Backup Documents 06/22/2010 Item #16A10ORIGINAL DOCUMENTS CHECKLIST & ROUTING SL1P� 0
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO 1 V
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper. Attach to original document Original document, should he hand dcliNrered to the Board Ot)ice- The completed routine slip and original
documents arc 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 information needed. If the document is already complete with the
exception of the Chairman's sianature-draw aline through routim lines #1 through #4. complete the checklist. and forward to Sue Filson (line #5).
Route to Addressee(s)
(List in routing order
Office
Initials
Date
1.
appropriate.
Agenda Item Number
6 A d
2.
Original document has been signed/initialed for legal sufficiency. (All documents to be
3.
9 1
Number of Original
3
4.
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Documents Attached
5.3-an m;4ehet) Executive Manager
Board of County Commissioners
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. 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
!'h A,2 G A ,C e, r R.¢ m s
Phone Number
S..l — g 9 '.) )(
Agenda Date Item was
appropriate.
Agenda Item Number
6 A d
Approved by the BCC
Original document has been signed/initialed for legal sufficiency. (All documents to be
Type of Document
9 1
Number of Original
3
Attached
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Documents Attached
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark "N /A" in the Not Applicable column, whichever is
Yes
N/A (Not
appropriate.
(InitiaIL
Applicable)
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
N/A
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
si ature and initials are required.
5.
In most cases (some contracts are an exception), the original document and this routing slip
N/A
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 your deadlines!
6.
The document was approved by the BCC on L (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.
16A 10
MEMORANDUM
Date: June 24, 2010
To: Margaret Ramos, Administrative Supervisor
Transportation Engineering & Construction Management
From: Ann Jennejohn, Deputy Clerk
Minutes & Records Department
Re: Resolution 2010 -119: Memorializing Supplemental
Agreement #1 to Asset Management Contract #BD -418
with the Florida Department of Transportation
Attached are three (3) certified Resolutions and three (3) original copies of the
documents referenced above (Item #16A10), adopted by the Board of County
Commissioners June 22, 2010.
After forwarding to the State for further processing, please return a fully executed
copy of the document to the Minutes and Records Department so that it may be
kept as part of the Board's Record.
If you should have any questions, please call me at 252 -8406.
Thank you.
Attachments (3)
RESOLUTION NO. 2010 - 1 1 9 16 A 10
A RESOLUTION BY THE BOARD OF COUNTY COMMISSIONERS OF COLLIER
COUNTY, FLORIDA MEMORIALIZING THE BOARD'S APPROVAL OF
SUPPLEMENTAL AGREEMENT NUMBER ONE TO ASSET MANAGEMENT
CONTRACT # BD -418 WITH THE FLORIDA DEPARTMENT OF
TRANSPORTATION ( "FDOT "), WHEREBY FDOT WILL REIMBURSE COLLIER
COUNTY $3,847.04 TO APPLY ADDITIONAL PAVEMENT MARKINGS AND
STRIPINGS ON SR82 AT THE INTERSECTION OF CR850 WITHIN COLLIER
COUNTY (FDOT PROJECT #412918- 1- 72 -01) AND AUTHORIZING ITS CHAIRMAN
TO EXECUTE THE SUPPLEMENTAL AGREEMENT.
WHEREAS, at the June 22, 2010, meeting of the Collier County Board of Commissioners the
Board approved entering into Supplemental Agreement Number One to asset Management Contract
# BD -418 with the FDOT, whereby FDOT will reimburse Collier County $3,847.04 to apply
additional pavement markings and stripings on SR82 at the intersection of CR850 within Collier
County (FDOT Project #412918- 1- 72 -01); and
WHEREAS, FDOT requires the Board to provide a resolution memorializing and confirming
the Board's aforementioned affirmative vote approving the Supplemental Agreement and
authorizing its Chairman to execute the Supplemental Agreement;
NOW, THEREFORE, BE I1' RESOLVED BY THE BOARD OF COUNTY
COMMISSIONERS OF COLLIER COUNTY, FLORIDA, that:
1. The Board of County Commissioners approves, and authorizes its Chairman to sign, the
aforementioned Supplemental Agreement with FDOT.
2. A certified copy of this Resolution shall be forwarded to FDOT along with the
Supplemental Agreement for execution by FDOT.
THIS RESOLUTION ADOPTED after motion, second, and majority vote favoring same, this
22nd day of June, 2010.
ATTEST:
DWIGHTRC7I clerk
u �1
By lJ �•�
id legal sufficiency:
/�r4
Sco R. Teach,
Deputy County Attorney
BOARD OF COUNTY COMMISSIONERS
OF COLLIER COUNTY, FLORIDA
By.
FRED W. COYLE, Ch e
Itm# LU'�110
Agenda
Date
'• � 11
16A 10
Contract No.: BD -418
Financial Project No.: 412918- 1 -72 -01
Page I of 2
STATE OF FLORIDA DEPARTMENT OF TRANSPORTATION
MAINTENANCE AGREEMENT
SUPPLEMENTAL AGREEMENT 41
This is Supplemental Agreement 91 which modifies the STATE OF FLORIDA
DEPARTMENT OF TRANSPORTATION MAINTENANCEAGREEMENT, hereinafter referred to as
the "Agreement ", between COLLIER COUNTY, hereinafter referred to as the "COUNTY" and the
STATE OF FLORIDA, DEPARTMENT OF TRANSPORTATION, hereinafter referred to as the
"DEPARTMENT" dated June 28, 2002.
WITNESSETH
A. WHEREAS, the DEPARTMENT and the COUNTY entered into a Maintenance Agreement for
the COUNTY to perform certain services identified in Section 1 — Services and Performance;
and
B. WHEREAS, the DEPARTMENT has requested and the COUNTY has agreed to supplement
the original Agreement to install a No- Passing Zone on SR 82 at CR 850 (Section 03050, at MP
1.695), Collier County, pursuant to the terms and conditions set forth in Attachment "A ",
attached hereto and made a part of. The work consists of removing of thermoplastic markings
and RPMs and replacing with new thermoplastic markings with RPMs as shown in Attachment
"A" ; and,
C. WHEREAS, the DEPARTMENT and the COUNTY have agreed to add FM No. 428631 -1 -52-
01 and funds in the amount of Three Thousand Eight Hundred Forty Seven and 04/100 Dollars
($3,847.04) to cover the additional work; and
D. WHEREAS, the DEPARTMENT and the COUNTY have agreed that upon completion by the
COUNTY and acceptance by the DEPARTMENT of the additional requested work, payment
will be made to COUNTY as a lump sum payment in the amount of Three Thousand Eight
Hundred Forty Seven and 04/100 Dollars ($3,847.04).
NOW, THEREFORE, that for and in consideration of the mutual covenants, promises and
representations contained herein, the parties agree as follows:
I. All expressions used herein, unless herein separately defined, shall have the same meaning
herein as in the original Agreement.
2. Except as expressly or by necessary implication modified hereby, all provisions of the original
Agreement shall remain in full force and effect in accordance with their terms but in the event
of any inconsistencies between the provisions of the Agreement and the provisions of
Supplement Agreement #1, the latter shall prevail.
3. Except as set forth herein, all terms and conditions of said original Agreement shall remain in
force and effect during the remainder of this Agreement and any Supplements.
4. There are no other modifications.
16A 10
Contract No.: BD -418
Financial Project No.: 412918- 1 -72 -01
Paso 2 oft
IN WITNESS W1 iEREYF, the COUNTY has caused this Supplemental Agreement #I to be
executed in its behalf this 2�� day of S 2010, by the authorized to
enter into and execute same by Resolution Number _01 0 -1 1 9 dated Jun _ P_22 . 2 01 n
2010 and the DEPARTMENT has executed this Supplemental Agreement #1 through its District
Secretary or authorized designee. Florida Departincnt of Transportation, this clay of
010.
COI '[F'R COl INTY
Signaturc
NAME FRED -19. -00.YLE___
Print
TITLE: yKi1 F�
Collier County Legal
Signature
TITLE: I LE: CHAIRMAN
S'I'A "I'1: OF FLORIDA DEPARTMENT OF Ti2ANSPORTATION
AI -PEST: (Sl :AL) BY:
ExeeullVC Secretary District One Secretary or Desionee
DA1'li:
NAME
Print
DOT District Maintenance Administrator
Approval: / f
Signature
NAME:
DOT Legal Review:
Print
Signature
Availability of Funds Approval:
im ri::: 04 -19 -2010
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