Backup Documents 02/28/2012 Item #16D 8ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT T 8'`
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGN
Print on pink paper. Attach to original document. Original documents should be hand delivered to the Board Office. The completed routing slip and original
documents are to be forwarded to the Board Office only after the Board has taken action on the item.)
ROUTING SLIP
Complete routing lines #1 through #4 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 #4 cm le- the chP 1,1j r j f r .—I t- i.,,, I'Ai .i.on n:..o 44�N
Route to Addressee(s)
(List in routing order)
Office
Initials
Date
1. Colleen Greene
County Attorney
(Initial)
Applicable)
2.
2/28/2012
Agenda Item Number
16.D.8
3.
signed by the Chairman, with the exception of most letters, must be reviewed and signed
4.
Debamnent and FFATA Forms
Number of Original
2
5. Ian Mitchell, Executive Manager
to the BCC
Board of County Commissioners
Documents Attached
3
91 I -Z
6. Minutes and Records
Clerk of Court's Office
PRIMARY CONTACT INFORMATION
(The primary contact is the holder of the original document pending BCC approval. 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, including Sue Filson, need to contact staff for additional or missing
information. All original documents needing the BCC Chairman's signature are to be delivered to the BCC office only after the BCC has acted to approve the
item.)
Name of Primary Staff
Marilyn Matthes
Phone Number
5933511
Contact
appropriate.
(Initial)
Applicable)
Agenda Date Item was
2/28/2012
Agenda Item Number
16.D.8
Approved by the BCC
signed by the Chairman, with the exception of most letters, must be reviewed and signed
Type of Document
Debamnent and FFATA Forms
Number of Original
2
Attached
I
Documents Attached
INSTRUCTIONS & C URCKT .TRT
1: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip, Revised 6 -15 -2011
Initial the Yes column or mark "N /A" in the Not Applicable column, whichever is
Yes
N/A (Not
appropriate.
(Initial)
Applicable)
1.
Original document has been signed/initialed for legal sufficiency. (All documents to be
signed by the Chairman, with the exception of most letters, must be reviewed and signed
by the Office of the County Attorney. This includes signature pages from ordinances,
resolutions, etc. signed by the County Attorney's Office and signature pages from
contracts, agreements, etc. that have been fully executed by all parties except the BCC
Chairman and Clerk to the Board and possibly State Officials.)
2.
Is the Chairman's original signature required?
A& M_
3.
All handwritten strike - throughs and revisions have been initialed by the County Attorney's
n/a
Office and all other parties except the BCC Chairman and the Clerk to the Board.
4.
The Chairman's signature line date has been entered as the date of BCC approval of the
document or the final negotiated contract date, whichever is applicable.
5.
"Sign here" tabs are placed on the appropriate pages indicating where the Chairman's
mm
si gnature and initials are required.
6.
In most cases (some contracts are an exception), the original document and this routing slip
n/a
should be provided to Ian Mithchell in the BCC office within 24 hours of BCC approval.
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!
7.
The document was approved by the BCC on_02/28/2012 (enter date) and
mm
NIA is not
all changes made during the meeting have been incorporated in the attached
a.0 pptiou
document. The County Attorney's Office has reviewed the changes, if applicable.
forti,te 6
1: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip, Revised 6 -15 -2011
1608 vI
MEMORANDUM
Date: March 12, 2012
To: Marilyn Matthes, Director
Collier County Public Library
From: Ann Jennejohn, Deputy Clerk
Minutes & Records Department
Re: Library Services /Technology Access "Collier Connects"
Grant Application Paperwork
Attached for further processing is the original document referenced above
(Item #16D8) approved by the Board of County Commissioners on
February 28, 2012.
After forwarding for signature and subsequent return, if you would please
return a fully executed copy to the Minutes & Record's Department we
will have a complete document for the Board's Official Record.
If you have any questions, please feel free to contact me at 252 -8406.
Thank you.
Attachment
1608 1
Federal Funding Accountability and Transparency Act ( FFATA) Reporting
Subgrantees must complete the Federal Funding Accountability and Transparency Act
Reporting form. The FFATA Act requires that information on federal awards and
executive compensation be made available to the public through a single searchable
website, www.USASpending.gov.
Applicability and What to Report
A. If, in the previous fiscal year, the subgrantee's gross income from all sources was
under $300,000, it is exempt from the requirements to report:
1. Subawards, and
2. The total compensation of the five most highly compensated executives of the
subgrantee.
