CN-770000-22005.pdf

(Revised – 5/2019)

Florida Fish & Wildlife Conservation Commission Contract/Agreement Routing Review Form

1. TYPE: New Amendment #_____________ Task Assignment #______________ Renewal/Extension Modification Expenditure Contract Expenditure Grant MOA/MOU Revenue Generating

2. Contract Number: 3. Contract Manager’s Name/Telephone Number:

4. Project Manager: Date: Telephone #: Division/Office:

5. Financial Non-Financial Method of Procurement: Solicitation #:

6. Project Title/Contract Description:_____________________________________________________________________________

7. Original Contract Amount Increase Amount Decrease Amount Revised Contract Amount

8. Contract Begin Date: Original End Date: New End Date:

9. Vendor Name: Telephone#:

10.Vendor’s Contact Name:

11. Vendor/Tax ID# Seq.#

12. Cost/Price Analysis Required? Yes No 13. Risk Assessment Required? Yes No

14. Administrative Review/Signature Reviewed

If Reviewed Electronically, check box to indicate “Reviewed” and include the continuous email of approvals.

If Reviewed in Hard Copy, please initial under “Reviewed”, Print Name, Date and indicate if edits are required.

Contract Manager Name: Date:

FBO Contract Admin.:

Date: Edits: Yes No If not applicable, indicate with “N/A” Budget Reviewer Name:

Date: Edits: Yes No Delegate based on current Fiscal Year Delegation of Authority Div/Off Director or Delegate:

Date: Edits: Yes No If not applicable, indicate with “N/A” Chief Information Officer:

Date: Edits: Yes No Applicable when one or more of the following applies (Over $325k, a five-year or longer contract term, Requires OED Execution), if none apply indicate with “N/A”

General Services Section Leader:

Date: Edits: Yes No

15. Contract Execution (MUST be Hard Copy Review/Signatures)

If not executed for any reason, please notify FBO Contract Administration and the Contract Manager

Date: Legal Signature:

Print Name:

Return to the Contract Manager for Vendor Signature Date Sent to Vendor: Date Received Back from Vendor:

By signature, the Contract Manager Confirms no changes were made after Legal review during initial routing and review.

Contract Manager Signature: Date:

Print Name:

If changes were made after Legal review, attach a documented list of changes and route back to Legal prior to proceeding with any further approvals or execution.

Legal Signature: Date:

Print Name:

Date:

If not applicable (under $500k or less than 5 years or does not require OED Execution), indicate with “N/A”

**Chief Operating Officer Signature:

Print Name:

Executive Director or Designee Signature:

Print Name:

EXECUTION DATE:

(Date Signed by Ex. Dir. or Designee)

Date Entered into FACTS: FBO Contract Admin. Signature:

Date Received: Print Name:

**Contract Attestation, if anticipated expenditures of $500,000 or more: I confirm that this contract or purchase order contains or complies with the requirements of FBO Memorandum 2016-01.

FCCM #:

22005 Carolyn Kalinowski/850-617-9619 Carolyn Kalinowski 06/30/2022 850-617-9619

Okaloosa County Artificial Reef Construction 2022/23 Deploy at least 44 pre-fabricated concrete modules as 4 patch reefs within the LAARS Site A permitted area

60,000.00

25-Request for Application, method of competitively awarding State Federal grants to non-profits and other governmental entities.

9/30/2023 Okaloosa County Board of County Commissioners 850-609-5394

Alex Fogg 59-6000765 015

✔ 12/5/2022 N/A

12/6/2022

12/7/2022

N/A

12/12/2022

N/A

MFM

12/28/2022

James M. Collins III

12/1/2022 1/9/2023

1/9/2023

Carolyn Kalinowski

N/A

N/A

N/A

N/A

Dan Ellinor 1/13/2023

FWC CONTRACT/GRANT REVIEW FORM INSTRUCTIONS

(INCLUDES MOA/MOU’s, INTER-AGENCY AGREEMENTS AND ANY OTHER TYPE OF CONTRACTUAL AGREEMENT)

1. Type: Check the box next to the appropriate type of agreement to indicate what is to be reviewed/executed. If the type is an Amendment or Task Assignment, also indicate the number (i.e. Amendment # 1 indicates this is the first amendment to this contract.)

