Backup Documents 07/09/2019 Item #16D 8 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 16 0 a
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 ing lines#1 throw #2 as appropriate for additional signatures,dates,and/or information needed. If the document is already complete with the
excep of the Chairman's signs e,draw a line through routing lines#1 through#2,complete the checklist,and forward to the County Attorney Office.
R ute to Addressee(s) ( ist in routing order) Office Initials Date
. Wendy Klopf Community and Human 07/09/19
Services
2. County Attorney Office County Attorney Office 11d,1ci
3. Minutes &Records Clerk of Court's Office
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 Wendy Klopf/CHS Phone Number 252-2901
Contact/ Department
Agenda Date Item was 07/09/19 Agenda Item Number 16D8
Approved by the BCC /
Type of Document CCE,ADI,HCE Amendment �/ Number of Original 3 sets of 2
Attached 42D eil5;60 Documents Attached
PO number or account
number if document is
to be recorded
INSTRUCTIONS & CHECKLIST
Initial the Yes column or mark"N/A"in the Not Applicable column,whichever is Yes N/A(Not
appropriate. (Initial) Applicable)
1. Does the document require the chairman's original signature? NA
2. Does the document need to be sent to another agency for additional signatures? If yes, NA
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 WK
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 NA
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 NA
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 NA
signature and initials are required.
7. In most cases(some contracts are an exception),the original document and this routing slip NA
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. Be aware of y r deadlines!
8. The document was approved by the BCC on 07.09.2019 nd all changes made during WK
the meeting have been incorporated in the attached document. The County
Attorney's Office has reviewed the changes,if applicable.
9. Initials of attorney verifying that the attached document is the version approved by the WK
BCC,all changes directed by the BCC have been made,and the document is ready for the
Chairman's signature.
6\_,C
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
16ga
Amendment 03 CCE 203.18.003
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC.
COMMUNITY 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)and amends contract CCE 203.18.
The purpose of this amendment is to(1)extend this contract for 60 days or until a new 2019 CCE 203.19 contract is executed,
whichever comes first.
This amendment shall be effective on July 1,2019.
RECITALS:
WHEREAS, on June 29, 2018, the parties entered into the Standard Contract for social services to be provided
to Collier County's frail and elderly seniors (hereinafter referred to as "Contract"); and
WHEREAS, on.October 17, 2018,the parties entered into a First Amendment to the Contract;
WHEREAS, on April 18, 2019,the parties entered into a Second Amendment to the Contract; and
WHEREAS, Section 3 of the Contract provides that the agreement is to expire on June 30,2019; and
WHEREAS,the funding source for a successor agreement for senior services is not yet available to the
Agency from the Florida Department of Elder Affairs;
WHEREAS, the Parties are satisfied with the arrangement that they currently enjoy under the Contract so that
both parties wish to extend the Contract to August 30, 2019 while they await notification of funding of a successor
contract.
NOW, THEREFORE, in consideration of the foregoing Recitals, and other good and valuable consideration, the
receipt and sufficiency of which is hereby mutually acknowledged,the Parties agree as follows:
1. The foregoing Recitals are true and correct and are incorporated by reference herein.
2. Both parties agree to extend the contract to August 30, 2019.
3. All other provisions of the Contract are to remain in effect and are to be performed at the level specified in
the agreement.
SIGNATURE PAGE TO FOLLOW
1
a
Amendment 03 CCE 203.18.003
IN WITNESS WHEREOF, the parties hereto have caused this 2-page amendment to be executed by their officials there unto
duly authorized.
Contractor: COLLIER COUNTY BOARD OF AREA AGENCY ON AGING FOR SOUTHWEST
COUNTY COMMISSIONERS FLORIDA,INC.
SIGNED BY: "e/ � '- ��, SIGNED BY:7414.42Nti 1924-01A—Th
NAME: Skelohen _I CC-8x0 \ NAME: MARIANNE G LORINI
TITLE: `u-\O\tC ._ e` CE'. 0- \ tod TITLE: PRESIDENT/CEO
DATE: LP i I is-,f q DATE: 61`2)715
Federal Tax ID: 59-6000588
Fiscal Year Ending Date: 09/30
Approved as to form and legality
Assistant County Attort Q, P\\\��
2
1 6 0 8
Amendment 04 ADI 203.18.004
AREA AGENCY ON AGING FOR SOUTHWEST FLORIDA,INC.
ALZHEIMER'S DISEASE INITIATIVE PROGRAM
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)and amends contract ADI 203.18.
