Backup Documents 06/09/2009 Item #16J 3
MEMORANDUM
Date:
June 9, 2009
To:
Lisa Melvin, Assistant General Operations Mgr.
Clerk's Finance Department
From:
Teresa Polaski, Deputy Clerk
Minutes & Records Department
Re:
State Revenue Sharing Application for 2009-2010
Attached, per your request, please find the original application referenced
above (Agenda Item #16J3), approved by the Collier County Board of
County Commissioners on Tuesday, June 9, 2009.
We have retained a copy of the original document for the official record.
If you should have any questions, please call me at 252-8411.
Thank you.
Attachment (1)
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16J3
CLERK OF THE CIRCUIT COURT
COLLIER COUNTY, FLORIDA
FINANCE AND ACCOUNTING DEPARTMENT
FROM:
RE:
SUE FILSON, EXECUTIVE MANGER, BCC
LISA N. MELVIN, ASSISTANT GENERAL OPElv\TIONS MANAGER, CLERK'S FINANCE
APPLICATION FOR REVENUE SHARING
TO:
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This application for Revenue Sharing has been put on the agenda for the June 9th board meeting. The
item is 16]. Please have Chairman Fiala sign it. Once signed, please forward the signed application to
:rvlinutes and Records along with the enclosed memo?
Any questions, please call me at 774-5438.
Thanks
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Application for Revenue Sharing 2009-2010 State Fiscal Year
(Chapter 218, Part II Florida Statutes)
DR-700218
R. 04/09
Application deadline is June 30, 2009
Mail completed original application to:
Department of Revenue
Revenue Accounting Subprocess
P.O. Box 6609
Tallahassee, FL 32399-6609
(850) 487-1150
reven ueaccou nt i ng@dor.state.fl.us
Please TYPE or PRINT
Name of County COLLIER
OR
Name of Municipality County
Telephone Number 239.530.6299
Fax Telephone Number 239.774.2096
Mayor or Chairman of Governing Body Donna Fiala, Chairman, Collier Board of County Commissioners
Chief Fiscal Officer Dwight E. Brock, Clerk of the Circuit Court of Collier County
E-mail Address
Crystal. Kinzel@collierclerk.com
Official Mailing Address P.O. Box 413016, Naples, FL 34101-3016
IX\ Check here if the address represents a change from the previous application.
Federal Employer 1.0. Number
(required for new participants only).
Please complete the questions below to determine your eligibility to participate in Revenue Sharing for this fiscal
year.
1. Have you submitted your financial statements for fiscal year ending 09/30/07 to the Department of Financial Services
as required by s. 218.32, F.S.?
(!)Yes 0 No
2. Have you made provisions for annual postaudits of your financial accounts as provided by
s. 11.45. F.5.?
(!)Yes
ONO
02/26/2009
09/30/2008
Date of Audit Report
Fiscal Year-End
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DR-700218
R. 04/09
Page 2
3. Have you reported on your most recent financial statement revenues equivalent to three mills calculated based on
your 1973 taxable values? This revenue should be net of debt service or special millages approved by the voters.
The revenue can be generated by a combination of ad valorem tax, utility tax, occupational license tax, or a payment
from the county as allowed by s. 125.01, Florida Statutes.
(!)ves ONO
4. If you have a law enforcement department, answer the questions below: (If you have a contracted or strictly
volunteer department, skip to question 5)
(A) Have your law enforcement officers, as defined by s. 943.10(1), F.5., met the qualifications for employment as
established by the Criminal Justice Standards and Training Commission, and do you compensate them at an
annual salary rate of six thousand dollars ($6,000) or more?
@ves 0 No
(8) Does the salary structure and salary plans for law enforcement officers meet the requirements of
Chapter 943 F.5.?
(!)ves 0 No
5. If you have a fire department, answer the questions below: (If you have a contracted or strictly volunteer
department, skip to question 6)
(A) Have your firefighters, as defined by s. 633.30(1), F.5., met the requirements stated in s. 633.34, 633.35, and
633.382 F.5.
(!) Yes 0 No
(8) Does your fire department employ any full-time firefighters, who currently have either a bachelor's degree or
associate degree from a college or university which is applicable to fire department duties, if the degree is not a
requirement for their current position?
(!)ves ONO
(C) If so, are these firefighters currently receiving supplemental compensation for those degrees?
(!)ves 0 No
6. Are dependent special districts budgeted separately from the general budget of your government? Do they meet the
provisions for annual postaudit of their financial accounts in as provided by s. 11.45(3), F.5.?
(!)ves 0 No 0 Does Not Apply
7. Have you met the requirements of s. 200.065, F.5., if applicable? (The annual certification must be within 30 days of
adoption of an ordinance or resolution establishing a final property tax levy or, if no property tax is levied, not later
than November 1.
(!)ves ONO
The portion of revenue sharing funds which, according to Part II, Chapter 218, F.5., would otherwise be distributed
to a unit of local government which has not certified compliance or has otherwise failed to meet the requirements
of s. 200.065, F.5., shall be deposited in the General Revenue Fund for the 12 months following a determination of
noncompliance by the department.)
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DR-700218
R. 04109
Page 3
I certify that all information is accurate and true to the best of my knowledge. I further certify that I will promptly
report to the Department of Revenue any changes in the above information. I also realize that failure to provide timely
information required, allows the Department to utilize the best information available. If no such information is available,
the Department will take necessary action including disqualification, either partial or entire, and you will waive your
right to challenge the determination of the Department to your share of funds, if any, beyond your minimum entitlement,
according to the privilege of receiving shared revenues from the Revenue Sharing Trust Funds.
Do you believe that you have complied with ALL eligibility requirements as listed above?
(!) Yes 0 No
If the answer to question above is (NO), please provide an attachment of the revenue necessary to meet your obligations
because pledges or assignments or trusts entered into which obligated funds received from revenue sharing.
Signed:
Date:
s- ~7-~'J
,
Signed:
Date:
~.. 9-D1
Mail completed original application to address shown below.
Florida Department of Revenue
Revenue Accounting Subprocess
PO Box 6609
Tallahassee FL 32399-6609
reven ueaccou nti ng@dor.state.fl.us
arm & legal sufficiency