Backup Documents 10/24/2017 Item #16D 6 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 16C 6
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 arc 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 NIonday preceding the Board meeting. !0
**NEW** ROUTING SLIP (LD AA4 4 trztA S 6,
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
2.
3. County Attorney Office County Attorney Office CLN to/Q.4'1 7
4. BCC Office Board of County Commissioners \, ly
�N e \-
V \o\\
5. Minutes and Records Clerk of Court's Office 1025(( 2:Wpm
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 or additional or missing information.
Name of Primary Staff Joshua Thomas/T ssie Sillery Phone Number 252-8989 or 252-5840
Contact/ Department PTNE Division d ATM Dept)
Agenda Date Item was 10-24-2017 Agenda Item Number 16 D-6(3859
Approved by the BCC
Type of Document Shirley Conroy After the Fact ZOO
Number of Original 1
Attached "Resolution" O O Documents Attached
PO number or account
number if document is to Fed Ex
be recorded
Also please email a copy to ioshuathornasicolliergov.net &tessiesillery c colliergov.net
Special instructions: Please FedEx; One original plus five copies of the Resolution
�jieCommission for the Transportation Disadvantaged �� C
r 605 Suwannee Street, Mail Station 49 l
vo" Tallahassee, FL 32399-0450 2,50
INSTRUCTIONS&CHECKLIST
Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is appropriate. Yes N/A(Not
(Initial) Applicable)
1. Does the document require the chairm is original ignature? JT
2. Does the document need to be sent to another agency for additional signatures? If yes,provide JT
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 JT
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 .f 5
5. The Chairman's signature line date has been entered as the date of BCC approval of the document JT
or the final negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's signature JT
and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip JT
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 10-24-2017 and all changes made during the N/A is•
not at
meeting have been incorporated in the attached document. The County Attorney's Officeopttonfor
has reviewed the changes,if applicable. this line:
9. Initials of attorney verifying that the attached document is the version approved by the BCC,all -.114, /A is•not an
changes directed by the BCC have been made,and the document is ready for the Chairman's dam" oition for
signature. " inline:
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 6 D 6
-,1--,-z .,4, — -ti-ACountylofColli r
CLERK OF THE CIICU COURT
COLLIER COUNTY COI3JRTHO SE
3315 TAMIAMt TRL E STE 102 Dwight E. Brock-Cle‘r\kkiLf Circuit Court P.O.BOX 413044
NAPLES,FL 34112-5324 ; NAPLES,FL 34101-3044
Clerk of Courts • Comptroller • Auditor • odian of County Funds
October 26, 2017
Commission for the Transprotation Disadvantaged
Attn: Karen Somerset
Assistant Executive Director
605 Suwannee Street
Mail Station 49
Tallahassee, Florida 32399-0450
Re: Resolution 2017-200; After-the-fact filing of the Shirley Conroy Rural
Area Capital Assistance Program Grant
Transmitted herewith is the original referenced document for your records per
request, as adopted by the Collier County Board of County Commissioners of
Collier County, Florida on Tuesday, October 24, 2017, during Regular Session.
Please forward/e-mail a copy of the fully executed aformentioned documents to
(martha.vergara@collierclerk.com) for the Boards Official Records.
Very truly yours,
DWIGHT E. BROCK, CLERK
---.)(\/t.'bLil--)"----VitI -
Martha Vergara, Deputy ler
Phone- (239) 252-2646 Fax- (239) 252-2755
Website- www.CollierClerk.com Email-CollierClerk@collierclerk.com
160 6
PUFF AND RETAIN THIS COPY BEFORE AFFIXING TO THE PACHACE.NO POUCH NEEDED-
{
I
j
I
k t iemj is
1.-z ❑ A o f
1b a
E ` A l 1� r ' Ips g al
C S b 8 - t ❑ E L° �j
S � L� g ie
4" st s2 1 mF❑ H
1 gli Mil III
I I =Y A ❑
o�
18N8118 "- G i ❑ $7
i 1
I ❑ ❑ ❑ ❑ e d
Y h 2 g4
a L i+ ti (---,
s
i w > I ❑ > I ~
11 e
i El $ i At it i
s s
i; E iii E z I R
O e
m E esp E c g r 1 a ,i et B i R
t. O F o, Eyg g',. .E qr�`�, c.! E 1 ❑ b 8R Be
a bYsszS c c s c` 2gt >a e,
O ✓y+ K ILL S a fi ttS W w .6��.: c E ❑ '� .c LI R
Ea d
rnI
�. x ,'QQ B L I ,b tp , e .` Ogg a po ig
II!
F�
8_ W t� � .n a tg' N H`x 2Y' Z a.-13 a BB i
sr ❑ ❑ ❑ mUC ❑ ❑ o ❑ Ir- ❑i! , Ail
Lri ct is 4
c:, ii !ii t
u ti ft
�' fl .. liii li ii o-�
ca ` ❑ ❑
v •
N)
rte- • � �,
C3 M , -� ,.
►a ; •
:‘ :,1,
qtr, - ,
E � •
;
t (I) 4 5 ,1
„,.:,
I :
— Vo 1 i em-
mot, = ke,...'nk
*k 2ca I LA___ -44 q.16,‘ iro t ; libis .:,2 L IF*,
r
E
mm i am
Q pI W Y, � .
S NZI I :i I2 atc2 I; 2i1' t,
..••. N M
6E66E9170081 x3Pa3o9'0081 Woo.xepal
Ha I r---10
- L___" L.J` .
1 6 D 6
RESOLUTION 2017- 2 0 0
A RESOLUTION OF THE BOARD OF DIRECTORS OF THE COLLIER
COUNTY BOARD OF COUNTY COMMISSIONERS, APPROVING THE
AFTER-THE-FACT FILING OF AN APPLICATION FOR A SHIRLEY
CONROY RURAL AREA CAPITAL ASSISTANCE PROGRAM GRANT
APPLICATION WITH THE FLORIDA COMMISSION FOR THE
TRANSPORTATION DISADVANTAGED.
WHEREAS, this BOARD has the authority to file this Grant Application and to undertake a
transportation disadvantaged service project as authorized by Section 427.0159,Florida Statutes,and Rule
41-2,Florida Administrative Code.
NOW,THEREFORE,BE IT RESOLVED BY THE BOARD THAT:
1. The BOARD has the authority to file this grant application.
2. The BOARD authorizes and approves of staff's execution and filing of the Shirley Conroy Rural Grant
application on behalf of the Collier County Board of County Commissioners with the Florida
Commission for the Transportation Disadvantaged.
3. The BOARD'S Registered Agent in Florida is:Jeffrey A. Klatzkow,County Attorney. The registered
address is 3299 Tamiami Trail,Naples,Fl 34112.
4. The BOARD authorizes its Chairman to sign any and all agreements or contracts which are required in
connection with the application.
5. The BOARD authorizes the County Manager to sign any and all assurances,reimbursement invoices,
warranties, certifications and any other documents which may be required in connection with the
application or subsequent agreements.
THIS RESOLUTION IS ADOPTED this 24th day of October, 2017, after motion, second and majority
vote in favor of adoption.
ATTEST.
' •
Dwight Brock,Clgrk
BOARD OF COUNTY COMMISSIONERS
1f } , COLLIER C ri TY,FLORIDA
13y 11 a►
, a, By: /
Attest as to Chairman s
PENNY TAYLOR, j,, IRMA
signature only.
Approv As to Fo Legality:
By: 3Jennifer A.Belpedio
Assistant County Attorney ,Q\\
\.O