The purpose of this amendment is to(1)extend this contract for 60 days or until a new 2019 ADI 203.19 contract is executed,
whichever comes first.
This amendment shall be effective on July 1, 2019.
RECITALS:
WHEREAS, on June 29, 2018, the parties entered into the Standard Contract for social services to be provided
to Collier County's frail and elderly seniors (hereinafter referred to as "Contract"); and
WHEREAS, on October II, 2018, the parties entered into a First Amendment to the Contract;
WHEREAS, on April 18, 2019, the parties entered into a Second Amendment to the Contract;
WHEREAS, on May 1, 2019,the parties entered into a Third Amendment to the Contract; and
WHEREAS, Section 3 of the Contract provides that the agreement is to expire on June 30, 2019; and
WHEREAS, the funding source for a successor agreement for senior services is not yet available to the
Agency from the Florida Department of Elder Affairs;
WHEREAS, the Parties are satisfied with the arrangement that they currently enjoy under the Contract so that
both parties wish to extend the Contract to August 30,2019 while they await notification of funding of a successor
contract.
NOW,THEREFORE, in consideration of the foregoing Recitals, and other good and valuable consideration,the
receipt and sufficiency of which is hereby mutually acknowledged, the Parties agree as follows:
1. The foregoing Recitals are true and correct and are incorporated by reference herein.
2. Both parties agree to extend the contract to August 30, 2019.
,s4T NO All other provisions of the Contract are to remain in effect and are to be performed at the level specified in
the agreement.
SIGNATURE PAGE TO FOLLOW
1
16D8
Amendment 04 ADI 203.18.004
IN WITNESS WHEREOF, the parties hereto have caused this 2-page amendment to be executed by their officials there unto
duly authorized.
Contractor: COLLIER COUNTY BOARD OF AREA AGENCY ON AGING FOR SOUTHWEST
COUNTY COMMISSIONERS FLORIDA,INC.
•
111P.
SIGNED BY: F/ — SIGNED BY: %a-La;.
NAME: � r l Y C me it NAME: MARIANNE G LORINI
TITLE: 1u hc. SeYt.XCe.. iekok TITLE: PRESIDENT/CEO
DATE: 1p i(g I 1_1 DATE: /..2V//.9
Federal Tax ID: 59-6000588
Fiscal Year Ending Date: 09/30
Approved as to form and legality
Assis'"'t County Anon r 03 (';,
\\
2
16D8
Revised August 2007
Attestation Statement
Agreement/Contract Number ADI 203.18
Amendment Number 004
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.
.`
AO -
I,
Signature o'Recipient/C tractor representative Date
Approved as to form and legality
Assistant County ttt -ney ` \`\
(0 V
Revised August 2007
160 8
Amendment 04 HCE 203.18.004
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)and amends contract HCE 203.18.
The purpose of this amendment is to(1)extend this contract for 60 days or until a new 2019 HCE 203.19 contract is executed,
whichever comes first.
This amendment shall be effective on July 1, 2019.
RECITALS:
WHEREAS, on June 29, 2018, the parties entered into the Standard Contract for social services to be provided
to Collier County's frail and elderly seniors (hereinafter referred to as "Contract"); and
WHEREAS, on October 11, 2018,the parties entered into a First Amendment to the Contract;
WHEREAS. on February 25, 2019, the parties entered into a Second Amendment to the Contract;
WHEREAS, on May 3, 2019,the parties entered into a Third Amendment to the Contract; and
WHEREAS, Section 3 of the Contract provides that the agreement is to expire on June 30, 2019; and
W1•IERE;AS, the funding source for a successor agreement for senior services is not yet available to the
Agency from the Florida Department of Elder Affairs;
WHEREAS, the Parties are satisfied with the arrangement that they currently enjoy under the Contract so that
both parties wish to extend the Contract to August 30,2019 while they await notification of funding of a successor
contract.
NOW,THEREFORE, in consideration of the foregoing Recitals, and other good and valuable consideration,the
receipt and sufficiency of which is hereby mutually acknowledged, the Parties agree as follows:
1. The foregoing Recitals are true and correct and are incorporated by reference herein.
2. Both parties agree to extend the contract to August 30, 2019.
3. All other provisions of the Contract are to remain in effect and are to be performed at the level specified in
the agreement.
SIGNATURE PAGE TO FOLLOW
1
6
8
Revised August 2007 D
Attestation Statement
Agreement/Contract Number HCE 203.18
Amendment Number 004
I,Stephen V 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 ' •cipient/Cont ct r representative Date
Approved as to form and legality
Assistant County A 416 •y \1\\�
1 1
Revised August 2007
0