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Backup Documents 01/13/2009 Item #16D 8 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 16 D 8 TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO THE BOARD OI<' COUNTY COMMISSIONERS OFFICE FOR SIGNATURE Print on pink paper. Altach to original document. Original documcnb should be hand delivered to the linal'd Ol1'icc The completed routing slip ,md Llriginal documents are to be forwarded to the Board Olliee only after the Board has taken action on the item.) ROUTING SLIP Complete routing lines # 1 through #4 as appropriate for additional signatures, dates, and/or inlormatiol1 needed. ]1' the document is already complete with the exceotion of the Chairman's signature, draw a line through routing lines # I throll~ 1 #4, complete the checklist. and forward to Sue Filson {line #5) Route to Addressee(s) Office Initials Date (List in routinp" orderl J,Frank Ramsey Housing and Human Service .A" A' J /14/09 ~ 2. Colleen Greene County Attorney's Otlice CJYlG 1-15-cA 3, CO tlLL -- -' 4, -- - .. ----------_.__._~.._-_." -_.._~-- .-...------- ---.--f' 5, Sue Filson, Executive Manager Board of County Commissioners 6. Minutes and Records Clerk of Court's Office PRIMARY CONTACT INFORMATION (The primary conta;t is the holder of the original dncument pending nee approval. Normally the primary clllltact is Ihe person who en::att'd/prcpared the executive summary. Primary contact information is needed in the event one of Ule addressees ah'lVe. inc1LlIing Sw: l-i1snn. need (() cmlact slaff j;1r additional or missing information. All original doeumenls needing the 13ce Chairman's signature arc 10 he dcliven:u I,) the Bee olllee l)nly alter the [~C(" has acted to approve the item) Name of Primary Staff Frank Ramsey, Housing Manager Phone Number 252-2336 Contact Agenda Date Item was 01/13/2009 Agenda Item Number 160-8 AnDroved bv the BCC Type of Document Agreement Numher of Original 1 Attached DOCUlnents Attached 1. INSTRUCTIONS & CHECKLIST Initial the Yes column or mark "N/A" in the Not Applicable column, vvhichevcr is a TO fiate. Original document has been signed/initialed for legal sufficiency. <All documents to be signed by the Chaim1an, 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 BeC Chainnan and Clerk to the Board and ossihly State Officials,) All handwritten strike-through and revisions have been initialed by the County Attorney's Office and all other arties exce t the BCC Chairman and the Clerk to the Board The Chaimlan's signaturc line date has been t::ntercd as the date of Bee approval of the document or the 11nal nCHotiated contract date \vhichever is a Iicable. "Sign here" tabs are placed on the appropriate pages indicating where the Chairman's si nature and initials are rc uired. In most cases (some contracts are an exception), the original document and this routing slip should be provided to Sue Filson in the BCC on;ce within 24 hours of BCC approval. Some documents arc time sensitive and require forwarding to Tallahassee within a certain time frame or the Bec's actions are nullified. He aware of your deadlines! The document was approved by the Bee onlll/13/2009 and all chan~cs made durin~ the meeting have been incorporated in thc attached ducumcnt. The County Attorney's Office has reviewed the chan es, if a licablc. Yes (Initial) NI A (Not ^ licablc) 2, 3, 4, 5, 6, 7ft I: Forms/ County Forms/ BCC Forms/ Original Documents Routing Slip V...'WS Original 9(LUl4, Revised L26_0:'i, Revised 2.2405 MEMORANDUM Date: January 20,2009 To: Frank Ramsey, Housing Manager Housing & Human Services Department From: Ann Jennejohn, Deputy Clerk Minutes & Records Department Re: An agreement providing for a $150,000 State Housing Initiative Partnership (SHIP) Grant to "Housing Opportunities Made for Everyone, Inc," (HOME) for the acquisition and/or rehabilitation of residential dwelling units benefitting qualified lower income residents Enclosed is a copy of the document referenced above, (Agenda Item #16D8) approved by the Board of County Commissioners on Tuesday, January 13, 2009, The Minutes & Records Department has kept the original for the Board's perrnanentrecord, If you should have any questions, please contact me at 252-8406, Thank you. Enclosures 1608 16D8 AGREEMENT BETWEEN COLLIER COUNTY AND HOUSING OPPORTUNITIES MADE FOR EVERYONE. INC. SHIP ACOUlSITION-REHABILITATIONINEW CONSTRUCTION This Agreement ("Agreement"), effective this 13th day of January, 2009, is made by and between Collier County, a political subdivision of the State of Florida, hereinafter referred to as "COUNTY," and Housing Opportunities Made for Everyone, Inc., a public not-for-profit corporation, existing under the laws of the State of Florida, having its principal office at 4351 Gulf Shore Boulevard #19N, Naples, Florida 34103, hereinafter referred to as "SPONSOR." RECITALS: WHEREAS, the COUNTY is a participant in the State Housing Initiatives Partnership (SHIP) Program; and WHEREAS, pursuant to the SHIP Program, the COUNTY is undertaking certain activities to primarily benefit housing for very low - low - and moderate income persons and neighborhoods; and WHEREAS. the Local Housing Assistance Plan (LHAP) Fiscal Year 2007-2010 was adopted on April 24, 2007 through Resolution No. 2007-96; and WHEREAS, through Resolution No, 2008-212 the Board of County Commissioners ("Board") adopted a revision to the three-year LHAP amending a strategy that outlines the intended use of SHIP funds for fiscal years 2007-2008, 2008-2009 and 2009-2010; and WHEREAS, the Board finds that the activities undertaken in connection with this Agreement constitute valid and worthwhile County purposes, and as such, that SPONSOR should be duly funded or reimbursed for the expenses as set forth herein. WITNESSETH: NOW, THEREFORE, in consideration of the mutual promises and covenants herein contained, it is agreed by the Parties as follows: I. All of the Recitals are true and correct and are hereby expressly incorporated herein by reference as if set forth fully below. Page I of 16 1608 II. DEFINITIONS (I) "COUNTY" means Collier County, and where applicable, its authorized representative( s), (2) "SHIP" means the State Housing Initiatives Partnership Program of Collier County, S 420.907-.9079, Florida Statutes, (3) "SPONSOR" means Housing Opportunities Made for Everyone, Inc, (4) "Very low - low - and moderate income persons" means the definition set by S 420.9071, Florida Statutes. (5) "Project" means the work contemplated to be performed as set forth in Exhibit "A." (6) "Florida Housing Finance Corporation" means the agency governing the SHIP Program. II. SCOPE OF SERVICES The SPONSOR shall, in a satisfactory and proper manner, as determined by COUNTY, perform the tasks necessary to conduct the program outlined in Exhibit "A," and shall submit each request for advancement and/or reimbursement of funds using Exhibit "8," all of which are attached hereto and made a part hereof. The SPONSOR may request advance funds for acquisition of eligible property with the required documentation. Payments for eligible work tasks and/or activities may be made directly to the provider of the service(s), as approved by HOUSING AND HUMAN SERVICES, at SPONSOR'S written request. IV, TIME OF PERFORMANCE The effective date of this Agreement is written above, and the services of the SPONSOR shall be undertaken and completed within twelve (12) months from date of executed Agreement. V. CONSIDERATION AND LIMITATION OF COSTS The SPONSOR shall be paid by the COUNTY for allowable costs, using SHIP funds, determined by COUNTY, in an amount not to exceed ONE HUNDRED FIFTY THOUSAND AND 00/100 DOLLARS ($150.000,00) for the services described in Exhibit "A." Funding shall not exceed fifty-thousand dollars per residential unit. All activities specified in Exhibit "A" shall be performed by SPONSOR employees, or shall be solicited under a procedure acceptable to the COUNTY, Contract administration shall be handled by the SPONSOR and monitored by the COUNTY, which shall have access to all records and documents related to the project. Payments for eligible work tasks and/or activities Page 2 of 16 16D8 may be made directly