Backup Documents 04/27/2010 Item #16D 5ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 D 5
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
ROUTING SLIP
Complete routing lines NI 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 il I through 44 . complete the checklist. and forward to Ian MirchelI lone ast
Route to Addressee(s)
List in routing order
Office
Initials
Date
1. Frank Ramsey
BUS
Agenda Item Number
4/27/2010
2. Colleen Greene
County Attorney's Office
4/27/2010
3.
Signature Authority forms (2)
Number of Original
3
4.
_...
Documents Attached
5. Ian Mitchell, Executive Manager
Board of County Commissioners
�I2' l0
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. Normallv 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
Contact
Lisa Oien / Housing & Human Services
Phone Number
252 -6141
Agenda Date Item was
April 27, 2010
Agenda Item Number
16D5
Approved by the BCC
Original document has been signed/ initialed for legal sufficiency. (All documents to be
LO
Type of Document
Signature Authority forms (2)
Number of Original
3
Attached
Cover letter (1) Letter has been e- mailed
Documents Attached
to Ian Mitchell for BCC letter head. A
letter without letterhead isincluded in
this package to be swapped out.
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
Applicable)
1.
Original document has been signed/ initialed for legal sufficiency. (All documents to be
LO
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
LO
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
LO
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
LO
signature and initials are required.
5.
In most cases (some contracts are an exception), the original document and this routing slip
LO
should be provided to Ian Mitchell in the BCC office with in 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 4/27/2010 (enter date) and all changes
LO
made during the meeting have been incorporated in the attached document. The
Countv Attorney's Office has reviewed the changes, if applicable.
opt
I: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip W WS Original 9.03.04, Revised 1.26.05, Revised 2.24.05
MEMORANDUM
Date: April 30, 2010
To: Lisa Oien,
Housing and Human Services
From: Martha Vergara, Deputy Clerk
Minutes & Records Department
Re: Signature Authority Form (Attachment I)
Attached you will find two (2) original forms and three (3) original letters, as
referenced above (Agenda Item #16D5) and approved by the Board of County
Commissioners on Tuesday, April 27, 2010.
Please forward the fully executed original document upon receipt to
the Minutes and Record's Department for the Board's permanent
record.
If you should have any questions, please call me at 252 -7240.
Thank you.
16D 5
AW
�1 fi 41t��
Board of Collier County Commissioners
Donna Fiala Frank Halas —
Tom Hennin g
District 1 District 2 District 3 Fred District Coyle
4
April 27, 2010
Department of Community Affairs
Division of Housing and Community Development
Florida Small Cities and Disaster Recovery CDBG Programs
2555 Shumard Oak Boulevard
Tallahassee, Florida 32399 -2100
To the Department of Community Affairs:
Please accept updated signature authority forms for Disaster Recovery Initiative Grants
#07DB- 3V- 09- 21- 01 -Z01 and #08DB- D3- 09- 21- 01 -A03.
The enclosed signatory authority forms were approved by the Board of Collier County
Commissioners at a regularly scheduled public meeting on April 27, 2010.
Yours truly,
Flu
W.
Fred W. Coyle W
Chairman of the Board of County Commissioners
W. Harmon Turner Building • 3301 East Tamiami Trail • Naples, Florida 34112.239- 252 -8097 • FAX 239 - 252 -3602
Jim Coletta
District 5
16D 5
Attachment K
Florida Small Cities Community Development Block g
Grant, Disaster Recovery and Neighborhood Stabilization Programs
SIGNATURE AUTHORITY FORM
........................................ ............................... ........................Submit an origina /Signature Authority Form with each rnnnarr
Recipient
Contract #
Board of Collier County Commissioners 07D6- 3V- 09- 21- 01 -Z01
.o.... _......... _ _ ............ .
Mailing Address (Street or...Post Office... Box) ..................................................................................... ...............................
3301 Tamiami Trail East
................................................... ...............................
................................................. ...............................
City, State and Zip Code
Naples, Florida 34112
....................................................................................... ................................................................
