Backup Documents 02/09/2010 Item #16F1
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ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIPI 6 F 1
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 OtIice. 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 # I through #4 as appropriate for additional signatures, dates, and/or infonnation needed. If the document is already complete with the
S . . #
exceotion of the Chairman's signature, draw a line throwzh routing lines #1 throwzh #4, complete the checklist, and forward to ue FJison (lme 5).
Route to Addressee(s) Office Initials Date
(List in routin!! order)
1. '" <1'\\1>1' (~r '1(" ~ C ~ CA.l\\ Y ~\l w 1\ I: Y emEJ 8-1\.10
2.
3.
4.
;( .to. ~ I....:-tc.l r \ \
~. SHe FilsoH, Executive Manager Board of County Commissioners A <'/ll/lO
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. Nonnal1y 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 Marlene Foord Phone Number 252-4768
Contact
Agenda Date Item was February 9, 2010 Agenda Item Number 16F I
Aoproved bv the BCC
Type of Document Grant Application Number of Original I
Attached Documents Attached
I.
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark "N/A" in the Not Applicable column, whichever is
a ro riate.
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 rrom ordinances,
resolutions, etc. signed by the County Attorney's Office and signature pages rrom
contracts, agreements, etc. that have been fully executed by all parties except the BCC
Chairman and Clerk to the Board and ossibl State Officials.)
All handwritten strike-through and revisions have been initialed by the County Attorney's
Office and all other arties exce t the BCC Chairman and the Clerk to the Board
The Chairman's signature line date has been entered as the date ofBCC approval of the
document or the final negotiated contract date whichever is a plicable.
"Sign here" tabs are placed on the appropriate pages indicating where the Chairman's
si nature and initials are re uired.
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 rrame or the BCC's actions are nullified. Be aware of our deadlines!
The document was approved by the BCC on ~ _ (enter date) and all changes
made during the meeting have been incorporated i We attached document. The
Count Attorne 's Office has reviewed the chan es, if a Iicable.
Yes
(Initial)
N/A (Not
A licable)
2.
3.
4.
5.
6.
JO
I: Forms/ County Forms! BCe Forms! Original Documents Routing Slip WWS Original 9.03.04, Revised 1.26.05, Revised 2.24.05
J
16F 1
MEMORANDUM
Date:
February 12,2010
To:
Marlene Foord, AICP
Grants Coordinator
From:
Ann Jennejohn, Deputy Clerk
Minutes & Records Department
Re:
A Volunteer Fire Assistance Grant Application
for the purchase of critical equipment for
Ochopee's Fire Control District
Attached is the original grant application referenced above (Item # 16Fl),
approved by the Board of County Commissioners on February 9, 2010.
The Minutes and Record's Department will hold a copy of the application
in the Board's official records.
If you should have any questions please feel free to call me at 252-8406.
Thank you.
Attachment (1)
16F 1
EXECUTIVE SUMMARY
Recommendation to approve the submittal and authorize the chairman to
sign a Volunteer Fire Assistance grant application in the amount of $9,410
for the purpose of purchasing eight VHF Mobile Radios, five pagers, twenty
Chest Harnesses, and Foam for the Ochopee Fire Control District.
OBJECTIVE: To obtain Board of County Commissioners approval to submit and
authorize the Chairman to sign an application for a Volunteer Fire Assistance matching
(50/50) grant in the amount of $9,410.00 for the purpose of purchasing eight VHF
Radios, five pagers, twenty Chest Harnesses and Foam.
CONSIDERATIONS: Ochopee Fire Control District ("Ochopee") has received this type
of grant from the Florida Division of Forestry for the past 31 years. The grant has been
used to purchase equipment to improve firefighter safety and firefighting capabilities. We
have since acquired two 1978 6X6 five ton vehicles from the Division of Forestry that
Ochopee Fire Control District is refurbishing through grant funding readying the vehicles
to use this brush fire season. However, these vehicles have to be outfitted with
Communications and Firefighting equipment as well. The 50/50 grant will allow
Ochopee Fire Control District to complete the task of readying these vehicles for the
upcoming season in a manner that will benefit the Department plus keep within the
current and future budget constraints. The radios will be installed in all the District's
vehicles extending this type of coverage, therefore, increasing communications with State
and Federal Agencies.