to the provider of the service(s), as approved by HOUSING AND HUMAN SERVICES, at SPONSOR'S written request. VI. NOTICES All notices required to be given under this Agreement shall be sufficient when delivered to COUNTY at its office, presently located at 330 I E Tamiami Trail, Suite 211, Naples, FL 34112, and to the SPONSOR when delivered to its office at the address listed on page one (I) of this Agreement. VII. SPECIAL CONDITIONS The SPONSOR agrees to comply with the requirements of the SHIP Program as described in the 9 420.907 through 420.9079, Florida Statutes, and Chapter 67.37 of the Florida Administration Code. All work performed by SPONSOR, any contractor(s) and their subcontractor(s), must conform to the requirements ofthe following: I. 2005 Environmental Health & Safety 2. 2004 Florida Building Code (includes Energy Efficient Code) 3. 2004 Florida Building Code/Fuel Gas 4, 2004 Florida Building Code/Mechanical 5. 2004 Florida Building Code/Plumbing 6, 2004 Florida Building Code/Americans with Disabilities 7. 2005 National Electric Code 8. 2002-01 Building Construction Administrative Code VIII. GENERAL CONDITIONS A. IMPLEMENTATION OF PROJECT ACCORDING TO REOUIRED PROCEDURES The SPONSOR shall implement this Agreement in accordance with applicable Federal, State, and County laws, ordinances and codes. No payments will be made until approved by COUNTY. B. AMENDMENTS This Agreement, along with all exhibits and attachments, may be amended only by written agreement executed by the governing boards of both parties, except that COUNTY representative may approve adjustments between line item amounts, scope clarifications, or an extension of time and schedule provided in Exhibit "A" that do not Page 3 of 16 1608 change the project, or exceed the amount funded by the COUNTY, as stated herein. Any modifications to this contract shall be in compliance with the County Purchasing Policy and Administrative Procedures in effect at the time such modifications are authorized, C. INDEMNIFICATION To the maximum extent permitted by Florida law, the SPONSOR shall indemnify and hold harmless Collier County, its officers and employees from any and all liabilities, damages, losses and costs, including, but not limited to, reasonable attorneys' fees and paralegals' fees, to the extent caused by the negligence, recklessness, or intentionally wrongful conduct of the SPONSOR or anyone employed or utilized by the SPONSOR in the performance of this Agreement. This indemnification obligation shall not be construed to negate, abridge or reduce any other rights or remedies which otherwise may be available to an indemnified party or person described in this paragraph. This section does not pertain to any incident arising from the sole negligence of Collier County. The foregoing indemnification shall not constitute a waiver of sovereign immunity beyond the limits set forth in ~ 768.28, Florida Statutes. D, TERMINATION In event of tennination for any of the following reasons, all finished or unfinished documents, data studies, surveys, drawings, maps, models, photographs, reports prepared, and capital equipment secured by the SPONSOR with funds under this Agreement shall be returned to HOUSING AND HUMAN SERVICES or the COUNTY, In the event of termination, the SPONSOR shall not be relieved of liability to the COUNTY for damages sustained by the COUNTY by virtue of any breach of the Contract by the SPONSOR, and the COUNTY may withhold any payment to the SPONSOR for set-off purposes until such time as the exact amount of damages due to the COUNTY from the SPONSOR is determined. 