Project Contact Person
..................................................... ...............................
Telephone #
Marcy Krumbine, Director
Collier County Housing and Human 239 - 252 -8442
Funding Source
[ ] Small Cities CDBG
[ X] Disaster Recovery
[ ] Neighborhood Stabilization
Local Government DUNS #
E -mail Address
marcykrumbing@colliergov.net
.................... .
Financial Contact Person .. ... .... .......... ..... ..... .............................
.
Telephone #
.....................
E -mail Address ... ............................. . .... .............................. .................._......................... ............... ......... _ .......
.
Terri Daniels, Accounting
Supervisor, Collier county Housing ' 239 - 252 -2689
and Human Services terridaniels(c collieroov net
....... ............ . ....
............................. . ......... ..............................
.............................................._.......................................... ... ............-.......... ... ... ....................._.........
Requests for Funds (RFFs) require (check on e); [X] one signature [ ] two signatures of individuals authorized below. RFFs
must be submitted via email in a odf format from the email address of one of the individuals listed below. RFFs submitted from
other email addresses will not be processed by the Department.
Typed Name .................... ......... _............ ................. .............................. ............ ..............
....................
Frank Ramsey, ousing Manager
[ X ]Check here -if-'a bove person is authorized to submit RFFs
Typed Name
Lisa Oien, Grants Coordinator
......................................................... ............................... .
[ X) Check here if above person is
Typed Name
Date
Signature
4/27/2010
E -mail Address
frankramsey(d)collieraov net
Date Signature
_ - ............... .. ... ................. ..... ....
......
to submit RFFs ; E -mail Address
Date
Signature
........._._ ....................................................................._ ................. _................................ ............. . ...........
..... ........
...................... ..........................._...
Check here if above person is authorized to submit RFFs E-mail Address
......
certify, as the recipient's Chief Elected Official, that the above signatures are of the individuals authorized to sign Requests for
Funds and to submit RFFs electronically.
TypedName ....................................................................................................... ...............................
Fred W. Coyle, Chairman Date Signature
Board of Collier County Commissioners 4/27/2010_. _ �}
..............................
[X] Check here if your local government utilizes Electronic Funds Transfer (EFT) from the State of Florida.
[X] Check here if your local government will be working on a reimbursement basis.
............. ...............................
CDBG payments to 1011 /governments using EFTare automatically deposited in the local government's
............
............................
account is interest bearing, the CDBG funds must be transferred to a non - interest bearing account. Please call the CDBGIf the
Program at 850/922 -1878 or 487 -3644 if you have questions. You can check the status of your deposit at the Comptroller's
website: htto:/ /flair dbf state fl us /.
................................ .._.......................
............................................................ ............................... .
Local governments not receiving EFT, and not working on a reimbursement basis, must establish a non - interest bearing account.
Provide account information for the financial institution (insured by FDIC) below. All signatures on the account must be bonrlpd
Name of Financial Institution
Fifth Third Bank
....................... .......................................
........................................ ...............................
Street Address or Post Office Box
999 Vanderbilt Beach Road
................. ............................ I. .
ity, State and...Zip Code ...............................
Naples, Florida 34108
Account Number
113 -8577
-.1 ..... ........................................... . . . . . . . . . . . . .
Telephone Number
239 - 591 -6397
Approved as to form & legal sufficiency
OWW1163HT E. HOCK Glogi ,
Colleen Greene,
Assistant County Attorney"
ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 D 5
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
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
erzcen inn of the Chairman's si.ahue rim. a line through routing line, # I through #4 comnlde the checklist_ and forward to Ian Mitchell !line #51.
Route to Addressee(s)
List in muting order
Office
Initials
Date
Lisa Oien
HITS
(initial)
5/6/2010
for nick u
Original document has been signed/ initialed for legal sufficiency. (All documents to be
LO
3.
