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Backup Documents 04/27/2010 Item #16D 2ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 Q 2 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 exception of the Chairman's simatu... drawn line th.nnnh rni,n "o limo— it IT, ., ..... h se ­1­. +k. .... Route to Addressee(s) List in routing order ___... .._._..., ., __.. ._._..._. ............... .................... Office w., I Hwkn Initials "un, n". Date 1. Terri Daniels Housing and Human Services Dept. Agenda Item Number 4/28/2010 2. Ian Mitchell, Manager BCC Board of County Commissioners 41Zfl'�p 3. Minutes and Records Clerk of Court's Office Number of Original (6) 3 copies for each 4. Amend #3 m Documents Attached agreement 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 Contact Terri Daniels Phone Number 252 -2689 Agenda Date Item was April 27, 2010 Agenda Item Number 16D2 Approved by the BCC Original document has been signed/initialed for legal sufficiency. (All documents to be Type of Document Community Care for the Elderly CCE.203.09 Number of Original (6) 3 copies for each Attached Amend #3 m Documents Attached agreement Home Care or the Elderly HCE 203.09 Amend #2 INSTRUCTIONS & CHF.CK1JRT 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 ApplicableL 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, cjnG- 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 aware of our deadlines! 6. The document was approved by the BCC on (enter date) and all changes 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 16D 2 MEMORANDUM Date: April 28, 2010 To: Terri Daniels, Grants Supervisor Human Services Department From: Martha Vergara, Deputy Clerk Minutes & Records Department Re: Contract # #CCE. 203.09 Amendment #3 Attached, please find three originals as referenced above (Agenda Item #16D2), approved by the Board of County Commissioners on Tuesday, April 27, 2009. 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 Amendment #003 Contract CCE 203.09 STANDARD CONTRACT AREA AGENCY ON AGING Collier County Board of Commissioners This AMENDMENT, entered into by the Area Agency on Aging for Southwest Florida, Inc., hereinafter referred to as the "agency ", and Collier County Board of Commissioners hereinafter referred to as the "recipient', amends agreement #CCE 203.09. The purpose of this amendment is to: 1. Increase the Spending Authority by $60,000, and 2. Revise the Attachment III, Exhibit -1 and Budget Summary, Attachment VII. 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 3 page amendment to be executed by their officials there unto duly authorized. ATTEST: DWIGHT E. BROCK,.Clerk B` •iout" go-to Approved as to form and legal sufficiency / Assistant County Attorney FEDERAL ID NUMBER: 59- 60000558 FISCAL YEAR -END DATE: 9/30 BOARD OF COUNTY COMMISSIONERS COLLIER C UNTY, FLORIDA By: __ fit_ 0 k i."J L, . FRED COYLE, CHAIRMAN �— Date: April 27, 2010 AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA NAOMI MANNING, BOARD PRESIDENT Date: April 27, 2010 2 Amendment #003 1w Contract CCE 203.09 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 TOTAL FEDERAL AWARD COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT TO THIS AGREEMENT ARE AS FOLLOWS: 2. STATE RESOURCES AWARDED TO THE RECIPIENT PURSUANT TO THIS AGREEMENT CONSIST OF THE FOLLOWING: MIAs LHINU KESUUKCES FOR FEDERAL PROGRAMS PROGRAM TITLE FUNDING SOURCE CFDA AM011NT � TOTAL STATE AWARD STATE FINANCIAL. A4NKTA WCR cnutvrm mn v.._ �. PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT Community Care for the Elder) - Collier General Revenue/TSTF 65010 $715,478.00 TOTAL AWARD $715,478.00 COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO THIS AGREEMENT ARE AS FOLLOWS: 