Backup Documents 01/23/2018 Item #16D4 4
ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 b
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 Initials Date
1. Susan Golden Community and Human
Services 10(tc?
2. Jennifer Belpedio County Attorney Office °//5- ) 1
3. BCC Office Board of County7�
Commissioners N0i7z5y
4. Minutes and Records Clerk of Court's Office
2(051( 2:560n
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 Susan Golden/CHS Phone Number 252-2336
Contact/ Department
Agenda Date Item was 01/23/2018 Agenda Item Number 16.D.4
Approved by the BCC
Type of Document Substantial Amendment to HUD Action Number of Original
Attached Plan FY2017-2018&FY2016-2017; Documents Attached 3
approve contract amendment Immokalee
Fire District
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 signature? a 14 r
2. Does the document need to be sent to another agency for additional signatures? If yes, NA
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 SG
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 NA
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 SG
'4' 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 SG
si•nature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip NA
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 01/23/2018 and all changes made during the SG A is Writ
meeting have been incorporated in the attached document. The County Attorney's et><on4ffor
Office has reviewed the changes, if applicable. I $
;fie
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 dr f 1 nfor
Chairman's signature. s;lrnea
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 2Cj
1 6 0 4
MEMORANDUM
Date: February 6, 2018
To: Susan Golden
Community & Human Services
From: Ann Jennejohn, Deputy Clerk
Minutes & Records Department
Re: Substantial Amendment to HUD Action Plan
FY2017-2018 & FY2016-2017; Immokalee Fire District
Attached are two (2) original copies of the amendment referenced above, (Item #16D4)
Approved by the Board of County Commissioners on Tuesday, January 23, 2018.
The third original amendment document has been held in the Minutes and Records
Department for the Board's Official Record.
If you have any questions, please contact me at 252-8406.
Thank you.
Attachment
1604
JAN 25'18 pt e1• 1
FAIN# B-17-UC-12-0016
B-16-UC-12-0016
B-15-UC-12-0016
B-14-UC-12-0016
B-13-UC-12-0016
Federal Award Date(s) Est. 10/20I7
Federal Award Agency HUD
CFDA Name Community
Development Block
Grant
CFDA/CSFA# 14.218
Total Amount of $350,000$493399
Federal Funds Awarded
Subrecipient Name Immokalee Fire
Control District
DUNS# 010544356
FEIN# 59-2198877
R&D No
Indirect Cost Rate No
Period of Performance 10/01/2017-
09/30/2018
Fiscal Year End 09/30
Monitor End: 12/2023
FIRST AMENDMENT TO AGREEMENT BETWEEN COLLIER COUNTY
AND
IMMOKALEE FIRE CONTROL DISTRICT
IMMOKALEE FIRE STATION PROJECT
This Amendment is entered into this day of ---,10-INAIN 2018, by and between the
Immokalee Fire Control District, a political subdivision 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 September 26, 2017, the COUNTY entered into an Agreement for awarding
Community Development Block Grant Program funds to be used for the Immokalee Fire Station
Project(hereinafter referred to as the"Agreement");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 December 23, 2017 with a 30 day Citizen Comment period form December 23, 2017 thru January 23,
2018.
Immokalee Fire Control District
CD 17-04 IDIS#561
lmmokalee Fire Station
First Amendment Page 1 of 4
I 6 0 4 1
WHEREAS, the Parties desire to amend the Agreement to increase the amount of project funds;
and
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 k-Tiwough 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 provided herein and, as determined by Collier County
Community and Human Services(CHS) Division,perform the tasks necessary to conduct the program as
follows:
Immokalee Fire Station Property Acquisition
Description of project and outcome:
CHS, as an administrator of the CDBG program,will make available CDBG funds up to the gross
amount of$3505899$493,399 to the Immokalee Fire Control District for property acquisition.
The project includes but not limited to the acquisition and associated costs of property to be
acquired for the development of a new Immokalee Fire Station.
*
1.2 PROJECT DETAILS
A. Project Description/Project Budget
Description Federal Amount
Project Component 1:Property Acquisition and associated costs $358;988$493,399
Immokalee Fire Control District
CD 17-04 IDIS#561
Immokalee Fire Station
First Amendment Page 2 of 4
1 6 04
Total Federal Funds: $330,999$493,399
* * *
1.4 AGREEMENT AMOUNT
The COUNTY agrees to make available • - - .•: _. :. . •:Four Hundred Ninety
Three Thousand Three Hundred Ninety Nine Dollars ($350,989-08$493,399) for use by the
SUBRECIPIENT, during the term of the agreement (hereinafter, shall be referred to as the
"Funds").
* * *
Signature Page to Follow
Immokalee Fire Control District
CDI7-04 IDIS#561
immokalee Fire Station
First Amendment Page 3 of 4
1 6 04
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 • ' CO " 4 T CO 0 ! ERS OF
DWIGHT E.BROCK,CLERK COLLIE' CO ' r ' '
By: By: , L Al*
� • tZlee. fn:r Solis, Chairman
a;! lerk
'Attest as t ''0 ,'� s k
�r. .d Date: l "J
`signature`iq ..ty
Immokalee Fire Control District
By: P(Iti,10,
Patricia Anne Goodnight Chairman
Date: V:23/020/a'
Approved as to form and legality:
Jennifer .Belpedio
Assistant County Attorne 0-97�(1'",
t`
Date: \\Ii5
item#
Agenda ___
Date ___
Date 2-5— I rg
Rec'd
Immokalee Fire Control.District Deputy 0 k
CD17-04 IDIS#561 n„
Immokalee Fire Station
First Amendment Page 4 of 4