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Backup Documents 06/08/2010 Item #16D 2ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP16 D TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE 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 _. _ . . . . ,___. _ ,:__ . _ .._ .....�. r ;. ao .n. ,, h ea —1,t, thr nherkl,,t and Forward to Sue Filson (line #5). exception or we t rauman s st nano,,, oa.. a,,,,,,,,,,,,,, „..,..,,.. Route to Addressee(s) List in routing order ...._,, ........._ ...., __.. .__ __ _ - Office Initials Date 1. Terri Daniels Housing and Human Services Dept. (Initial ) 6/8/2010 2. Ian Mitchell, Manager BCC Board of County Commissioners Agenda Item Number 4�9 to 3. Minutes and Records Clerk of Court's Office 4. Reports for Choose Life License Plate Funds Number of Original (5) 1 copy of each 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 Name of Primary Staff Terri Daniels Phone Number 252 -2689 Contact appropriate. (Initial ) A licable Agenda Date Item was June 8, 2010 Agenda Item Number 16D2 Approved by the BCC signed by the Chairman, with the exception of most letters, must be reviewed and signed Type of Document Reports for Choose Life License Plate Funds Number of Original (5) 1 copy of each Attached ReTiorts for 2005, 2006, 2007, 2008, 2009 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 appropriate. (Initial ) A licable 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. 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 3. 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. 4. "Sign here" tabs are placed on the appropriate pages indicating where the Chairman's signature and initials are required. 5. In most cases (some contracts are an exception), the original document and this routing slip should be provided to Sue Filson 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 4wAre of your deadlines! 6. The document was approved by the BCC on k I K I V (enter date) and all changes made during the meeting have been incorporat U 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 16D 2 MEMORANDUM Date: June 9, 2010 To: Terri Daniels, Grants Supervisor Human Services Department From: Martha Vergara, Deputy Clerk Minutes & Records Department Re: Contract: Reports for Choose Life License Plate Funds (Reports for 2005, 2006, 2007, 2008, and 2009) Attached, please find five originals as referenced above (Agenda Item #16D2), approved by the Board of County Commissioners on Tuesday, June 8, 2010. Please return a fully executed copy once all signatures have been obtained for the Board's permanent records. If you should have any questions, please call 252 -7240. Thank you. 160 ANNUAL CHOOSE LIFE SPECIALTY LICENSE PLATE AFFIDAVIT TO DHSMV BY COUNTY County COLLIER 2005 Fiscal Year Ending County Prior Year Ending Balance Annual Plate Fees Received From State Interest Earned on Fees Total Available for Distribution by the County Annual Plate Fees Distributed to Agencies Amount Retained by Agency from Previous Year Total Available for Agency Expenditures Annual Plate Fee Fxoenditures by Agencies $ 61,007.00 $ 21,329.00 $ 980.00 83,316.00 m 50,007.00 $ 0.00 50,007.00 Secnndarv: Women Infants Total Counseling 1,964.00 1,964.00 Training 15,445.00 15,445.00 e ",501.00 14,687.00 14,687.00 Adoption 3,797.00 3,797.00 Total Secondary Expenditures 1,063.00 1,063.00 n 501.00 501.00 Other Material Needs 0.00 Total Primary Expenditures $ 37,457.00 $ 61,007.00 $ 21,329.00 $ 980.00 83,316.00 m 50,007.00 $ 0.00 50,007.00 Secnndarv: Women Infants Total Counseling 2,081.00 2,081.00 Training 0.00 Advertising 0.00 Adoption 6,572,00 6,572.00 Total Secondary Expenditures $ 8,653.00 Total Primary and Secondary Expenditures $ 46,110.00 Primary expenses as a % of total Expenditures 812 % Secondary expenses as a % of total Expenditures 18.8 % Percentage of Distributed Fees Utilized sz.z % Amount Returned By Agency (if any) to County $ 0.00 3,897.00 Amount Retained by Agency (if any) $ 37,206.00 County Fiscal Year Ending Balance $ We certify that all recipient agencies and the County have complied with Florida Statutes, 320.08056 and 320.08058(30). U) CA A�� June 8, 2010 Fred Coyle, Chair, Board of County C6 issioners Date ATTE/±S�Trr: Approv d as oform and le al sufficiency DW�Vr7f E. bCt Revised January 2010 1 Colleen 6r ene, Assistant County Attorney nan dv 01a " to c mfnwM • livatwi 011 i +• 2