2. Contract Number: For all new agreements, the Purchasing/Contract Administration Unit will assign FWC contract numbers. For all modifications/ amendments/renewals to an agreement, the Contract Manager must enter the contract number on the Contract/Grant Routing Review Form.

3. Contract Manager’s Name & Telephone #: Enter the name and telephone number of the employee who is a Certified Contract Manager and is responsible for managing the contract. Select the appropriate acronym to indicate which Division/Office will manage the agreement or will fund the agreement.

4. Project Manager: Enter the name of the person who assisted in the preparation of the agreement and assists in ensuring the execution of the contract. This should be the person any reviewer can contact for questions regarding the project.

5. Financial/Non-Financial: Check the appropriate box to indicate if the agreement is financial (involves payments) or non-financial (no payments involved). Select the appropriate Method of Procurement to be used. This identifies the type of procurement from which the contract is derived.

6. Project Title/Contract Description: Provide a brief description of the commodities/services to be delivered or rendered.

7. Enter the Original Contract Amount total. If an amendment, enter the amount of the Increase/Decrease and the Revised Contract Amount.

8. For new, unexecuted agreements, enter the anticipated begin date and end date of contract/grant. For existing or executed agreements, enter the actual begin date (the execution date of the original contract/grant, or the date the last person signed the original contract/grant, whichever is later.) For renewals, enter the original end date as the date the agreement is expected to terminate. If the agreement is to be extended or has been extended, enter that date as the revised end date. The end date will change with each renewal.

9. Vendor Name/Telephone #: Enter the name and telephone number of the entity or person with whom we are contracting to provide commodities/services.

10. Vendor’s Contact Name: Enter the name of the contractor's primary contact person during the contract term.

11. Vendor/Tax ID#: Enter the Vendor Number or the Tax ID Number of the “Contractor” of this contract/grant.

12. “Cost/Price Analysis Required?”: If a Cost Analysis is required as per s.216.3475, check "Yes" and attach the analysis with this Contract/

Grant Routing Review Form. If it is not required, check "No".

13. “Risk Assessment Required?” Check "Yes" if a Financial Assistance Recipient Risk Assessment form has been completed. (Example: Sub-

Recipients, flow through contracts or grants) Check "No" if not applicable. If you have any questions concerning whether Federal funding and/or State match was used, please contact your appropriate Budget Approver.

14. Administrative Review: This review is conducted prior to routing for Contract Execution in the order presented on the form and can be performed in either Electronic (via email and track changes) or Hard Copy format.

• Electronic Review - In order to maintain a comprehensive and transparent account of review/approve/disapprove, the electronic transmissions MUST be in a continuous string of emails. (i.e. Continuous forwarding from the original email sent by the Contract Manager for initial review/approval.)

o Approved: Each reviewer will click in the box under “Reviewed”, type Reviewer name and date reviewed, click in the box next to “No” indicating no edits, and forward to the next applicable reviewer. Once all applicable reviewers designated in this section have reviewed, the final reviewer will forward the continuous email string with all documents attached to the Contract Manager.

The Contract Manager will then prepare Hard Copy of documents to be submitted to Legal to begin the Contract Execution process.

o Edits indicated: Any reviewer indicating edits that are not substantial to prevent routing to the next reviewer will utilize track changes/comments in the document(s) and forward the continuous email string to the Contract Manager to implement edits.

o Disapproved: If there are significant edits within the document(s) that need to be addressed prior to moving on to the next reviewer, that reviewer will forward the continuous email string with attached document(s) to the Contract Manager before the document(s) continue to the next reviewer.

