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Backup Documents 07/24/2012 Item #16D 2TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNl� 2 ROUTING SLIP i 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 routine lines #1 through #4 comnlete the checklist and forward to Tan Mitn.hen !line A';) Route to Addressee(s) (List in routing order Office Initials Date 1. Ian Mitchell, Executive Manager Board of County Commissioners � /.4 01 2. Minutes and Records Clerk of Courts Office GM for pick u 3. Jennifer Benghuzzi State of Florida Department of Children & Families Agenda Item Number 16.D.2 *'L%. I 1"l- 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 Ian Mitchell, needs 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 Geoffrey Magon Housing, Human and Phone Number 252 -2336 Contact Veteran Services (Initial) Please call or e-mail 1. Original document has been signed/ initialed for legal sufficiency. (All documents to be GM for pick u Agenda Date Item was ^-. 4 ,4" -3 u Ly Q,+ 'Zio 1 t Agenda Item Number 16.D.2 Approved by the BCC by the Office of the County Attorney. This includes signature pages from ordinances, Type of Document Amendments with DCF Number of Original 3 Attached contracts, agreements, etc. that have been fully executed by all parties except the BCC Documents Attached INSTRUCTIONS & CHECKLIST I: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip W WS Original 9.03.04, Revised 1.26.05, Revised 2.24.05 Initial the Yes column or mark "N /A" in the Not Applicable column, whichever is Yes N/A (Not aviDroDriate. (Initial) Applicable) 1. Original document has been signed/ initialed for legal sufficiency. (All documents to be GM 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. 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 3. The Chairman's signature line date has been entered as the date of BCC approval of the GM document or the final negotiated contract date whichever is applicable. 4. "Sign here" tabs are placed on the appropriate pages indicating where the Chairman's GM signature and initials are required. 5. In most cases (some contracts are an exception), the original document and this routing slip GM should be provided to Ian Mitchell 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! 6. The document was approved by the BCC on 7/24/12 (enter date) and all changes GM made during the meeting have been incorporated in the attached document. The County Attorney's Office has reviewed the changes, if applicable. I: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip W WS Original 9.03.04, Revised 1.26.05, Revised 2.24.05 co ter COUnty Public Services Division August 9, 2012 Housing, Human & Veteran Services Jennifer Benghuzzi Department of Children and Families 1317 Winewood Boulevard Building 6, Room 255 Tallahassee, Florida 23299 -0700 Jennifer, 1602 Included are three copies of the amendment to the agreement between the State of Florida Department of Children and Families and Collier County for the CJMHSA Grant. One is for your records and the other two are for Collier County. Please send back two executed copies with the original signatures to me at the county so that I may have them filed with the appropriate department. Please let me know if you have any questions. Feel free to call me at 239 - 252 -2336 or send me an email. Thanks Sincerely, Geoffrey Magon Grants Coordinator Housing, Human, and Veteran Services Collier County Government 239.252.2336 Housing, Human and Vet�n ,Ser_ 3339 Tamiami Trail East, Suite 211 • Naples, FL 34112 -5361 239 - 252 -CARE (2273) • 239 252 -HOME (4663) • 239 - 252 -CAFE (2233) • 239 - 252 -RSVP (7787) • 239 - 252 -VETS (8387) • www .colliergov.net /humanservices [GHT E. BROCK OF THE CIRCUIT COURT UNTY COURTHOUSE COMPLEX TAMIAMI TRAIL EAST P.O. BOX 413044 ES, FLORIDA 34101 -3044 Department of Children & Families .„ Attn: Jennifer Benghuzzi 1317 Winewood Boulevard Building 6, Room 225 Tallahassee, FL 23299 -0700 16D2 LHZ25 160? Amendment #0001 July 1, 2012 THIS AMENDMENT, entered into between the State of Florida, Department of Children and Families, hereinafter referred to as the "department" and Collier County Board of County Commissioners hereinafter referred to as the "County," amends Memorandum of Understanding (MOU) # LHZ25. 