Backup Documents 01/12/2021 Item #16D 1 ORIGINAL DOCUMENTS CHECKLIST & ROUTING SLIP 1 6 D
TO ACCOMPANY ALL ORIGINAL DOCUMENTS SENT TO
THE BOARD OF COUNTY COMMISSIONERS OFFICE FOR SIGNATURE
Print on pink paper. Attach to original document. "Fite 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 routinglines#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. Judith Sizensky Community and Human 01/05/21
Services
2. County Attorney Office County Attorney Office2fiq / y/-7(
3. BCC Office Board of County FIT b
Commissioners J}\ '
4. Minutes and Records Clerk of Court's Office mac kap( ' Sas
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 Judith Sizensky/CHS Phone Number 252-2590
Contact/Department
Agenda Date Item was 1.12.2021 Agenda Item Number 16.D. l
Approved by the BCC
Type of Document Designation of Signature Authority-James Number of Original
Attached C. French Documents Attached
PO number or account Document to be sent via email and FedEx to
number if document is FDOT(will provide account#)
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? JS
2. Does the document need to be sent to another agency for additional signatures? If yes, N/A
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 JS
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 JS
document or the fmal negotiated contract date whichever is applicable.
6. "Sign here"tabs are placed on the appropriate pages indicating where the Chairman's JS
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 your deadlines!
8. The document was approved by the BCC on 01/12/2021 and all changes made during JS
the meeting have been incorporated in the attached document. The County an n o:i
Attorney's Office has reviewed the changes,if applicable. I i
9. Initials of attorney verifying that the attached document is the version approved by the
BCC,all changes directed by the BCC have been made,and the document is ready for the • •
Chairman's signature.
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
1 6D1
MEMORANDUM
Date: January 20, 2021
To: Joshua Thomas, Grants Support Specialist
Grants Management Office
From: Teresa Cannon, Sr. Deputy Clerk
Minutes & Records Department
Re: Designation of Signature Authority—James C. French
Attached, for your records, please find a scanned copy of the document
as referenced above, (Item #16D1) approved by the Board of County
Commissioners on January 12, 2021.
An original has been kept by the Board's Minutes and Records
Department, as part of the Board's Official Records.
If you have any questions, please contact me at 252-8411.
Thank you.
Attachment
1bD1
MEMORANDUM
Date: January 20, 2021
To: Judith Sizensky, Operations Coordinator
GMD Road Maintenance
From: Teresa Cannon, Sr. Deputy Clerk
Minutes and Records Department
Re: Designation of Signature Authority — James C. French
Attached you will find a copy of the document as referenced above (Item #16D1),
approved by the Collier County Board of County Commissioners on Tuesday, January
12, 2021.
The original will be held in the Board's Minutes and Records Department to be kept
as part of the Board's Official Records.
If you have any questions, please contact me at 252-8411.
Thank you.
Attachment
1601
Cotter County
Public Services Department
DESIGNATION OF SIGNATURE AUTHORITY
RE: DESIGNATION OF SIGNATURE AUTHORITY FOR FTA ASSISTANCE AWARDS
The Collier County Board of County Commissioners hereby designates
(James C. French, Public Services Department Head) as authorized to access the
Federal Transit Administration's (FTA) Electronic Application/Award
Management System, also referred to as the Transit Award Management System
(TrAMS), and use a Personal Identification Numbers (PIN) to execute the
annual Certifications and Assurances issued by the Federal Transit Administration
(FTA), to transmit and submit all applications to FTA for Federal assistance (or
amendments thereafter), and to execute all awards of FTA assistance on behalf of
the officials named below, thus binding the Applicant/Recipient's compliance
with FTA's requirements.
ATTEST: BOA' G OA,I UNTY COM SSIONERS
Crystal K. Kinzel, Clerk of Courts COLLI: '•LINTY, FLO
By: 011448
PrintName:' .Nr q C4
-Q v r ar.%liL Chairman
Dated: lI 490 larOat
tO Chairman's
sidnafiste on
Appr•ve+ as to Form d L gality:
Scott R. Teach
Deputy County Attorney
rikt
Public Services Department•3339 Tamiami Trail East,Suite 217•Naples,Florida 34112 •239-252-8468 •FAX 239-252-3958
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