The brush fire season is quickly approaching these vehicles will be crucial in the
upcoming months; therefore, equipping them will boost Ochopee's resources increasing
fire protection of life and property during future events.
FISCAL IMPACT: The total cost of the VHF Radios, Pagers, Chest Harnesses & Foam
is $9,410.00 as this is a 50/50 matching grant; the Division of Forestry will pay $4,705.00
leaving the Ochopee Fire Control District to provide $4,705.00 from the Ochopee fire
Control Fund (146) Reserves. If awarded, a subsequent item will be brought before the
board to accept the grant and approve the necessary budget amendments.
GROWTH MANAGEMENT IMPACT: There is no Growth Management Impact
associated with this Executive Summary.
LEGAL CONSIDERATIONS: This item has been reviewed by the County Attorney's
Office and is legally sufficient for Board action. - CMG
16F 1
RECOMMENDATION: That the Board of County Commissioners approve and
authorize the Chairman to sign the submittal of a Volunteer Fire Assistance Grant
application in the amount of $9,410.00 for the purpose of purchasing VHF Radios,
Pagers, Chest Hamesses and Foam.
PreDared Bv: Alan McLaul!hlin. Fire Chief
16F 1
(\l,t~~
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L.:..,:(Y
Florida Department of Agriculture and Consumer Services
Division of Forestry
VOLUNTEER FIRE ASSISTANCE GRANT APPLICATION
.
CIlARlESH.8RO'lSOIl
CO~""'ISSIOt;fR
lEGAL NAME Collier County Board of Commissioners FORM OF ORGANIZATION: (Municipal Fire District. Non-Profit, County)
Ochopee Fire Contl-ol District
ADDRESS PO Box 70
CITY Everglades City IF COUNTY. UST VFD'S BENEFITING FROM GRANT'
I ZIP _.~--_.._-_.._-
STATE Florida 34139
COUNTY Collier COUNTY #
EMPLOYER IDENTIFICATION NUMBER (EIN)
rs-r;-rr;-roT~T~r;15 18 I
IS FIRE DEPARTMENT LOCATED IN AN INCORPORATED TOWN?
YES ~ NO 0 IFYES, NAME OF TOWN: I Everg1ade's CiYy
POPULATION OF TOWN 150d
PROTECTED AREA EST. POPULA TlONI4 rd 0
WHAT IS THE FIRE DEPARTMENT ISO RATING? 16
IS FIRE OEPARTMENT NIMS COMPLIANT? YES 131 NO 0
CURRENT COOPERATIVE AGREEMENT WITH OOF? YES r;] NO 0
SIZE (SQ MILESIlll 0 0
DISTANCE OF CLOSEST MUTUAL AID FIRE DEPARTMENT:I
NAME OF FIRE DEPARTMENT: I.E t N 1 FU'
as ap es Ire
32
Dist
. .
NUMBER OF FIREFIGHTERS' PAID: 114 VOLUNTEERS'
NO OF INCIDENTS PAST YEAR: WILDLAND FIRE I 4 7 OTHER
NO, OF FIREFIGHTERS CERTIFIED AS:
WILDLAND FIREFIGHTER I Ii 7"
13
1584
HAS APPLICANT RECEIVED GRANT fUNDS FROM ANY SOURCE IN
THE PAST 12 MONTHS? YES ill NO 0
IF YES, WHERE? rn-epl ,aT the' frd:.el~ior "& OOF
AMOUNT'S 116,165.39
LIST TOTAL FUNDS RECEIVED FROM OTHER TAXING AUTHORITIES
SUCH AS CITY, COUNTY, TAXING DISTRICTS (Past 12 Months)
AMOUNT S 1 0
WILDLAND FIREFIGHTER 111
LIST OF FIRE FIGHTING VEHICLES: --
TYPE MAKEIYR.MODEL PUMP CAPACITY (GPM) WATER CAPACITY (GAL)
Engine 131 Emergency One Comm 1000 1000
Tanker Walker 500 3000
Bl:ush (2) 6x6 Military (DOF) 300 750
ESTIMATED GRANT FUNDING REQUEST' LIST OF EQUIPMENT OR SUPPLIES TO PURCHASE WITH GRANT FUNDS:
FEDERAL S 4705 NUMBER DESCRIPTION AMOUNT
APPLICANT S 4705 8 VHF Mobile Radios $4600
COUNTY S 5 Pagers $21 7 5
TOTAL S 9410 25 5 Gal Palls of Class A Foam $1875
'''''--''-'-" -.---- ---_._-~ I--_n__.