April 27, 2010
Agenda Item Number
16D5
4.
by the Office of the County Attorney. This includes signature pages from ordinances,
5. Ian Mitchell, Executive Manager
Board of County Commissioners
Number of Original
3
Attached
Chairman's glildnal signature needed
Documents Attached
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 he delivered to the BCC office only after the BCC has acted to approve the
item.)
Name of Primary Staff
Lisa Oien / Housing & Human Services
Phone Number
252 -6141
Contact
appropriate.
(initial)
Please call or e-mail
for nick u
Original document has been signed/ initialed for legal sufficiency. (All documents to be
LO
Agenda Date Item was
April 27, 2010
Agenda Item Number
16D5
Approved by the BCC
by the Office of the County Attorney. This includes signature pages from ordinances,
Type of Document
3 Modification packages
Number of Original
3
Attached
Chairman's glildnal signature needed
Documents Attached
INSTRUCTIONS & CHECKLIST
1: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip W WS Original 9.03.04, Revised 1.26.05, Revised 2 .2405
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
LO
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
LO
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
LO
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
LO
signature and initials are required.
5.
In most cases (some contracts are an exception), the original document and this routing slip
LO
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 4/2712010 (enter date) and all changes
LO
it
made during the meeting have been incorporated in the attached document. The
County Attorney's Office has reviewed the changes, if applicable.
l
1: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip W WS Original 9.03.04, Revised 1.26.05, Revised 2 .2405
160 5
MEMORANDUM
Date: May 10, 2010
To: Lisa Oien,
Housing and Human Services
From: Martha Vergara, Deputy Clerk
Minutes & Records Department
Re: Modification #7 to Grant Agreement for
DCA Contract #07DB- 3V- 09- 21- 01-ZOI
Attached you will find three (3) original documents (with Chairman's original
signature), as referenced above (Agenda Item #16D5) and approved by the Board
of County Commissioners on Tuesday, April 27, 2010.
Please forward the fully executed original document upon receipt to
the Minutes and Record's Department for the Board's permanent
record.
If you should have any questions, please call me at 252 -7240.
Thank you.
MODIFICATION NUMBER 7 TO GRANT AGREEMENT BETWEEN
THE DEPARTMENT OF COMMUNITY AFFAIRS AND COLLIER COUNTY
This Modification is made and entered into by and between the State of Florida,
Department of Community Affairs, (the Department'), and Collier County ,
(the Recipient'), to modify DCA Contract Number 07DB- 3V- 09- 21- 01 -ZO1 , award
date June 20. 2007 , ( "the Agreement').
WHEREAS, the Department and the Recipient entered into the Agreement,
pursuant to which the Department provided a grant of $ 2,339,882 to Recipient under
the Small Cities Community Development Block Grant ( "CDBG ") Program as set forth
in the Agreement;
WHEREAS, the Department and the Recipient desire to modify the Agreement;
NOW, THEREFORE, in consideration of the mutual promises of the parties
contained herein, the parties agree as follows:
o Reinstate Agreement
1. The Agreement is hereby reinstated as though it had not expired.
X Extend Agreement
2. Paragraph 3, Period of Agreement is hereby revised to reflect an ending date
of December 19, 2010 .
X Revise Activity Work Plan
3. The Attachment B, Activity Work Plan section of the Agreement is hereby
deleted and is replaced by the revised Attachment B, Activity Work Plan
section, which is attached hereto and incorporated herein by reference.
o Revise Program Budget and Scope of Work
4. The Attachment A, Program Budget and Scope of Work sections of the
Agreement are hereby deleted and replaced by the revised Attachment A, the
Program Budget and Scope of Work, which are attached hereto and
incorporated herein by reference.
160 5
Modification # 7
DCA Contract Number: 07DB- 3V- 09- 21- 01 -ZO1
Recipient: Collier County
Page 2
o Change in Participating Parties
5. The Attachment G, Special Conditions section, is hereby modified to delete
all references to " " as the Participating
Party, and replace them with " as the
Participating Party with the understanding that the Recipient and the new
Participating Party will enter into a Participating Party Agreement containing
provisions and caveats that meet or exceed the conditions agreed to in the
Participating Party Agreement between the Recipient and the original
Participating Party.
o Inclusion of an Unmet Need as Addressed in the Original Application
6. The Attachment A, Program Budget and Scope of Work section of the
Agreement is hereby deleted and is replaced by the revised Attachment A, the
Program Budget and Scope of Work, which is attached hereto and
incorporated herein by reference.