• Hard Copy Review o Approved: Each reviewer will initial under “Reviewed” to indicate approval, print name and date reviewed, check

“No” indicating no edits, and route to the next applicable reviewer.

o Edits indicated: Any reviewer indicating edits that are not substantial to prevent routing to the next reviewer, will initial under

“Reviewed”, print name and date reviewed, check “Yes” indicating edits, and route to the next applicable reviewer.

o Disapproved: If there are significant edits within the document(s) that need to be addressed prior to moving on to the next reviewer, that reviewer will print their name, date reviewed and check “Yes” indicating edits. The reviewer will return all documentation to the Contract Manager for editing before continuing to the next reviewer.

15. Contract Execution: Contract Execution MUST be conducted in Hard Copy with original signatures and in the order presented on the form.

• The Legal Office review is required regardless of dollar amount. Once reviewed, Legal will return the document(s) to the Contract

Manager to obtain Vendor Signature.

• Contract Manager will indicate Date Sent to Vendor and Date Received Back from Vendor

• If no changes were made by the vendor, the Contract Manager will sign the attestation indicating as such. If changes were made by the vendor, the Contract Manager will provide a documented list of changes and obtain Legal review prior to the completion of this form and execution of the contract.

• Chief Operating Officer review is required if the Contract Amount is $500,000 or more.

• Executive Director or Designee review is required regardless of the amount. Designee is based on the agency's approved Delegation of

Authority. Execution Date is the date signed by the Executive Director or Designee. Once signed and dated, the Executed Contract will be sent in its entirety to the FWC Purchasing Contract Administration Unit (Mail Station 4A2.)

• FBO Contract Administration: The employee within the Finance and Budget Office, Purchasing, Contract Administration Unit who receives the Executed Contract, will sign and indicate the Date Received.

• Date Entered in FACTS: Once the Executed Contract has been entered into FACTS, the employee within the Finance and Budget Office, Purchasing, Contract Administration Unit will indicate the date entered.

• Should you have any questions completing the Contract /Grant Routing Review Form, please contact the Purchasing/Contract Administration Office at (850) 488-6551.

(Revised – 5/2019)

FLORIDA FISH AND WILDLIFE CONSERVATION COMMISSION

DIVISION OF MARINE FISHERIES

MEMORANDUM

TO: FWC Contract Reviewers

FROM: Carolyn Kalinowski, Fisheries Biologist IV

Division of Marine Fisheries Management

DATE: January 24, 2023

SUBJECT: Grant Agreement for Artificial Reef Program entitled

'Okaloosa County Artificial Reef Construction 2022-23'

The recipient of this grant agreement is the Okaloosa County Board of County Commissioners. The purpose of this project is to construct one marine artificial reef complex by deploying at least 44 prefabricated modules within the LAARS Site A permitted area at 15 nautical miles southeast of Destin Pass in Federal waters off Okaloosa County in the Gulf of Mexico at a depth range of 110-114 feet.

This is an expenditure grant agreement in the amount of $60,000.00, to be paid as a single final reimbursement, using a combination of federal funds from a grant from the U.S. Fish and Wildlife Service, Federal Aid in Sport Fish Restoration Program, CFDA No. 15.605 and state funds from the Marine Resource Conservation Trust Fund, CSFA No. 77-007. Additionally, the grantee will provide $60,000.00 local match. There are no unusual or contentious aspects to this grant agreement.

Project EOs:

5R (FGTF) - $32,000

7M (MRCTF) - $28,000

If you have any questions, please call me at 850-617-9619 or electronically at carolyn.kalinowski@myfwc.com. Your assistance is appreciated.

CRK

Enclosures:

• Contract Routing Review Form

• FACTS Form

• Contract Manager’s Checklist

• Cost Analysis (Excess CAT II)

• Recipient Risk Assessment

• FWC Conflict of Interest Form

• FSAA State Project Determination Checklist (form DFS-A2-PD)

• FSAA Checklist for Non-state organization (form DFS-A2-NS)

• Grant Agreement, with attachments (one original copy enclosed) mailto:carolyn.kalinowski@myfwc.com