(Federal not more than 50% of tolal. Applicant at least 50% of 20 Chest Hat-nesses $ 760
tolal in matChing funds_)
We understand that this Is a 50 percent maximum cost-share program (Cooperalive Foreslry Assistance Act of 1978, PL 95-313), and that funds on
deposit up to 50 percent of the actual purchase price of the items approved \'lill be committed to our project TO THE BEST OF MY KNO\NlEDGE AND
BELIEF, ALL DATA IN THIS APPLICATION ARE lRUE AND CORRECT. THE GOVERNING BODY OF THE APPLlOANT HAS DULY AUTHORIZED
THIS OOCUMENT.
Type Name of Authorized Represenlalive
Title
Telephone Number: (239 )
695-4114~
Fred ~'l. Coyle
Si9flfJ.t~:2ff Autho.riled Representative
j"1.t.~_ L,) (".....
Chairman
Date Signed <1n~ Sb'm~f~,<,'"
~:li ( We, ,.
FN( (239 1695-3473
Email'
DACS-11484 REV. 3/06
DWIGHT E.~BRdt:K, Clerk
BY:~'~
Atttn... ,...... .
Colleen reene,
Assistant County Attorney
16F 1
FOIlII AD-100fT (1911
u. S. DEPARTMENT OF AGRICULTURE
Certification Regarding Deba/1uent, Suspension, and Other
ResponsibIlity Matters - Plil1l8/Y Covered Transactions
This certil1cation is required by the regulations implementing Executive Order 12549, Debarment and Suspension,
7 CFR Part 3017, Section 3017.510, Participants' responsibilities. The regulations were published as Part IV of the
January 30, 1989, FedeIal ReRI'ter(pages 4722.4733). Copies of the regulations may be obtained by contacting the
Department of Agriculture agency onering the proposed covered transaction.
(Before completing certification, read instructions 0/1 rellelSfl.)
(I) The prospective primary participant cCftilies to the best of its knowledge ,md bclict: that it and its principals:
(a) arc not presently dcbarred, suspended, proposed for debarment, declared ineligible, or \'ollllll~uily
excluded frolll covered Iransllctions by nllY Federal department or agency;
(b) have not within a three-year period preceding this proposal been convicted of or had a civil judgment
rendered against them for cOlllmission of fraud or a criminal offense in conncction with obtaining,
attempting to obtain, or performing a public (Federal, Slate or Local) transaction or contraclunder a
public transaction; violation of Fcdcral or State antitrust statutes or commission of embezzlement. th~ft,
forgery, bribery. falsitication or destruction of records, making false statements, or receiving stolen
property;
(c) arc not presently indicted tel' or otherwise criminally or civilly charged by a governmental entity
(Federal, State or Local) with commission of any of the oftenses enumerated in paragraph (I )(b) ofrhis
certification: and
(d) ha\'e 110t within a three-year period preceding this application/proposal had one or more public
transactions (Federal, Slate or LOt.:al) terminated for calise or defimlt.
(2) Where the prospective primary parlicipomt is unable to certify to any ufthe statements in this I.:crlification,
such prospective p~lrticipant shall attach an explanation to this proposal.
ORGA,V1ZATTii::JN,'J,,\fE ~----~-_._~-"---------rPRIA'I'ARjj!.,'iI\1BFROR PRO/FCf N.-\.\1E
Collier County Board of Commissioners
Ochopee Fire Control District
N.J.,\f1~- tlND flTLI.:'OFtlUTIIURlLl:.DREPR!:Sl:.'NfAJJl".c-
Fred N, Coyle
SIGS..! rLiRE
.Af.~ L.,) C,,~
DATF
z./,d,O
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ATTESt:. .
DWIGHTE,.~ROCK. C,.,k
!3Y;'~. ~i&co.c..
.. . _ u" _ _ _' .
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Colleen reene,
Assistant County Attomey
16F 1
Form AD-I047 (f/:J!j (KF:\'FRSF)
INSTRUCTIONS FOR CERTIFICATION
1. By signing and submitting this form, the prospective primary participant is providing the c~rtification set Olll
011 the reverse side in accordance with these instructions.
