Backup Documents 05/28/2019 Item #16D3 1603
Colter County
Public Services Division
community&Human services
Memorandum
To: Minutes & Records
CC:
From: Wendy Klopf, Grant Coordinator, Services for Seniors
Date: May 28, 2019
Subject: ATF-Executed Amendment HCE 203.18.003 with Area Agency on Aging of SWFIa
(AAA)
CHS is providing executed Amendment 3 from Area Agency on Aging of SWFIa (AAA) on May 28, 2018.
• 1603-HCE 203.18.003
Enclosed are the copies for Minutes and Records since they did not require the BCC signature due to
Resolution 2010-122, designating the Public Service Administrator authority to sign the amendments.
Let me know if you need anything.
Thanks
Wendy Klopf
Grant Coordinator-Services for Seniors
252-2901
co.Mier county
July 2018--June 2019 HCE 203.18.003 16 0 3
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC.
HOME CARE FOR THE ELDERLY
COLLIER COUNTY BOARD OF COUNTY COMMISSIONERS
THIS AMENDMENT is entered into between the Area Agency on Aging for Southwest Florida,Inc. ("Agency")and Collier
County Board of County Commissioners, ("Contractor"),amends agreement HCE 203.18.
The purpose of this amendment is to increase the allocation for Collier County by $4,630 for services and amend
4. Contract Amount and revise ATTACHMENT II,Exhibit 2 and ATTACHMENT IX.
4. Contract Amount:
The Agency agrees to pay for contracted services according to the terms and conditions of this contract in
an amount not to exceed $59,080.00, or the rate schedule, subject to the availability of funds. Any costs or
services paid for under any other contract or from any other source are not eligible for payment under this
contract.
All provisions in the contract and any attachments thereto in conflict with this Amendment shall be and are hereby changed to
conform to 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 contract.
This Amendment and all its attachments-ale hereby made part of the contract.
IN WITNESS THEREOF,the Parties hereto have caused this amendment,to be executed by their undersigned officials as duly
authorized; and agree to abide by the terms, conditions and provisions of this HCE contract as amended. This Amendment is
effective on the last date the Amendment has been signed by both Parties.
CONTRACTOR: COLLIER COUNTY AREA AGENCY ON AGING FOR
BOARD OF COUNTY CO SSIONERS SOUTHWEST FLORIDA,INC..
SIGNED BY:� '�'212.9 - SIGNED BY: P /'7 -t-
NAME: STEPHEN Y CARNELL NAME: MARIANNE G LORINI
TITLE: PUBLIC SERVIES DEPARTMENT HEAD TITLE: PRESIDENT/CEO
DATE: 14/.3I/CI DATE: -/3J/J
Federal Tax ID: 59-6000558
Fiscal Year Ending Date: 09/30 Approved as to form and legality
DUNS: 076997790
A. ` 1 `�
A,ristant Count 4 Attorney (--\(; )
30
July 2018--June 2019 HCE 203.18.003
ATTACHMENT II-EXHIBIT6 D 3
2 FUNDING SUMMARY
Note: Title 2 CFR, as revised, and Section 215.97,F.S.require that the information about Federal Programs and State
Projects included in Attachment II,Exhibit 1 be provided to the recipient. Information contained herein is a prediction of
funding sources and related amounts based on the contract budget.
1. FEDERAL RESOURCES AWARDED TO THE SUBRECIPIENT PURSUANT TO THIS
CONTRACT CONSIST OF THE FOLLOWING:
GRANT AWARD (FAIN#): FEDERAL AWARD DATE:
DUNS NUMBER: 076997790
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL FEDERAL AWARD
COMPLIANCE REQUIREMENTS APPLICABLE TO THE FEDERAL RESOURCES AWARDED PURSUANT
TO THIS CONTRACT ARE AS FOLLOWS:
FEDERAL FUNDS:
2 CFR Part 200—Uniform Administrative Requirements, Cost Principles,and Audit Requirements for Federal Awards.
OMB Circular A-133 —Audits of States,Local Governments, and Non-Profit Organizations
2. STATE RESOURCES AWARDED TO 1HE RECIPIENT PURSUANT TO THIS CONTRACT CONSIST
OF THE FOLLOWING:
MATCHING RESOURCES FOR FEDERAL PROGRAMS
PROGRAM TITLE FUNDING SOURCE CFDA AMOUNT
TOTAL STATE AWARD
STATE FINANCIAL ASSISTANCE SUBJECT TO SECTION 215.97,F.S.
PROGRAM TITLE FUNDING SOURCE CSFA AMOUNT
Home Care for the Elderly General Revenue-Collier 65.001 $ 59,080.00
TOTAL AWARD $ 59,080.00
COMPLIANCE REQUIREMENTS APPLICABLE TO STATE RESOURCES AWARDED PURSUANT TO THIS
CONTRACT ARE AS FOLLOWS:
STATE FINANCIAL ASSISTANCE
Sections 215.97&215.971,F.S.,Chapter 69I-5,F.A.C, State Projects Compliance Supplement
Reference Guide for State Expenditures
Other fiscal requirements set forth in program laws,rules and regulations
2
July 2018—June 2019 HCE 203.18.003
1603
ATTACHMENT IX
ANNUAL BUDGET SUMMARY
1. HCE Services (Subsidies &
Case Management) Collier S 59,080.00
Total $59,080.00
3
Revised August 2007 16 0 3
Attestation Statement
Agreement/Contract Number HCE 203.18
Amendment Number.003
I,Stephen Y Carnell ,attest that no changes or revisions have been made to the
(Recipient/Contractor representative)
content of the above referenced agreement/contract or amendment between the Area Agency on Aging for
Southwest Florida and
Collier County Board of County Commissioners .
(Recipient/Contractor name)
The only exception to this statement would be for changes in page formatting,due to the differences in
electronic data processing media,which has no affect on the agreement/contract content.
Signature of Recipi$' /Contractor representative Date
Approved as to form and legality
VIA
Assistant Count Home
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Revised August 2007
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