B. If the subgrantee is not exempt as provided in paragraph A., the subgrantee shall
report the names and total compensation of each of its five most highly
compensated executives, if -
In the subgrantee's preceding fiscal year, the subgrantee received:
a) 80 percent or more of its annual gross revenues from Federal procurement
contracts (and subcontracts) and Federal financial assistance subject to the
Transparency Act, as defined at 2 CFR 170.320 (and subawards); and -
b) $25,000,000 or more in annual gross revenues from Federal procurement
contracts (and subcontracts), and Federal financial assistance subject to the
Transparency Act (and subgrantees); and
2. The public does not have access to information about the compensation of the
executives through periodic reports filed under section 13(a) or 15(d) of the
Securities Exchange Act of 1934 (15 U.S.C. 78m(a), 78o(d)) or section 6104 of
the Internal Revenue Code of 1986. (To determine if the public has access to the
compensation information, see the U.S. Security and Exchange Commission
total compensation filings at w.ww.se.c..qov/answers/execomr).htm.)
Florida Department of State
Division of Library and Information Services
i R
Definitions
Total compensation means the cash and noncash dollar value earned by the
executive during the subgrantee's preceding fiscal year and includes the following (for
more information see 17 CFR 229.402(c)(2)):
i. Salary and bonus.
ii. Awards of stock, stock options, and stock appreciation rights. Use the dollar
amount recognized for financial statement reporting purposes with respect to
the fiscal year in accordance with the Statement of Financial Accounting
Standards No. 123 (Revised 2004) (FAS 123R), Shared Based Payments.
iii. Earnings for services under non - equity incentive plans. This does not include
group life, health, hospitalization or medical reimbursement plans that do not
discriminate in favor of executives, and are available generally to all salaried
employees.
iv. Change in pension value. This is the change in present value of defined
benefit and actuarial pension plans.
v. Above - market earnings on deferred compensation which is not tax - qualified.
vi. Other compensation, if the aggregate value of all such other compensation
(e.g., severance, termination payments, value of life insurance paid on behalf
of the employee, perquisites or property) for the executive exceeds $10,000.
Executive means officers, managing partners, or any other employees in management
positions.
Data Universal Numbering System (DUNS) number means the nine -digit number
established and assigned by Dun and Bradstreet, Inc. (D &B) to uniquely identify
business entities. A DUNS number may be obtained from D &B by telephone
(866.705.5711) or the Internet (htt.p: / /fedgov.dnb.com /webform).
Florida Department of State
Division of Library and Information Services
1608
CERTIFICATION REGARDING
DEBARMENT, SUSPENSION, INELIGIBILITY AND VOLUNTARY EXCLUSION
LOWER TIER COVERED TRANSACTIONS
This certification is required by the regulations implementing Executive Order 12549,
Debarment and Suspension, 45 CFR 1183.35, Participants' responsibilities. The regulations
were published as Part VI1 of the May 26,1988 Federal Register (pages 19160 - 19211). Copies of
the regulations may be obtained by contacting the person to which this proposal is submitted.
(BEFORE COMPLETING CERTIFICATION, READ INSTRUCTIONS ON REVERSE)
(1) The prospective lower tier participant certifies, by submission of this proposal, that
neither it nor its principals are presently debarred, suspended, proposed for debarment,
declared ineligible, or voluntarily excluded from participation in this transaction by any federal
department or agency.
(2) Where the prospective lower tier participant is unable to certify to any of the statements
in this certification, such prospective participant shall attach an explanation to this proposal.
BOARD OF COUNTY COMMISSIONERS,
COLLIER COUNTY, FLORIDA
By: ►/" �.�t�n
FRED COYLE, Chairman
ATTEST:
itryla� 1
DWIGHT' k- -6RO & C)ferk
By: C
A
Approved,�qlo forttrtegal sufficiency:
Assistant County Attorney
ED Form GCS -009, 6/88
t;
1608 M
Federal Funding Accountability and Transparency Act (FFATA) Reporting
Name of Organization: Collier County Board of County Commissioners_
DUNS Number:
Check one of the following-
XX The organization does not meet the applicability requirements to report the total
compensation of the top five subgrantee executives and will not report total
compensation for the preceding completed fiscal year.
The organization meets the applicability requirements to report the total
compensation of top five subgrantee executives for the preceding completed
fiscal year.
Name
1.
2.
3.
4.
5.
Total Compensation
BOARD OF COUNTY COMMISSIONERS,
COLLIER COUNTY, FLORIDA
By: W' Date: Februar 2
m �8, 2012
R D.COVPf Chairman
A3TTS�
W" �1 WLWW - W
I sufficiency:
Assistant County Attorney
Florida Department of State
Division of Library and Information Services