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Backup Documents 01/22/2013 Item #16D2 16 it 2 HOUSING HUMAN AND VETERIAN SERIVCES INTEROFFICE MEMORANDUM TO: Board Minutes and Records FROM: Lisa N. Carr, Grant Coordinator, HHVS DATE: January 23, 2013 RE: January 22, 2013 Agenda Item 16. D.2 Please find attached four 1 fully executed amendment that was approved by the BCC on January 22, 2013, Agenda Item 16.D.2 for recording in Minutes and Records. The Board Chairwoman's signature is not necessary. Feel free to contact me if you have any questions. Thank you for your assistance. 1602 Amendment 003 NSIP 203.12.003 AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC. dba SENIOR CHOICES OF SOUTHWEST FLORIDA STANDARD CONTRACT NUTRITION SERVICES INCENTIVE PROGRAM THIS AMENDMENT is entered into between the Area Agency on Aging for Southwest Florida, Inc., dba Senior Choices of Southwest Florida ("Agency") and Collier County Board of County Commissioners, ("Contractor"), amends agreement NSIP 203.12. The purpose of this amendment is to increase allocation in the amount of $10,482. Additionally this amendment (1) revises sections of the standard contract, (2) revises ATTACHMENT I-SECTION III—Method of Payment rate from $.68 per meal to$.753786755 per meal and revise ATTACHMENT III Exhibit-1. The purpose of this amendment is to amend the following contract sections(Paragraphs and Attachments): "STANDARD CONTRACT: Revise the Standard Contract with the following changes: (1) Amend section 4. ATTACHMENT I,STATEMENT OFF WORK: (1) Amend section 3.1; and CONTRACT ATTACHMENTS: (1) Revise Attachment III, Exhibit– 1. Line denotes completion of above summary "STANDARD CONTRACT: The Standard Contract is hereby revised as follows. (1) Section 4 is hereby amended to read: 4. Contract Amount The Agency agrees to pay for contracted services according to the terms and conditions of this contract in an amount not to exceed$45,628 or the rate schedule, subject to the availability of funds. Any costs or services paid for under any other contract or from any other source are not eligible for payment under this contract. CONTRACT ATTACHMENTS: (1) ATTACHMENT III,EXHIBIT 1 is hereby revised and attached hereto. 1 Amendment 003 16D NSIP 203.12.003 This amendment shall be effective on the last day this amendment is signed by both Parties. All provisions in the agreement and any attachments thereto in conflict with this amendment shall be and are hereby changed to conform with 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 agreement. This amendment and all of its attachments are hereby made a part of this agreement. IN WITNESS WHEREOF, the parties hereto have caused this 4 page amendment to be executed by their officials there unto duly authorized. Contractor COLLIER COUNTY AREA AGENCY ON AGING FOR SOUTHWEST BOARD OF COUNTY FLORIDA,INC.DBA SENIOR CHOICES OF COMMISSIONERS SOUTHWEST FLORIDA SIGNED BY: ��4;'�� , SIGNED BY: NAME: Stephen Y. Carnell NAME: Hanna McColough Board Vice President for TITLE: Interim Administrator, Public Services Administrator TITLE: BOARD PRESIDENT DATE: December 20, 2012 DATE: December 26, 2012 Federal Tax ID: 59-6000558 Fiscal Year Ending Date: 09/30 Approved as to form 8 iovitti Suiflolancy Assista —au?,t ,Attorra v 2 Amendment 003 16 © 2 NSIP 203.12.003 ATTACHMENT I SECTION III: METHOD OF PAYMENT 3.1 STATEMENT OF METHOD OF PAYMENT This is a fixed rate contract. The Agency shall make payment to the Contractor for provision of services up to a maximum number of units of service and at the prospective rate stated below: Service to be Provided Unit of Service Unit Rate Eligible Congregate and 1 unit= 1 meal $0.753786755 Home Delivered Meals The prospective rate is based on the estimated OAA grant award. COLLIER Service to be Unit of Service Unit Rate Maximum Allocation Provided Units Eligible Congregate I unit= I meal $0.753786755 60,532 $ 45,628 and Home Delivered Meals 3 Amendment 003 16 El 2 NSIP 203.12.003 ATTACHMENT III EXHIBIT— 1 1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS AGREEMENT CONSIST OF THE FOLLOWING: PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT Nutrition Services Incentive Program Older Americans Act 93.053 $ 45,628.00 TOTAL FEDERAL AWARD $ 45,628.00 COLLIER PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT Nutrition Services Incentive Program Older Americans Act 93.053 $ 45,628.00 TOTAL FEDERAL AWARD $ 45,628.00 4 1602 Attestation Statement Agreement/Contract Number NSIP 203.12 Amendment Number 003 I, Stephen Y.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 dba as Senior Choices of Southwest Florida and Collier County Board of Commissioners (Signature of 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; /L � 12/20/2012 Signature of ecipient ontractor representative Date Stephen Y.Carnell,Interim Administrator Collier County Public Services Division Approved as to form & legal Sufficiency Assts t County Attorney