2. The inability of a person to provide the ccrlitication required below will not necessarily rcsull in denial of
participation in this covered transaction. The prospcl:tive participant shall submit an explanation of why it
cannot provide the certification set out on this form. The certification or explanation will be considered in
connection with the department or agency's determination \vhelher to enter into this transaction. However,
Hlilurc of tile prospective primary participant to furnish a certifkation or an exphllHltion shall disquality such
person l1-om participation in this lmllsaction.
3. The certification in this elause is a material representation offacl upon which reliance was placed whcnthc
department or llgency determincd to enter into this trallsaction. If it is later determined thai the prospective
primary participant knowingly rendered an erroncolls ccrtifh..ation, in addition to other remedies available to
the Federill Government, the departmcnt or agene)' may terminate this trallsnction for cause or dcfnult.
4. The prospective primary participant shall provide inullcdiate written notice to the department or agency to
whom this proposal is submitted ifat nny time the prospective primary participant learns that its certification
wns erroncous whcn submitted or has become erroneolls by reason of changed circllmstances.
5. The terms "covered tnlllsnction," "debarred," "suspended," "ineligible," "lower tier covered transaction,"
"participant," "persoll," "primnry covered transaction," "principal.t1 "proposnl," and "volunrarily excluded," as
lIsed in this clause, have the meanings set out in the Definitions nnd Coverage scctions oflhe rules
implementing Executive Order 12549. You may conlact the department or agency to which this proposal is
being submitted for assiSl<lllce in obtaining a copy of those regulutions.
6. The prospective primary pmticipnnt agrees by submitting this form that, should the proposed covered
transaction be entered into, it shall not knowingly enter into allY lower tier covered transaction with a persoll
who is debarred, suspended, declared ineligible, or voluntarily excluded from pnrticipation in this covered
trnnsaction, unless ulIlhorized by the department or agency entering into this transaction.
7. The prospectivc primary participant turther agrees by submitting this form that it will include this clause
titled "Certith..ation Regarding Debarment, Suspension, Ineligibility and Voluntary Exclusion. Lower Tier
CovCl'ed Transaclions," provided by the deparll1lcnl or agency entering into this covered transaction, without
modification, in all lower ticr covered transactiuns and in nil solicitations for lowcr tier covcred transactions.
8. A participant ill a covered transactiolllllay rely UpOIl <l certification ofa prospective pnrticipant in a lower tier
covered transaction that it is llot debarred, suspended, ineligible, or volunt:uily excluded tiOln the covered
transaction, unless it knows that the cerlification is erroneollS. A participant may decide the method and
lleqllt'llcy by which it determincs the eligibility ofils principals. Each participant may, but is 1I0t requircd to,
check the Nonprocuremcllt List.
9. Nothing l:ontaincd ill the foregoing shall be construcd to require estnblishment ofa system ofrccords ill order
to render ill good faith the certi1ication required by this clnllse. The knowledge and illformntioll ofa
partidp<mt is not required to exceed that which is normally possessed by n prudent persoll in the ordinnry
course of business dealings.
10. Except for transactions authorized under paragraph 6 ofthcsc instructions, Ira jJlHticipant in a cO\-crcd
transaction knowingly enters into a lower tier covered transaction with a person who is suspended, debnrred,
ineligible, or voluntarily excluded fh_lIll participation in this transaction, in addition to other remedies
available to the Fed~ral Government, the depnrtment or agency may terminate this lrnllsactioll 1'01' calise or
dctlllllt.
2
16Fl1
0.\10 Appro\'l\1 ~o. 0348-0040
ASSliRANCES.. NON.(XJ:';STRI'CTIO:'; PROGR'\~IS
~ot(": Certain of these nssurances 1113)' not be applicable to )'our proj~ct or program. Ir)'Oll have questions, please contact Ihe awarding agency.
Further, certnin Federal awarding agencies may require npplicanls to cerlify to additional assurances. If slIch is the case. )'Oll \\ill be
notified.
As the d\ll\' authorized [cneese-Illative of the applicant I ('('nit\< that the uDolicanr:
1. lias the legal authority to apply rOt Federal assistance, and the
instihltiollal, managerial and tinancinl capahility (including funds
suflicient 10 pay the lion-Federal shure of project cosls) to ensure
proper planning. mmHlgcment Olle! l'ompletion of the projel't
described inlhis application.