1. TERMINATION FOR CAUSE Should the SPONSOR be found to have failed to perform in a manner satisfactory to the COUNTY as per this Agreement, the COUNTY may terminate said agreement immediately for cause; further the COUNTY may terminate this Agreement for convenience with a seven (7) day written notice. The COUNTY shall be sole judge of non-performance, 2, TERMINATION FOR CONVENIENCE Page 4 of 16 16D8 At any time during the term of this Agreement, either party may, at its option and for any reason, terminate this Agreement upon ten (10) working days written notice to the other party, Upon termination, the COUNTY shall pay the SPONSOR for services rendered pursuant to this Agreement through and including the date of termination. E. INSURANCE. The SPONSOR or Contractor, if applicable, shall provide insurance as follows: Commercial General Liabilitv: Coverage shall have minimum limits of $300,000 Per Occurrence, Combined Single Limit for Bodily Injury Liability and Property Damage Liability. This shall include Premises and Operations; Independent Contractors; Products and Completed Operations and Contractual Liability. Workers' Compensation: Insurance covering all employees meeting Statutory Limits of Chapter 440, Florida Statutes, and all Federal Government Statutory Limits and Requirements. Special Requirements: Collier County shall be listed as the Certificate Holder and included as an Additional Insured on the Comprehensive General Liability Policy. Current, valid insurance policies meeting the requirement herein identified shall be maintained by SPONSOR or Contractor, if applicable, during the duration of this Agreement. Renewal certificates shall be sent to the COUNTY thirty (30) days prior to any expiration date. There shall be a thirty (30) day notification to the COUNTY in the event of cancellation or modification of any stipulated insurance coverage, SPONSOR or Contractor, if applicable, shall insure that all subcontractors comply with the same insurance requirements that he is required to meet. The SPONSOR or same Contractor. if applicable, shall provide COUNTY with certificates of insurance meeting the required insurance provisions. F, INDEPENDENT AGENT AND EMPLOYEES The SPONSOR agrees that, in all matters relating to this Agreement, it will be acting as an independent agent and that its employees are not Collier County employees and are not subject to the COUNTY provisions of the law applicable to COUNTY employees relative to employment, hours of work, rates of compensation, leave, unemployment compensation and employee benefits, IX. ADMINISTRATIVE REOUIREMENTS A. DOCUMENTATION AND RECORD KEEPING Page 5 of 16 1608 I. The SPONSOR shall maintain all records required by the COUNTY and SHIP Regulations, 2. All invoices, plans, surveys, information, documents, maps, and other data procedures developed, prepared, assembled, or completed by the SPONSOR for the purpose of this Agreement shall be made available to the COUNTY by the SPONSOR at any time upon request by the COUNTY. Upon completion of all work contemplated under this Agreement copies of all documents and records relating to this Agreement shall be surrendered to COUNTY if requested, B. PURCHASING All purchasing for services and goods, including capital equipment, shall be made by purchase order or by a written contract and in conformity with the procedures prescribed by the Collier County Purchasing Policy, which are incorporated herein hy reference. C. REPORTS, AUDITS, AND EV ALUA TlONS I. Payments and/or reimbursement will be contingent on the timely receipt of complete and accurate Request for Payment, attached herein as Exhibit "B," required by COUNTY, and on the resolution of monitoring or audit findings identified pursuant to this Agreement. 2. At any time during normal business hours and as often as the COUNTY or the Florida Housing Finance Corporation may deem necessary, there shall be made available by the SPONSOR for examination all its records with respect to all matters covered by this Agreement. 