7. The Attachment B, Activity Work Plan section of the Agreement is hereby
deleted and is replaced by the revised Attachment B, Activity Work Plan
section, which is attached hereto and incorporated herein by reference.
o Change in Number of Accomplishments and /or Beneficiaries
8. The Attachment A, Program Budget and Scope of Work section of the
Agreement is hereby deleted and is replaced by the revised Attachment A, the
Program Budget and Scope of Work, which is attached hereto and
incorporated herein by reference.
All provisions of the Agreement and any attachments thereto in conflict with this
Modification shall be and are hereby changed to conform to this Modification, effective
as of the date of the execution of this Modification by both parties.
All provisions not in conflict with this Modification remain in full force and
effect, and are to be performed at the level specified in the Agreement.
Modification # 7
DCA Contract Number: 07DB- 3V- 09- 21- 01 -Z01
Recipient: _ Collier County
Page 3
IN WITNESS WHEREOF, the parties hereto have executed this document as of
the dates set herein.
Department of Community Affairs
By:
Name:
Janice Browning
Title:
Director, Division of Housing
and Community Development
Date:
Approved as to form
affd�egal sufficiency:
�. c�
Colleen Greene
Assistant County Attorney
r
Recipient Name:
By:
Name: Fred W. Coyle
Title: Chairman, Board of
County Commissioners
Date: � Z7 <20tc
Attest:
DWIGHT E. BROCK, Clerk
By:
,D p ty Cler"
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To:
From:
Date:
Subject:
Re:
Hi Martha,
Memorandum
Martha Vergara
Lisa Oien
May 11, 2010
recording of an executed modification to agreement
Collier County and DCA for DRI grant #08DB- D3- 09.21.01 -A03
16D 5
This modification to agreement was approved by the board on 3/9/2010 then
sent to the Florida Department of Community Affairs for execution. Here is the
document signed by both parties for you to record. We have a copy in our file.
Please contact me if you have any questions
Thanks,
Lisa Oien
Grants Coordinator
Housing and Human Services
Department of Housing and Human Services
Collier County
16D 5
?.
2010 MAR, 21s Pf 3= 54
MODIFICATION NUMBER 4 TO GRANT AGREEMENT BETWEEN
THE DEPARTMENT OF COMMUNITY AFFAIRS AND COLLIER COUNTY
This Modification is made and entered into by and between the State of Florida,
Department of Community Affairs, (the Department"), and Collier County ,
(the Recipient "), to modify DCA Contract Number 08DB- D3- 09- 21- 0l -A03 , award
dated 2008 , ( "the Agreement ").
WHEREAS, the Department and the Recipient entered into the Agreement,
pursuant to which the Department provided a grant of $ 2,814,698.15 to Recipient under
the Small Cities Community Development Block Grant ( "CDBG ") Program as set forth
in the Agreement;
WHEREAS, the Department and the Recipient desire to modify the Agreement;
NOW, THEREFORE, in consideration of the mutual promises of the parties
contained herein, the parties agree as follows:
o Reinstate Agreement
1. The Agreement is hereby reinstated as though it had not expired.
X Extend Agreement
2. Paragraph 3, Period of Agreement is hereby revised to reflect an ending date
of November 13, 2010
X Revise Activity Work Plan
The Attachment B, Activity Work Plan section of the Agreement is hereby
deleted and is replaced by the revised Attachment B, Activity Work Plan
section, which is attached hereto and incorporated herein by reference.
o Revise Program Budget and Scope of Work
4. The Attachment A, Program Budget and Scope of Work section of the
Agreement is hereby deleted and is replaced by the revised Attachment A, the
Program Budget and Scope of Work, which is attached hereto and
incorporated herein by reference.