1. Page 3, MOU, Item 10, is hereby amended to read: 10. County agrees to provide data and other information requested by the Criminal Justice Mental Health Substance Abuse (CJMHSA) Grant Technical Assistance Center (TAC) at the Louis de la Parte Florida Mental Health Institute of the University of South Florida to enable TAC to perform statutory duties established in the authorizing legislation. County agrees to submit a semi - annual program report and a semi - annual financial report, signed by the County Administrator, on or before May 1 and November 1, to the Florida Department of Children and Families. County agrees to submit a final program report and a final fiscal report, signed by the County Administrator, on or before the next regular semi- annual reporting date (May 1 or November 1) following the ending date of the program, to the Florida Department of Children and Families. The Department will provide County with templates and forms needed to file all required reports. 2. Page 3, MOU, Item 11, is hereby amended to read: 11. County agrees to be liable, to the extent provided by law, for all claims, suits, judgments, or damages, including court costs and attorney's fees, arising out of the negligent or intentional acts or omissions of the County, and its agents, sub - recipients and employees, during performance of the contracts authorized by this Grant Memorandum of Understanding. 3. Page 5, MOU, Item 24., a), is hereby amended to read: a) Official name of payee and address where payment is to be sent: Collier County Board of County Commissioners Attention: Clerk's Finance Office 3299 Tamiami Trail East, Suite 700 Naples, FL 34112 4. Page 5, MOU, Item 24., b), is hereby amended to read: b) The name, address, telephone number, and email address of the Grant Manager for the County under this Grant Memorandum of Understanding is: Kristi Sonntag, Manager, State and Federal Grants Housing, Human and Veteran Services 3339 Tamiami Trail East, Suite 211 Naples, FL 34112 Phone: 239- 252 -2486 KristiSonntaal'aacolliergov.net LHZ25 16D2 Amendment #0001 July 1, 2012 5. Page 5, MOU, Item 24., c), is hereby amended to read: c) The name, address, telephone number, and email address of the Procurement/Program Manager for the Department of Children and Families under this Grant Memorandum of Understanding is: Cynthia Holland Florida Department of Children and Families Substance Abuse and Mental Health 1317 Winewood Boulevard Bldg 6, Room 209 Tallahassee, FL 32399 -0700 Phone: (850) 717 -4622 cvnthia holland(&dcf.state.fl.us 6. Page 5, MOU, Item 24., d), is hereby amended to read: d) The name, address, telephone number, and email address of the Grant Manager for the Department of Children and Families under this Grant Memorandum of Understanding is: Jennifer Benghuzzi Florida Department of Children and Families Substance Abuse and Mental Health Program Office Contract Management Unit 1317 Winewood Boulevard Building 6, Room 256 Tallahassee, Florida 32399 -0700 Phone: (860) 717 -4348 Jennifer BenohuzziO- dcf.state.fl.us 7. Page 6, MOU, a new Item #28 is added to read: 28. Annual advanced payments shall be reduced by the amount of interest earned and reported to the Department on previous advanced funds. County agrees to return to the Department any unmatched grant funds, unused advance grant funds, and any unapplied interest accrued on advance grant funds following the ending date of the program. 8. Page 6, MOU, a new Item #29 is added to read: 29.The established total amount of match must be adhered to but may be reallocated among the subrecipients upon submittal of updated match commitment forms /letters. This amendment shall begin on July 1, 2012 or the date on which the amendment has been signed by both parties, whichever is later. All provisions in the MOU and any attachments thereto in conflict with this amendment shall be and are hereby changed to conform with this amendment. 2 LHZ25 16D2 Amendment #0001 July 1, 2012 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 a part of the contract. [SIGNATURES CONTAINED ON NEXT PAGE] LHZ25 Amendment #0001 July 1, 21 / G2 IN WITNESS THEREOF, the parties hereto have caused this four (4) page amendment to be executed by their officials thereunto duly authorized. PROVIDER: COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS SIGNED BY: W NAME: FRETS W. CO-1 t_ E TITLE: C (i A. i V, wtvi A >k DATE: FEDERAL WD NUMBER: 59- 6000558 HT QpCJ, Clerk aw i0c . S STATE OF FLORIDA DEPARTMENT OF CHILDREN AND FAMILIES SIGNED BY: NAME: Rob Siedlecki TITLE: Assistant Secretary for Substance Abuse and Mental Health DATE: AyTpro"nd is to form & legal SufMahncy Awls snt County Attorney