3. The SPONSOR, if applicable, agrees to comply with the requirements of the Florida Single Audit Act as defined in S 215,97. Florida Statutes, D, ADDITIONAL COUNTY AND SHIP REOUIREMENTS COUNTY shall have the right under this Agreement to suspend or terminate payments and reimbursement until the SPONSOR complies with any additional conditions that may be imposed by the COUNTY or SHIP at any time. Funds are subject to the recapture provisions of S 420.9075(5)(g), F/orida Statutes from eligible persons or eligible sponsors who default on the terms of a grant award or loan award. Page 6 of 16 16D8 X. OTHER PROGRAM REOUIREMENTS A. PROGRAM BENEFICIARIES One Hundred percent (100%) of the beneficiaries of the project funded through this Agreement must be very low- low - or moderate income persons as required by ~ 420.9071(10), Florida Statutes, All prospective home buyers of subject property, as listed on Exhibit "A," shall be qualified by COUNTY staff prior to transfer of title from SPONSOR to new owner. B, EV AUlA TlON AND MONITORING The SPONSOR agrees that COUNTY may carry out periodic monitoring and evaluation activities as determined necessary by COUNTY and that the continuation of this Agreement is dependent upon compliance with SHIP regulations. The SPONSOR shall, upon the request of COUNTY, submit information and status reports requested by the COUNTY, The SPONSOR shall allow COUNTY to monitor the SPONSOR on site, Such site visits may be scheduled or unscheduled as determined by COUNTY and Florida Housing Finance Corporation. C. CONFLICT OF INTEREST The SPONSOR covenants that no person who presently exercises any functions or responsibilities in connection with the Project, has any personal financial interest, direct or indirect, in the target areas or any parcels therein, which would conflict in any manner or degree with the performance of this Agreement and that no person having any conflict of interest shall be employed by or subcontracted by the SPONSOR. Any possible conflict of interest on the part of the SPONSOR or its employees shall be disclosed in writing to COUNTY provided, however, that this paragraph shall be interpreted in such a manner so as not to unreasonably impede the statutory requirement that maximum opportunity be provided for employment of and participation of low and very low-income residents ofthe project target area. XI. SEVERABILITY OF PROVISIONS If any provision of this Agreement is held invalid, the remainder of this Agreement shall not be affected thereby if such remainder would then continue to confonn to the terms and requirements of applicable law. XII. ENTIRE UNDERSTANDING This Agreement and its provisions merge any prior agreements, if any, between the Page 7 of 16 1608 parties hereto and constitutes the entire understanding. The parties hereby acknowledge that there have been and are no representations, warranties, covenants, or undertakings other than those expressly set forth herein. IN WITNESS WHEREOF, the parties hereto have caused this Agreement to be executed by their appropriate officials, as of the date first above written. ATTEST: Dwight E. Brock, Clerk of Courts BOARD OF COUNTY COMMISSIONERS COLLIER C UNT FLORIDA ',;' -' ,:'(';, By: 'Chl.tL ...~ Q.L. At!-t ~ to~l~le;k .fIMWt .f~ .,; / '/ , CHAIRMAN ~r;~+ rst Witness I/. d. G-~orv ~""c<V1 4'.1- ~e Second Witness e' /JJ1t:://lle;./.. K Row,) Type/print witness name ortun:~~. N BARLOW, Vice President, Real Estate Approved as to form and legal sufficiency: ~m~ / Colleen M. Greene Assistant County Attorney ltem# ~ Agenda U?-r?l Date ~I Date I_u::::...ra Rec'd LLI1L \ Page 8 of 16 1608 EXHIBIT "A" SCOPE OF SERVICES HOUSING OPPORTUNITIES MADE FOR EVERYONE. INC, THE SPONSOR AGREES TO: I. PROJECT SCOPE This project will provide safe, decent and affordable housing for very low - low - and moderate income persons in Collier County. This SHIP Program grant in the amount of One Hundred Fiftv Thousand and 0011 00 Dollars ($150,000,00) may be used to acquire and/or rehabilitate at least three (3) residential dwelling units in Collier County to benefit very low - low - or moderate income persons as defined by S 420.9071, Florida Statutes. Funding shall not exceed fifty-thousand dollars per residential unit and may include acquisition and/or rehabilitation. a, Acquisition SPONSOR may use project funds to finance the acquisition of eligible housing. Pursuant to S 420.9071(12), F/orida Statutes, COUNTY may allocate SHIP funds to eligible sponsors to partially assist in the construction, rehabilitation, or financing of eligible housing. Eligible housing is defined in S 420.9071(8), F/orida Statutes, b. Rehabilitation SPONSOR may use project funds to rehabilitate eligible housing. Pursuant to S 420.9071(12), Florida Statutes, COUNTY may allocate SHIP funds to eligible sponsors to partially assist in the construction, rehabilitation, or financing of eligible housing. Eligible housing is defined in S 420.9071(8), F/orida Statutes, Eligible work shall be determined by a Bid Specification Form prepared by HOUSING AND HUMAN SERVICES. 