16D 5
Modification # 4
DCA Contract Number: 08DB- D3- 09- 21- 01 -A03
Recipient: Collier Coun
Page 2
o Change in Participating Parties
5. The Attachment G, Special Conditions section, is hereby modified to delete
all references to " ," as the Participating
Party, and replace them with " " as the
Participating Party with the understanding that the Recipient and the new
Participating Party will enter into a Participating Party Agreement containing
provisions and caveats that meet or exceed the conditions agreed to in the
Participating Party Agreement between the Recipient and the original
Participating Party.
o Inclusion of an Unmet Need as Addressed in the Original Application
6. The Attachment A, Program Budget and Scope of Work section of the
Agreement is hereby deleted and is replaced by the revised Attachment A, the
Program Budget and Scope of Work, which is attached hereto and
incorporated herein by reference.
7. The Attachment B, Activity Work Plan section of the Agreement is hereby
deleted and is replaced by the revised Attachment B, Activity Work Plan
section, which is attached hereto and incorporated herein by reference.
o Change in Number of Accomplishments and /or Beneficiaries
The Attachment A, Program Budget and Scope of Work section of the
Agreement is hereby deleted and is replaced by the revised Attachment A, the
Program Budget and Scope of Work, which is attached hereto and
incorporated herein by reference.
All provisions of the Agreement and any attachments thereto in conflict with this
Modification shall be and are hereby changed to conform to this Modification, effective
as of the date of the execution of this Modification by both parties.
All provisions not in conflict with this Modification remain in full force and
effect, and are to be performed at the level specified in the Agreement.
16D 5
Modification # 4
DCA Contract Number: 08DB- D3- 09- 21- 01 -A03
Recipient: Collier Coup
Page 3
IN WITNESS WHEREOF, the parties hereto have executed this document as of
the dates set herein.
Department of Commprfiity /Affairs
By: `-ti Al
Name: J ice rowning
Title: Oirectk, Pivision of o ing
a y J�eve opment
Date: ((J
Approved as to form
and legal sufficiency:
By: �1lJ�fil�
Colleen Greene
Assistant County Attorney
Recipient Name: Collier Co my
1
By:
Name: Fred W. Coyle
Title: Chairman, Board of C unty
Commis s oners
Date: ct Z 0 G
Attest:
DWIGHT E. BROCK, Clem -
By:
puty Clerk
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EXHIBIT A -1 Contract Amendment for Subrecipient Agreement
Florida Administrative Code 9BER06 -1 CFDA# 14.228
"Immokalee Helping Our People in Emergencies, Inc." (IHOPE)
This amendment, dated Mat clh Cj , 2010 to the referenced agreement shall be
by and between the parties to the original Agreement, Immokalee Helping Our People in Emergencies, Inc.
(to be referred to as Subrecipient) and Collier County, a political subdivision of the state of Florida, (to be
referred to as "County").
Statement of Understanding
RE: Contract Florida Administrative Code 9BER06 -1 CDFA #14.228 "Immokalee Helping Our People in
Emergencies, Inc".
In order to continue the services provided for in the original Agreement document referenced above, the
Subrecipient agrees to amend the above referenced Agreement as follows:
Note: Words stmek-through have been deleted. Words underlined have been added.
A. PROJECT DESCRIPTION: One page 17 of 23 amend as follows
Final completion date for funded activity shall be no later then April 30 2 than Ma 13`h 2010.
G. WORK SCHEDULES: On page 18 and 19 of 23 amend as follows
Jask
End Date
Permitting
February
Relocation (residents)
February 2010
Demolition
March 2010
Site preparation
March -April 2010
Construction
April-May 2010
Utility Hook up
May 2010
Project Completion (receipt of Certificate of
Occupancy)
May 13, 2010
Please note that if any of these activities exceed the timelines by two months a revised work schedule must
be submitted to HHS.
