211 Palm Beach/Treasure Coast Agreement Fax Cover Sheet
211 Palm Beach/Treasure Coast
PO Box 3588
Lantana,FL 33465
To:Judi Hechtman
Phone:(561)383-2162
Email:judi.hechtman@211pbtc.org
Fax:(561)383-2172
Date: // g Pages:
From: /',I,
Agency Name: / ck eecJw e G
Contact Name: ?)P—i OA /?"e it tL
Phone Number: 263— -76' 3- 337
I have reviewed the details of our agency/site(s)/service(s),and:
The information is correct
We are enclosing corrections
AGENCY
City of Okeechobee Agency#: CICS0296
55 S.E.Third Avenue Last Formal Update: 11/2/2011
Okeechobee, FL 34974 Record Owned By: CICS
Date Entered: 10/17/1995
Mailing Address: Affliliate Agreement Date: 11/2/2011
55 SE THIRD AVE
Okeechobee, FL 34974
Phone Number EXT Dept/Contact Agency Fax
(863)763-3372 (863)763-1686
Agency County: OKEECHOBEE Year Incorporated:
Also Known As: IRS Status:
Agency Type: Municipal Government Agency FEIN:
Person In Charge: Brian Whitehall License/Accred.:
In Charge Title: City Administrator Annual Budget: $0.00
Email: bwhitehall@cityofokeechobee.com Source of Funds:
Website: http://cityofokeechobee.com
Hours of Operation: Monday-Friday/8 am-4:30 pm
Notes/Description: Municipal government.
Site(Location)
Site Name: City of Okeechobee Site ID: CICS0296AA
55 S .Third Avenue Last Formal Update: 11/2/2011
Okeechobee, FL 34974
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211 Palm Beach Treasure Coast Information from 211 Community Resource Database
Site Mailing Address:
55 SE THIRD AVE
Okeechobee, FL 34974
Phone Number EXT Dept/Contact Site Fax
(863)763-3372 (863)763-1686
Also Known As:
Person In Charge: Brian Whitehall
In Charge Title: City Administrator Site Accessibility:
Site Email: bwhitehall@cityofokeechobee.com Site Bus Access:
Site Website: http://cityofokeechobee.com
Site Hours: Monday-Friday/Oam4:JUpm
Notes/Description: Municipal government.
Site Service ID: o|CS002346
Program Name:
Taxonomy Code Site Service
TD-6000.4500 Local Officials Offices
Target Terms:
In Charge: Title:
Service Phone: Ext: Phone 2: Fax:
Site Service Email: bwhdoho||@citydbxeochobee.conn
Site Service Website: http://cityofokeechobee.com
Site Service Fees: Contact agency.
Site Service Hours: Monday-Friday/8 am-4:30 pm
Service Area: City of Okeechobee
Service Intake Process: Contact by phone or walk in
Service Eligibility: No restrictions.
Documents Required:
Language(s): English.
Notes/Description: Municipal government.
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211 Palm Beach Treasure Coast Information from 211 Community Resource Database
Site(Location)
Site Name: Police Department(Okeechobee) Site ID: CICS0296AB
50 SE 2nd Avenue Last Formal Update: 11/2/2011
Okeechobee, FL 34974
Site Mailing Address:
50 SE 2ND AVE
Okeechobee, FL 34974
Phone Number EXT Dept/Contact Site Fax
(863)763-5521 Non-emergency calls (863)763-7804
Also Known As:
Person In Charge: Dennis Davis
In Charge Title: Police Chief Site Accessibility:
Site Email: ddavis@cityofokeechobee.com Site Bus Access:
Site Website: htto://cityofokeechobee.com/New%20Police%20Dept2.htm
Site Hours: Every day/24 hours
Notes/Description: Local law enforcement agency.
Site Service ID: CICS002348
Program Name:
Taxonomy Code Site Service
FL-6500 Municipal Police
Target Terms:
In Charge: Title:
Service Phone: Ext: Phone 2: Fax:
Site Service Email: ddavis@cityofokeechobee.com
Site Service Website: http://cityofokeechobee.com/New%20Police%20Dept2.htm
Site Service Fees: No fees charged.
Site Service Hours: Every day/24 hours
Service Area: City of Okeechobee
Service Intake Process: Contact by phone or walk in.
Service Eligibility: No restrictions.
Documents Required:
Language(s): English.
Notes/Description: Local law enforcement agency.
9/18/2012 Page 3 of 4
211 Palm Beach Treasure Coast Information from 211 Community Resource Database
Palm B.Rachirmawre
41124111
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AFFILIATE AGREEMENT
To ensure continuity of care and support to clients, 211 Palm Beach/Treasure Coast enters into the
following agreement with:
City of Okeechobee CICS0296
(Print or type your agency name here.)
211 Palm Beach/Treasure Coast agrees:
1. To refer callers, who meet the eligibility requirement(s) of the Affiliate, to the Affiliate without
regard to race, color, creed, disability, national origin, age, sex, sexual orientation or economic
status for assessment/on-going services.
2. To be available as a resource to the Affiliate's clients 24 hours a day for telephone counseling and
information and referral to community resources.
3_ To be available to the affiliate's staff for information about and referrals to community resources.
The Affiliate agrees:
1. To receive clients, who meet the eligibility requirement(s), without regard to race, color, creed,
disability, national origin, age, sex, sexual orientation or economic status who are referred by 211
Palm Beach/Treasure Coast,
2. To advise clients of the 24-hour availability of 211 Palm Beach/Treasure Coast services.
3. To advise staff of the availability of 211 Palm Beach/Treasure Coast as a resource.
4_ To inform 211 Palm Beach/Treasure Coast when changes arise within the Affiliate.
5. That information provided is true and accurate to the best of their knowledge and that this
information may be induded in published materials and in local or statewide databases.
6. To provide 211 Palm Beach/Treasure Coast a yearly formal update when requested beginning at
the start of each calendar year for accuracy, deletion and new content. Agencies can update
formally during the year using the online update process proactively on the website.
This letter of agreement will remain in force until terminated by either party contingent upon thirty (30)
days written notice.
211 PALM BEACH/TREASURE COAST: AFFILIATE:
)
Susan K. Buza,Executive Director iiTEHALL , CIT ADMINISTRATOR
January 3, 2012 Septem , er 18 , 2012
Date Signed Date Signed
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211 Palm Beach Treasure Coast Information from 211 Community Resource Database