2. Will give the awarding agency, the Comptroller Gcn~ral of the
United States, and if approprialt'. the Slate, through an)' authorized
r~prescntati\'e, access to und the right to examine all rccords, hooks,
papcrs, or doclllllents related fa the award: and will establish a proper
accoullting systcm ill accordance "ith gencrally m.:cepteJ m:colllltillg
standards or agency directives.
3. Will establish safeguards to prohibit employees from using
lheir positions for 11 purpose that conslitutes or presenls lhe
appemunce of personal or organizlltiollal contlict of interest, or
personal gain.
4. Will initinte and compklt: the work within Ihe applicable time
frame aner receipt of nppro\'lll of tht, awarding agency.
5. Will comply with thc Intergo\ernmental Personnel Act of 1970
(42 U.S.c. *~ 4728-4763) I'daling 10 Im'scribed standards for merit
systems for prognuns fundcd under one of the nineteen statutes or
rcgulntions specified in Appendix ^ Ill' OPi\rs Standards for a Merit
System of Personnel Administr<ltion (5 C.F.R. 900, Subpart f).
6. Will comply \\'ith all Feueml statutes relating to
nondiscrimination. These includc but <lrc lIot limited to: {a)Tille VI
of the Civil Rights Act of 1964 (P.L. 88.352) "hidl prohibits
disl.'riminatinn on the bnsis afra..:e, color or nationnl origin; (b) litle
IX of the Education Amclldmenls of 1972, as amended (20 U.S.c. *~
1681.1683, and 1685-1(86), which prohihits discrimination on the
bilsis of sex: (c) Section 504 of the Rehabilitation Act or 1973, as
amended (29 lLS.C. * 794), which prohibits disnimination on [he
basis or handicaps; (d) fhe Agc Discrimination Act of 1975, as
alllended (42 U.S.c. ** 6101.6107). which prohibits discrimination
on Ihe bnsis of age;
(c) the Drug ;\busl' Oflke and Treatmellt Act of 1972 (P.L. 92.
255), as amended, relating to nondiscrimination 011 the b.lSis or drug
abuse; (t) the Comprehensive Alcohol Abuse and AkohoJism
Pn:\ention, T[t'alment and Rehabilitation Act of 1970 (P.L. 91.616),
as amcnded, r~lating to nondiscrimination Oil the basis of alcohol
abuse or akoholism: (g) ~* 523 and 527 of the Public Health Ser\'ice
Act of J9l2 (42 USe. 290.dd.J and 290 cc-3), as mnendcd, rdating
to contidentiality of akohlJI and drug abu.;;e patient rccords: (h) Title
VIII of the Civil Rights Act of 1968 (,)2 U.S.e. * 3601 et ~eq.), as
amended. rdating to nondiscrimination in the sale, rt'nlal or financing
of hOllsing: (I) any othcr nondiscrimination provisions in thc specific
stalute(s) under which application tor federal <lssbtullI.:e is bdng
made; and (j) the requir..'lllCTlIs of any other nondiscrimination
statute(s) whil.:h mily apply to the application.
7. Will comply, or has nlrendy complied, with the requirements of
Titles Il and III of the Uniform Relocation Assistance amI Real
Property Acquisition Policies Act of 1970 (PL. 961,646) whil:h
provide lor fair and equitable treatment of persolls displal.'ed or
whose propert). is acquired as a result of Federal or lcdcrally assisted
programs. These requirements apply to all illterests in real property
acquired for projcct purposes regardless of Fedeml participation in
pllrclw..,c't
8. Will compl)' \\ith the provis:ons ofthc Hcalth Act (5 U.s.e. **
1501-1508 and 732-,1-7328) which limit the political activities of
employees whose priueipal employment .lcti\'itics arc fundcd in
whole or in pllrt with Federul flln&~.
9. Will comply. as applicable, with the provisions or the Dilds.
Ral'oll Act (40 U.S.e. ** 276a fo 276:1-7), the Copeland Act (40
lJ.S.C. * 276c [lnd 18 U.S.c. ** R74l, and the COlltmct Work Hours
:lIld Safety Standards Act (40 USe. ** 327-333), rcgrmling InllOr
standards for federally assisted cOI:struction subagreements.