NOTE: Work schedules are in effect for program monitoring requirements only and as such are used by
HOUSING AND HUMAN SERVICES as general target goals rather than strict performance requirements
r`�
r:.
STATE OF FLORIDA
160 5
RECEIVED
MAY 0 7 2010
Board of County Commiesionara
DEPARTMENT OF COMMUNITY AFFAIRS
"Dedicated to making Florida a better place to call home"
CHARLIE CRIST THOMAS G. PELHAM
Governor MAY 0 3 2010 Secretary
The Honorable Fred W. Coyle
Chairman, Collier County BOCC
3301 East Tamiami Trail
Naples, Florida 34112 -4961
Re: Disaster Recovery Community Development Block Grant (CDBG) Program
Contract Number 08DB-D3 -09-21 -01 -A03 / Collier County
Dear Chairman Coyle:
A review of the proposed Modification Number 4 to the referenced subgrant agreement,
transmitted under cover of your letter dated March 9, 2010, has been completed. The review
indicates that the revised work plan appears to be in accordance with program requirements.
Your request to extend the grant period for 6 months is approved. The revised contract end date
is November 13, 2010. An approved copy of the fully executed modification is enclosed with
this letter. Please retain the modification in the official CDBG subgrant files.
If you have questions regarding this matter, please call Audrine Finnerty at
(850) 410 -0587.
Sincerely yours,
�t u
Ja u lyn W. Dupree
Co unity Program Manager
Flo da Small Cities CDBG, Disaster Recovery
and Neighborhood Stabilization Programs
J W D /af
Enclosure(s)
cc: Lisa Oien, Grant Coordinator, Housing and Human Services Department
2555 SHUMARD OAK BOULEVARD ♦ TALLAHASSEE, FL 32399 -2100
850 - 488 -8466 (p) ♦ 850 - 921 -0781 (f) ♦ Website: www.dca.state.fl.us
• COMMUNITY PLANNING 850-488-2356(p) 850-488-33G9(f) ♦ FLORIDA COMMUNITIES TRUST 850-922-2207(p) 850-921-1747(f)
♦ HOUSING AND COMMUNITY DEVELOPMENT 850-488-7956(p) 850-922-5623(f)
16D
MEMORANDUM
Date: June 15, 2010
To: Lisa Oien,
Housing and Human Services
From: Martha Vergara, Deputy Clerk
Minutes & Records Department
Re: Disaster Recovery and NSP Signature Authority Form
Attachment K
Attached you will find two (2) original signatures, as referenced above (Agenda
Item #16D5) and approved by the Board of County Commissioners on Tuesday,
April 27, 2010.
Please forward the fully executed original document upon receipt to
the Minutes and Record's Department for the Board's permanent
record.
If you should have any questions, please call me at 252 -7240.
Thank you.
ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP1 6 0 5
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
ROUTING SLIP
Complete routing lines k I through 44 as appropriate for additional signatures, dates, and/or information needed. if the document is already complete with the
exception of the Chairman's sianamre. draw a line throueh routine lines 41 throueh N4, complete the checklist, and forward to tan Mitchell (line 95).
Route to Addressee(s)
List in muting order
Office
Initials
Date
1. Lisa Oien
HHS
initial)
5/7/2010
for i u
Original document has been signed/ initialed for legal sufficiency. (All documents to be
LO
3.
April 27, 2010
Agenda Item Number
16D5
4.
by the Office of the County Attorney. This includes signature pages from ordinances,
5. Ian Mitchell, Executive Manager
Board of County Connnissioners
Number of
5/7/2010
6. Minutes and Records
I Clerk of Courts Office
Documents Attached
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
Lisa Oien / Housing & Human Services
Phone Number
252 -6141
Contact
appropriate.
initial)
Please call or a -mail
for i u
Original document has been signed/ initialed for legal sufficiency. (All documents to be
LO
Agenda Date Item was
April 27, 2010
Agenda Item Number
16D5
Approved by the BCC
by the Office of the County Attorney. This includes signature pages from ordinances,
Type of Document
Signature Authority Forms
Number of
2
Attached
Chairman's n in signature requi d
Documents Attached
I ,t
INSTRUCTI S & CHECKLIST
1: 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)
Applicable)
1.