2. BUDGET Total funds available under this Agreement shall not exceed One Hundred Fith and 0011 00 Dollars ($150,000.00) and the maximum award per unit shall be limited to fifty- thousand dollars, The maximum award per unit may be allocated between acquisition and rehabilitation. Page 9 of 16 16D8 a, Acquisition Line Item SHIP Identify Property $0.00 Purchase Property $50,000,00 Identify Buyer(s) $0.00 Transfer Property $0.00 Total Available for Acquisition* $50,000,00 'NOTE: SPONSOR may elect to allocate maximum award per unit between acquisition and rehabilitation, b, Rehabilitation Line Item SHIP Purchase Property $0,00 Bid Specification $0.00 Complete Rehabilitation Work $50,000,00 Transfer Property $0.00 Total Available for Rehabilitation* $50,000,00 'NOTE: SPONSOR may elect to allocate maximum award per unit between acquisition and rehabilitation. The Bid Specification Form, when prepared and if applicable, will be attached and incorporated into this Agreement and used to itemize the Rehabilitation budget. 3. STAFFING SPONSOR to provide list of staff directly responsible for reporting and request for payment processing. 4. FORMER PROJECTS Failure to adequately maintain any former SHIP funded projects may result in the delay of processing reimbursement requests for ongoing activities or in the forfeiture of future SHI P funds. Page 10 of 16 16D8 S. WORK SCHEDULE a, Acquisition Milestone Start Date Target Goals Identify Property January 2008 March 2009 Purchase Property March 2009 July 2009 Identify Buyer(s) July 2009 October 2009 Transfer Property October 2009 December 2009 b, Rehabilitation Milestone Start Date Target Goals Purchase Property January 2008 March 2009 Bid Specification March 2009 May 2009 Complete Rehabilitation May 2009 October 2009 Transfer Property October 2009 December 2009 NOTE: Performance milestones are in effectfor program monitoring requirements only, and a.\' .\"Uch, are used by HOUSING AND HUMAN SERVICES as general target goals rather than strict performance requirements, 6. REPORTS The SPONSOR shall submit detailed monthly progress reports to HOUSING AND HUMAN SERVICES outlining the status of specific activities under the project. Each report must account for the total activity for which the SPONSOR is paid with SHIP funds, in part or in whole, and which is required in fulfillment oftheir obligations under this Agreement. The progress reports shall be submitted on the form Exhibit "C". The progress reports shall be used as an additional basis for COUNTY'S approval of invoices, etc for payment. 7. COMPENSATION The COUNTY shall reimburse the SPONSOR for the performance of this Agreement upon completion or partial completion of the work tasks as accepted and approved by HOUSING AND HUMAN SERVICES pursuant to the submittal of monthly progress reports, but not more frequently than once per month. Progress payments to SPONSOR, as approved by HOUSING AND HUMAN SERVICES, can be made for any eligible Page 1 I of 16 16D8 activity listed in this Agreement. Eligible work tasks and/or activities shall include, but not be limited to, acquisition of property, rehabilitation ofthe property and rcsale of the property to an eligible person. Payments for eligible work tasks and/or activities may be made directly to the provider ofthe service(s), as approved by HOUSING AND HUMAN SERVICES. at SPONSOR'S request. Adherence to the work schedule identified in Section 5 will be required, unless modified in writing by PARTIES. Payment will be made upon receipt of a proper invoice and in compliance with S 218.70, F/orida Statutes, otherwisc known as the "Local Government Prompt Payment Act". END EXHIBIT "A" Page 12 of 16 16D8 