of the total advance amount on each of the reports,repaying advances issued the first two
months of the agreement.The adjustment shall be recorded in Part C, 1 of the report(ATTACH-
MENT VI O).
Note#3: Submission of expenditure reports may or may not generate a payment request. If final expenditure
report reflects funds due back to the Agency,payment is to accompany the report.
2
Revised August 2007 5
g 1 6D1
Attestation Statement
Agreement/Contract Number HCEI 203.16
Amendment Number 001
I, Steve Carnell ,attest that no changes or revisions have been made to the
(Recipient/Contractor representative)
content of the above referenced agreement/contract or amendment between the Area Agency on Aging for
Southwest Florida and
Collier County Board of County Commissioners
(Recipient/Contractor name)
The only exception to this statement would be for changes in page formatting,due to the differences in
electronic data processing media,which has no affect on the agreement/contract content.
v e
Signature of Recipient/Contractor representative Date
Approved as to form and legality
Assistant County Attorney \�(
Revised August 2007