Original document has been signed/ initialed for legal sufficiency. (All documents to be
LO
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
LO
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
LO
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
LO
signature and initials are required.
5.
In most cases (some contracts are an exception), the original document and this routing slip
LO
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 4/27/2010 (enter date) and all changes
LO
made during the meeting have been incorporated in the attached document. The
County Attorney's Office has reviewed the changes, if applicable.
IMF-
1: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip W WS Original 9.03.04, Revised 1.26.05, Revised 2.24.05
Attachment K
Department of Community Affairs
160 5
Florida Small Cities Community Development Block Grant, Disaster Recovery and Neighborhood Stabilization Programs
SIGNATURE AUTHORITY FORM
Submit an original Signature Authority Form with each contract.
Recipient Contract # Funding Source
Board of Collier County Commissioners 07DB 3V 09 -21 -01 ZO1 [ ] Small Cities CDBG
Mailing Address (Street or Post Office Box) [ X] Disaster Recovery
[ ] Neighborhood Stabilization
3301 Tamiami Trail East
City, State and Zip Code Local Government DUNS #
Naples,_ Florida 34112 076997790
Project Contact Person Telephone # E -mail Address
Marcy Krumbine, Director '..
Collier County Housing and Human 239- 252 -8442 marcykrumbinePcolliergov net
Services
Financial Contact Person Telephone # E -mail Address
Terri Daniels, Accounting
Supervisor, Collier county Housing 239- 252 -2689 terndanielsCalcollieroov.net
and Human Services
Requests for Funds (RFFs) require (check one); [X] one signature [ ] two signatures of individuals authorized below. RFFs
must be submitted via email in a pelf format from the email address of one of the individuals listed below. RFFs submitted from
other email addresses will not be processed by the Department.
Typed Name
Date Signature
Frank Ramsey, Housing Manager
4/27/2010
[ X ] Check here if above person is authorized to submit RFFs
E -mail Address
frankramsey(a)colliergov net
Typed Name
Date Signature
Lisa Olen, Grants Coordinator
4/27/2010
[ X] Check here if above person is authorized to submit RFFs
E -mail Address'.
IisaoienCa colliergov net
Typed Name
Date l Signature
', [ ]Check here if above person is authorized to submit RFFs
', E -mail Address --
I certify, as the recipient's Chief Elected Official, that the
above signatures are of the individuals authorized to in Req ests for
Funds and to submit RFF's electronically.
Typed Name
, 1
Date Signature- LK�,�i
Fred W. Coyle, Chairman
`-'� h
Board of Collier County Commissioners
4/27/2010'- 1 " .�.)
[X] Check here if your local government utilizes Electronic
Funds Transfer (EFT) from the State of Florida.
[X] Check here if your local government will be working on a reimbursement basis.
CDBG payments to /oca /governments using EFTare automatically deposited in the local government's general account. If the
account is interest bearing, the CDBG funds must be transferred to a non - interest bearing account. Please call the CDBG
Program at 850/922 -1878 or 487 -3644 if you have questions. You can check the status of your deposit at the Comptroller's
website: http://flair.dbf.state.fl.us/.
Local governments not receiving EFT and not working on a reimbursement basis, must establish anon- interest bearing account.
Provide account information for the financial institution (insured by FDIC) below. All signatures on the account must be bonded.
Name of Financial Institution Account Number
Fifth Third Bank 113 -8577
Street Address or Post Office Box Telephone Number
999 Vanderbilt Beach Road 239 -591 -6397
City, State and Zip Code Approved as to form & legal sufficiency
Naples, Florida 34108
._.. _. _. _ li6'�- ticlleen ._. rw/'""
Colleen Greene,
DWIGHT � [i0CK Ciw
Assistant County Attorney , 1