EXHIBIT "B" COLLIER COUNTY HOUSING AND HUMAN SERVICES REQUEST FOR PAYMENT SECTION I: REQUEST FOR PAYMENT SPONSOR Name: Housing Opportunities Made for Evervone, Inc. SPONSOR Address: 435] Gulf Shore Blvd # 19N, Naples, FL 34103 Unit#]: Project No: Payment Request # Dollar Amount Requested: $ SECTION II: STATUS OF FUNDS I. Total Loan Amount Unit #] $ $50,000.00 2. Sum of Past Claims Paid on this Account $ 3. Total Loan Amount Less Sum of Past Claims Paid on this Account $ 4, Amount of Previous Unpaid Requests $ 5. Amount of To day's Request $ 6. Current Loan Balance (Initial Loan Amount Awarded Less Sum ofillLRequests) $ 7. If applicable amount held as retainage to date by the County, ifnot retained by the sub-recipient. $ I certify that this request for payment has been drawn in accordance with the terms and conditions of the Agreement between the County and us as the SPONSOR, I also certifY that the amount of the Request for Payment is not in excess of current needs. Signature Date Title (approval authority under $ ] 4,999) (approval required $]5,000 and above) Supervisor Dept Director Page 13 of 16 16D8 EXHIBIT "B" COLLIER COUNTY HOUSING AND HUMAN SERVICES REQUEST FOR PAYMENT SECTION I: REQUEST FOR PAYMENT SPONSOR Name: Housing Opportunities Made for Evervone. Inc, SPONSOR Address: 4351 Gulf Shore Blvd # I 9N. Naples. FL 34103 Unit #2: Project No: Payment Request # Dollar Amount Requested: $ SECTION II: STATUS OF FUNDS 1. Total Loan Amount Unit #2 $ $50,000.00 2. Sum of Past Claims Paid on this Account $ 3, Total Loan Amount Less Sum of Past Claims Paid on this Account $ 4. Amount of Previous Unpaid Requests $ 5. Amount of To day's Request $ 6. Current Loan Balance (Initial Loan Amount Awarded Less Sum of1!lLRequests) $ 7. If applicable amount held as retainage to date by the County, ifnot retained by the sub-recipient. $ I certify that this request for payment has been drawn in accordance with the terms and conditions of the Agreement between the County and us as the SPONSOR. I also certify that the amount of the Request for Payment is not in excess of current needs. Signature Date Title (approval authority under $]4,999) (approval required $] 5.000 and above) Supervisor Dept Director Page 14 of]6 1608 EXHIBIT "8" COLLIER COUNTY HOUSING AND HUMAN SERVICES REQUEST FOR PAYMENT SECTION I: REQUEST FOR PAYMENT SPONSOR Name: Housing Opportunities Made for Evervone, fnc, SPONSOR Address: 4351 Gulf Shore Blvd # 19N, Naples, FL 34103 Unit #3: Project No: Payment Request # Dollar Amount Requested: $ SECTION 11: STATUS OF FUNDS 1. Total Loan Amount Unit #3 $ $50,000.00 2. Sum of Past Claims Paid on this Account $ 3, Total Loan Amount Less Sum of Past Claims Paid on this Account $ 4, Amount of Previous Unpaid Requests $ 5. Amount of To day's Request $ 6, Current Loan Balance (Initial Loan Amount Awarded Less Sum of<!!lRequests) $ 7, If applicable amount held as retainage to date by the County, ifnot retained by the sub-recipient. $ I certify that this request for payment has been drawn in accordance with the terms and conditions of the Agreement between the County and us as the SPONSOR. I also certify that the amount ofthe Request for Payment is not in excess of current needs. Signature Date Title (approval authority under $14,999) (approval required $15,000 and above) Supervisor Dept Director Page I 5 of 16 16D8 EXHIBIT "C" COLLIER COUNTY HOUSING AND HUMAN SERVICES SHIP MONTHLY PROGRESS REPORT Complete form for the past month and submit to Housing and Human Services staff by the lath day of the following month. Status Report for Month of: Submittal Date: SPONSOR Name: Project Number: I. Describe any action taken, relating to this project, during the past month, 2, What events/actions are scheduled for the next two months? 3, Describe any affirmative marketing you have implemented regarding this project. Please list and attached any recent media coverage of your organization relating to this project, 4, List any additional data relevant to the outcome measures listed in the Agreement, 5, Identify any potential issues that may cause delay, Page 16 of 16