2 z Amendment #003 160 Contract CCE 203.09 COMMUNITY CARE FOR THE ELDERLY PROGRAM BUDGET SUMMARY Collier County Housing and Human Services 1. CCE Spending Authority 2. Lead Agency Services - (CM, CA, Intake) 3. Lead Agency Operations 3. Total I ATTACHMENT VII $503,156.00 $114,000.00 $98,322.00 $715,478.00 2 160 2 Attestation Statement Agreement/Contract Number CCE 203.09 Amendment Number 3 I, Fred C" oy le attest that no changes or revisions have been made to (Recipient/Contractor representative) the content of the above referenced agreement/contract or amendment between the Area Agency on Aging for Southwest Florida, Inc. and Collier County Board of Commissioners (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. 'A "k ('.), (,-, irman Signature of Recipient/Contract r representative Approved as to form and Legal sufficiency Assistant County Attorney Revised April 2010 04/27/10 Date _ „S r BROM Cferk 16D 2 MEMORANDUM Date: April 28, 2010 To: Terri Daniels, Grants Supervisor Human Services Department From: Martha Vergara, Deputy Clerk Minutes & Records Department Re: Contract # #CCE. 203.09 Amendment #2 Attached, please find three originals as referenced above (Agenda Item #16136), approved by the Board of County Commissioners on Tuesday, April 27, 2009. 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. 16D Amendment #002 STANDARD CONTRACT Contract CCE 203.09 AREA AGENCY ON AGING Collier County Board of Commissioners This AMENDMENT, entered into by the Area Agency on Aging for Southwest Florida, Inc., hereinafter referred to as the "agency ", and Collier County Board of Commissioners hereinafter referred to as the "recipient', amends agreement #CCE 203.09. The purpose of this amendment is to; (1) amend paragraph 3.2.4 of Attachment I; and (2) revise and replace Attachment IX, Invoice Schedule. The purpose of this amendment is to; 1. Revise Rate Summary, ATTACHMENT VIII effective July 1, 2009 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 2 page amendment to be executed by their officials there unto duly authorized. ATTEST: DWIGHT E. BROCK.,,( Clerk By. 1 Attest, ,D%u *4 s 4iVW,ry oR, a Approved as to form and legal sufficiency fD QppU-}y1 Q9UC1 -t 0 Assistant County Attorney FEDERAL ID NUMBER: 59- 60000558 FISCAL YEAR -END DATE: 9/30 COLLIER COUNTY HOUSING AND HUMAN SERVICES BY: BOARD OF COUNTY COMMISSIONERS COLLIER COUNTY, FLORIDA �} By: FRED COYLE, CHAIRMAN Date: April 27, 2010 AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA NAOMI MANNING, BOARD PRESIDENT Date: April 27, 2010 2 16D Amendment #002 Contract CCE 203.09 ATTACHMENT VIII COMMUNITY CARE FOR THE ELDERLY PROGRAM RATE SUMMARY Collier County Services Total Rate Reimbursement Rate Case Management $50.51 $45.45 Case Aide $26.34 $23.70 C Chore $20.00 $18.00 Companion $20.00 $18.00 EARS $.83 $.75 EARS Plus $1.11 $1.00 Enhanced Chore $30.00 $27.00 Facility Respite (24 hours) $138.90 $125.00 Homemaking $20.00 $18.00 Personal Care $22.22 $20.00 Respite — In Home $20.00 $18.00 Skilled Nursing $38.89 $35.00 Adult Day Care $10.00 $9.00 Spec. Medical Equipment 100% Cost 90 % o Cost 2 2 160 2 Attestation Statement Agreement/Contract Number CCE 203.09 Amendment Number 2 I, Fred Covle attest that no changes or revisions have been made to (Recipient/Contractor representative) the content of the above referenced agreement /contract or amendment between the Area Agency on Aging for Southwest Florida, Inc. and Collier County Board of Commissioners (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. airman Signature of Recipient/Contractor representative Approved as to form and Legal sufficiency Assistant Count Attorney Revised April 2010 04/27/10 Date ATTEST. DWIGHT E. 131RIOCK, fork sy� art u to am Nadi: