Backup Documents 05/28/2019 Item #16D5 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 16 D 5
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper. Attach to original document. The completed routing slip and original documents are to be forwarded to the County Attorney Office
at the time the item is placed on the agenda. All completed routing slips and original documents must be received in the County Attorney Office no later
than Monday preceding the Board meeting.
**NEW** ROUTING SLIP
Complete routing lines#1 through#2 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 routing lines#1 through#2,complete the checklist,and forward to the County Attorney Office.
Route to Addressee(s) (List in routing order) Office Initials Date
1. Dawn Whelan Community and Human 05/10/19
Services
2. County Attorney Office County Attorney Office S/a g I
3. BCC Office Board of County \"4"k\>--
Commissioners
"-1J1\Commissioners •/ S`Z_qV`z\
4. Minutes and Records Clerk of Court's Office
5)- q )14 \ ztfrk
PRIMARY CONTACT INFORMATION
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,may need to contact staff for additional or missing information.
Name of Primary Staff Dawn Whelan,Grant Coordinator, Phone Number 239-252-4230
Contact/ Department Community and Hum Services
Agenda Date Item was May 28,2019 / Agenda Item Number 16D 5
Approved by the BCC
Type of Document Contract Number of Original 3 l//
Attached Documents Attached
PO number or account
number if document is N/A
to be recorded
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A"in the Not Applicable column,w,l jrheer' Yes N/A(Not
appropriate. (Initial) Applicable)
1. Does the document require the chairman's original signatur:. S A-A wlf) OK
2. Does the document need to be sent to another agency for addi ..1 sia atures9 'yes, DW
provide the Contact Information(Name;Agency;Address;Phone)on an attached sheet.
3. Original document has been signed/initialed for legal sufficiency. (All documents to be DW
signed by the Chairman,with the exception of most letters,must be reviewed and signed
by the Office of the County Attorney.
4. 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
5. The Chairman's signature line date has been entered as the date of BCC approval of the DW
document or the final negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's DW
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip DW
should be provided to the County Attorney Office at the time the item is input into SIRE.
'Some documents are time sensitive and require forwarding to Tallahassee within a certain
time frame or the BCC's actions are nullified. : 1 r• i f your deadlines!
8. The document was approved by the BCC 0 /28/1' and all changes made during
the meeting have been incorporated in the i document. The County .ri optio
Attorney's Office has reviewed the changes,if applicable. is line,
9. Initials of attorney verifying that the attached document is the version approved by the M� •
BCC,all changes directed by the BCC have been made,and the document is ready for t e c3
Chairman's signature. 0.1
\`CI\
I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05,Revised 11/30/12
Instructions 16 13 5
1) There are 3 original Contracts. Please return one Chairman signed Contracts to:
David Lawrence Mental Health Center, Inc
6075 Bathey Lane
Naples, FL 34116
And one Chairman signed contract to:
Dawn Whelan
Contract Specialist
Community and Human Services
239-252-4230
Thank you so much
I:Forms/County Forms/BCC Forms/Original Documents Routing Slip WWS Original 9.03.04,Revised 1.26.05,Revised 2.24.05;Revised 11/30/12
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MEMORANDUM
Date: May 30, 2019
To: Dawn Whelan, Grant Coordinator
Community & Human Services Department
From: Ann Jennejohn, Deputy Clerk
Minutes & Records Department
Re: Amendment #1 to the State Mandated Agreement with
the David Lawrence Mental Health Center, Inc.
Attached, you will find an original copy of the agreement referenced above (Item #16D5)
approved by the Board of County Commissioners Tuesday, May 28, 2019
An original will also be held in the Minutes and Records Department for the
Board's Official Record and the third original has been sent to David Lawrence
Mental Health Center.
If you have any questions, please contact me at 252-8406.
Thank you.
Attachment
Crystal K. Kinzel (�
war couRT 1 6 0
5
Collier County
0 Clerk of the Circuit Court and Comptroller
0 3315 Tamiami Trail East, Suite 102
A Naples, Florida 34112-5324
NtCSR couNT'i.�
May 30, 2019
David Lawrence Mental Health Center, Inc.
6075 Bathey Lane
Naples, FL 34116
Dear Sir,
Attached for your records is an original copy of the contract between Collier County
and David Lawrence Mental Health Center. This contract was approved by the Collier
County Board of County Commissioners during their meeting held May 28, 2019.
The Board will maintain an original copy of the contract for their records and the third
original copy has been sent to Dawn Whelan, with the County's Community and
Human Services Department.
If your office requires further information or you have questions, please feel free to
contact me at 239-252-8406.
Sincerely,
Crystal K. Kinzel, Clerk
Ann Jennejohn,
Deputy Clerk
Attachment
Phone-(239)252-2646 Fax-(239)252-2755
Website-www.CollierClerk.com Email-CollierClerk@collierclerk.com
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FIRST AMENDMENT TO
AGREEMENT BETWEEN COLLIER COUNTY
AND
DAVID LAWRENCE MENTAL HEALTH CENTER,INC.
tk
THIS FIRST AMENDMENT is made and entered into this day of 1 (Al'Y , 2019, by and
between Collier County, a political subdivision of the State of Florida, ("COUNTY" or"Grantee") having its
principal address as 3339 E.Tamiami Trail,Naples FL 34112, and DAVID LAWRENCE MENTAL HEALTH
CENTER, INC.,a private not-for-profit corporation existing under the laws of the State of Florida, ("DAVID
LAWRENCE CENTER" or"CONTRACTOR") having its principal office at 6075 Bathey Lane, Naples, FL
34116.
RECITALS
WHEREAS,on October 1,2018 the COUNTY entered into an Agreement with DAVID LAWRENCE
CENTER using Collier County General Funds.
WHEREAS, the Parties desire to amend the Agreement to change the number of prevention service
units from 1,200 to 3,000 and to amend the definition of prevention services to be consistent with the definition
set forth in 65E-14.
WHEREAS,the Parties also desire to amend the Agreement to change the number of non-duplicated
Collier County resident/clients with at least 1 (one) unit of service from 7,400 to 7,300 throughout the contract
for consistency.
WHEREAS, the parties further desire to amend the Agreement to change the number assigned to the
four types of prevention services to a cumulative total of 3,000.
WHEREAS,the parties desire to amend the Agreement to change the due date for submission of the
Annual Financial Statement and Audit to 9(nine)months following the end of the fiscal year.
NOW, THEREFORE, in consideration of foregoing Recitals, and other good and valuable
consideration,the receipt and sufficiency of which is hereby mutually acknowledged,the Parties agree to amend
the Agreement as follows:
Words Self-Tlgh are Deleted; Words Underlined are added
* *
ARTICLE III COMPENSATION AND REPORTS
B. Contract Deliverables
1. Clients Served MAY `It'd,19 RC
1
•
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The David Lawrence Center will serve a minimum of 7,300 nonduplicated Collier County residents/clients with
at least 1 unit of service, as defined by F.A.C. 65E-14 during the contract period.
Also, the David Lawrence Center will provide 1,200 3,000 prevention service units to children and adults in
the Collier County schools and surrounding community consistent with the definitions set forth in 65E-14 on
what constitutes prevention units, which includes direct, support and travel time.
3. Required Documents
Audited Financial Statement and Management Letter for fiscal year(s) in which contract funds are expended—
Due date:Nonprofits: 440-days-9 months following the end of the DAVID LAWRENCE CENTER'S fiscal
year(s)2 CFR §§200.500-200.521;
* *
ARTICLE IV AUDITS, MONITORING, AND RECORDS
* * *
D. Independent Audit
* * *
An original, bound or disk version from the agency's auditors must be submitted. The audit must be submitted
to the COUNTY no later than :•- • . .! :. 9(nine)months following the end of a non-profit
DAVID LAWRENCE CENTER'S fiscal year pursuant to 2 CFR §§200.500-200.521. If applicable, any
corrective action plan must be submitted to the County. Failure to submit the report within the required time
frame can result in withholding of payment, or termination of the contract by the COUNTY.
* * *
REMAINDER OF PAGE INTENTIONALLY LEFT BLANK
2
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Exhibit 2
PERFORMANCE OUTCOME REPORT
David Lawrence Center(DLC)
Performance Measures Fiscal Year(2018-2019).The quarterly targets listed below are approximate targets
and are not a condition of payment. David Lawrence Center is required to achieve the total served by the end
of the fiscal year.
Cumulative
1st 1st 2^4 3rd 4th Total all
2nd 3rd 4th Total
Quarter Ouarter Quarter Quarter Quarter Prevention
Performance 10/1- Actual Quarter Actual Quarter Actual Quarter Actual Number Services 3000
Measures 12/31 1/1- 4/1- 7/1- to be
3/31 6/30 9/30 served
•
•
+1Annually.
# of nonduplicated
Collier County 74007300
residents/clients 1825 1825 1825 1825
with at least 1 unit of
service during the
quarter.
# of Indicated
prevention service 200
units to children and 25 25 25 25 100*
adults in Collier
County schools and
surrounding
community
# of Selective
prevention service 2508
units to children and 312.5 312.5 312.5 312,5 1250*
adults in Collier
County schools and
surrounding
community
#of Universal Direct
prevention service 2500
units to children and 312,5 3125 312.5 312.5 1250*
adults in Collier
County schools and
surrounding
community
# of Universal
Indirect prevention
service units to 100 100 100 100 400*
children and adults
in Collier County
schools and
surrounding
community
Signature&Date: •
*DLC will'provide a variety of prevention types/methods. The numbers assigned by type are set up as an
approximate annual goal. The numbers by type/methods may fluctuate according to needs, but the total of
3,000 prevention units will be provided for the contract period.
3
160 5
* * *
1N WITNESS WHEREOF,the DAVID LAWRENCE CENTER and the COUNTY, have each, respectively, by
an authorized person or agent, hereunder set their hands and seals on the date first written above.
ATTEST: BOARD OF COUNTYCOMMISSIONERS OF
Crystal K. Kinzi~l, CLERK COLLIER CO - •RIDA
B ��/' :!- APA1110
QO L • Y — —
�� •,-. . Clerk �.
14'"tfs / Will.m L. McDaniel,Jr., Chain an
Attest as to Gtrman's
signature orlty. Date: -r0 a '3 a 0 1 c
Dated: `j"'jU —2019 DAVID LAWRENCE CENTER MENTAL
(SEAL) HEALTH C'NT , INC.
BY: '"IL Per_
Scott :w less, ec rive Director
Date: /i
Approved as to form and legality:
,.4_0 ._A-.7._3,,z__ P 0.
Jennifer K. Belpedio (> S 'l�
Assistant County Attorney
Date: wNO`d?r aC)1 Cl
Item# IC2
Agenda
Date _,.,,,—`
Date /�^'
Recd '`. -m--
Deputy Cie- ,
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