Item D21
~~
Louis LaTorre, Senior Director
Social Services/tabt
BOARD OF COUNTY COMMISSIONERS
AGENDA ITEM SUMMARY
MEETING DATE: 6/19-20/02
DIVISION: COMMUNITY SERVICES
BULK ITEM:
YES X
NO
DEP ARTMENT: SOCIAL SERVICES
AGENDA ITEM WORDING: Approval for Monroe County Board of County Commissioners Mayor Charles
McCoy, to sign the IV.B.MATCH COMMITMENT OF CASH DONATION FORMS, which are part of the Bid
Proposal for The Alzheimer's Disease Initiative and The Home Care For The Elderly Contracts, for Fiscal Year
July 1,2002 through June 30, 2003.
ITEM BACKGROUND: The approval for the Mayor to sign the attached documents will enable the County
to be in compliance with the Alliance For Aging Bid Proposal requirements.
PREVIOUS RELEVANT BOCC ACTION: None
CONTRACT/AGREEMENT CHANGES: NI A
STAlf.lf .l<.ECUMMENUATIUN: Approval
TOTAL COST: $71,118.75 (Alzheimer's Disease Initiative)
COST TO COUNTY: $9,303.00
TOTAL COST: $3,923.52 (Home Care For The Elderly)
COST TO COUNTY: $300,00
BUDGETED: YES-X- NO
REVENUE PRODUCING: YES X-ADI NO X-HCE AMT.PER MONTH
YEAR
APPROVED BY: COUNTY A TTYl OMB/Purchasing l RISK MANAGEMENT -X
DOCUMENT A TION:
INCLUDED X
DIVISION DIRECTOR APPROVAL:
TO FOLLOW
NOT REQUIRED
DISPOSITION:
AGENDA ITEM#: t" :U~.7 /
Revised 2/27/01
IV.B. MATCH COMMITMENT OF CASH DONATION
Agency Name:
Monroe County Board of County Commissioners/Monroe County In
Home Services Program
Donor Identification:
Name: f. .
Monroe County Board 0 County Comm~ss~oners
Street: GATO Bui lding - 1100 Simonton S tree t
City: Key West
S.tate: FL
ZIp:
33040
Phone: 305-292-4572
Authorized Representative: Charles McCoy
Mayor
Monroe County Board of County Commissione s
Total Amount
$ 9,303.00
ALZHEIMER"S DISEASE INITIATIVE
# Payments
1 ?
Amount/Payment
$ D_') 9::ated
Contribution Period
7/1/02 thru 6/30/03
Special Conditions:
Donor Certification:
I hereby certify intent to make the cash donation set forth above for use in the specified
program during the program's upcoming funding period. This cash is not included as
match for any other State or Federally assisted program,..g.r ~qntract and is not borne by
the federal government directly under any federal gr~ or c9'ntract.
Signature of Donor or Representative:
Date:
MAYOR CHARLES MCCOY
January 2002
IV,S. MATCH COMMITMENT OF CASH DONATION
Agency Name:
Monroe County Board of County Commiss'ioners/Monroe Countv In
Home Services Program
Donor Identification:
Name: Monroe County Board of County Commissioners
Street: GATO Building - 1100 Simonton Street
City: Key West
S.tate: FL
Zip:
33040
Phone: 305-292-4572
Authorized Representative: Charles McCoy
Mayor
Monroe County Board of County Commissione s
Total Amount
$ 100 00
HOME CARE FOR THE ELDERLY
# Payments
1 ?
Amount/Payment
$ 0,...,...., ~::d-ed
Contribution Period
7/1/02 thru 6/30/03
Special Conditions:
Donor Certification:
I hereby certify intent to make the cash donation set forth above for use in the specified
program during the program's upcoming funding period. This cash is not included as
match for any other State or Federally assisted program..,.Qt ~qntract and is not borne by
the federal government directly under any federal gr~ or cg'ntract.
Signature of Donor or Representative:
Date:
MAYOR CHARLES MCCOY
January 2002
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