10. Will comply, if nppticahle, with nood instlrance Illlrclwse
rCl.luirel11ents of Section 102 (a) of the Flood Disaster Protection Act
or 1973 (PL. 93-23~) which requires redpients III a ~pedal !lood
hazard area to participate in the
program and 10 purchase naod insurance if the total cost of insurable
construction and acquisition of510.000 or more.
11. Will I.'omply with em ironmenlal stllluJards \\'hich Illay be
prescribed pursuant to the following: (a) institution of t'11\'irollll1ental
quality eonlral mcastlrcs under the Nntional Environmental Policy
Act or 1969 (P.L. 91-1(0) and EweLlt!\'e Order (EO) 1151.); (b)
1l0tiJication of violating facilil~s pursllant to EO 11738; (c)
protection of wetlands pursuant to EO 11990; (d) e\lllllalion of nood
hazards in floodplains in Accordance with EO 11988; (e) aSS\lf;\nee of
project consistency with the appro\'ed State lllmUlgel11~lIt progrnlll
developcd under lhc Coaslal Z0I1C r-..fanagclllent Act of 1972 (16
1l.S.C. ** 1451 et seq.): (I) cOllt~mnit)' of Federal actions to State
(Clem Air) Implementation Plans ulHkr Scdioll I 76(e) of the Ck'ar
Air Act of 1955, as amended P2 1l.S.C. * HOI et scq.); (g)
protection of underground sources of drinking water under the Sure
Drinkil1g Water Act of 1974, flS amcndcd. (P.L. 93-523): and (It)
protection of cndangcred species under the Endangered Species Ad
of 1973. as "mended. (P.L 93.205).
12. Will comply "ith the Wild ilnd Scenic Rivers Ael of 1968 (16
USe. ** 1271 el seq.) rdated to protecting componcnts or potelltial
componcnts of the national wild and sccnie ri,'ers system.
V, 6.5 (02105)
Authorized for Local Reproduction
Shlt1JanJ Form 4249 (9-03)Prc~(,'rib\.'J by Oi\.1n Cin::ular A. 102
13. Will assist the awmding ageJK)' in assuring cOInpliam:c with
Sedion 106 of the Naliollill Historic Preservation Acl of 1966, as
amended (16 U.S.c. 470), FO 11593 (idcntiliCillion and protection of
historic properties). and the Archeological and Historic Preservation
Act of 1974 (16 U.S.c. 469a-1 et seq.).
14. Will compl)' with P.L. 93.348 regarding the protcction of
human subjects in\"oh'ed ill research, development. and relilted
activities supported by this award ofassislam:e.
15. Will comply with the Lahoratory Animal Wclfbre Act of 1966
(P.L. 89-544, as amended. 7 U.s.e. 2131 et seq.) pertaining to the
cnre, handling. and treatment of warm blooded animals held for
SIGNATURE OF AUTHORIZED CERTIFYING OFFICIAL
<'A_LL Lv. (.....
(
APPLICANT ORGANIZATION
Collier County Board of Commissioners
''':.' ,('..
AT'fE::n(';:' .
OWIGH!E. BA9CK. Clerk:.:
13.y.(I,...:,..~ ':'4
~... c.
Mteat I" to ......
.t--~........4. AA-...
16F 1
re.sean:h. teaching. or other acti,ities supported hy this award of
assistance.
16. Wil! cOlllpl~' with the Lcad~Ba~d Puillt Poisoning Prevention
Ad (42 U.S.c. ~~ 4801 cl scq.) which prohibits the use or lead based
paint in cOllstmction or rl.:habilitalion of residence slructures.
17. Will calise to be pcrfonlled the required tillallcial and
compliance auJits in accordnnce with the Single Audit Act or 198.J.
18. Will (OJl]ply with ,III applicable requirements of all uther
Federal klws, executive orders, regulations and poJi.:ies go\'crning
thb pmgralll.
TITLE
Chairman. Board of Cot.:.nty Commissioners
DATE
SUBMITTED 2111110
V, B-6 (02/05)
Authorized for Local Reproduction)
Still1J;nd Form 4248 (9.03
Prescribed by O~IB Circular A-I02
Item #
JCt?f I
Agenda J .q -I D
Date
Date ~-~l-l 0
Rec'd
Colleen reene,
Assistant County Attorney