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Res No 269-13-14087RESOLUTION NO. 269 -1 3 -14087 A Resolution authorizing the City Manager to execute a fiscal year 2014 grant agreement with Miami -Dade County for the After School House (Tutoring) grant. WHEREAS, the Mayor and City Commission desire to accept the grant from Miami - Dade County by and through its Office of Grants Coordination; and WHEREAS, the Agreement will provide funding for the After School House (Tutoring) program; and WHEREAS, the City Manager is authorized to execute the grant agreement in an amount of $26,775; and WHEREAS, the grant period begins on October 1, 2013 and ends on September 30, 2014. NOW, THEREFORE, BE IT RESOLVED BY THE MAYOR AND CITY COMMISSION OF THE CITY OF SOUTH MIAMI, FLORIDA THAT: Section 1: The City Manager is hereby authorized to execute the grant agreement with Miami -Dade County, Office of Grants Coordination for the After School House Program in the amount of $26,775. The grant agreement is attached to this resolution. Section 2: This resolution shall be effective immediately after the adoption hereof. PASSED AND ADOPTED this 1 7thday of Decembe22013 ATTEST: , I 6a: (�,' 11_� — � Y CLERK Alk2g READ AND LANGU F� ION 0 OVED AS TO FORM ALITY ANDS "R RIJ 6. COMMISSION VOTE: 5 -0 Mayor Stoddard: Yea Vice Mayor Liebman: Yea Commissioner Harris: Yea Commissioner Newman: Yea Commissioner Welsh: Yea CITY OF SOUTH MIAMI OFFICE OF THE CITY MANAGER INTER - OFFICE MEMORANDUM TO: The Honorable Mayor & Members of the City Commission FROM: Steven Alexander, City Manager DATE: December 17, 2013 Agenda Item No.: South Miami AII•Amedea City Ii r 2001 SUBJECT: A Resolution authorizing the City Manager to execute a fiscal year 2014 grant agreement with Miami -Dade County, Office of Management and Budget, Grants Coordination for the After School House (Tutoring) grant in the amount of $26,775. BACKGROUND: Miami -Dade County by and through its Office of Grants Coordination awarded the City of South Miami $26,775 to fund the After School House (Tutoring) Program. The grant period begins on October 1, 2013 and ends on September 30, 2014. The City of South Miami will be allocating the funds to help support the City's After School Program by paying for three (3) part -time instructors' salary at $8,925 each, for a total of $26,775. GRANTOR: Miami -Dade County Office of Management and Budget Grants Coordination (Formerly Known As Department of Human Services) — Local Granting Agency GRANT AMOUNT: $26,775 GRANT PERIOD: October I, 2013 through September 30, 2014 ATTACHMENTS: Miami -Dade County FY 2014 Contract for the After School House (Tutoring) Program (14- SMIA -CB) CB 14- SMIA -CB FY 2013 -14 County General Funds Ordinances # 13 -88 AND 13 -90 AGREEMENT 5"�_7 ( LI This Agreement made and entered into as of this day of, , by and between Miami -Dade County, a political subdivision of the State of Florida (hereinafter referred to as "County "), having its principal office at 111 N.W. 1St Street, 19th Floor, Miami, Florida 33128 and City of South Miami, a municipality existing within Miami -Dade under the laws of the State of Florida, having its principal office at 6130 Sunset Drive, South Miami, Florida 33143 (hereinafter referred to as "Provider"), states conditions and covenants for the rendering of human and social services. (hereinafter referred to as "Services ") for the County. WHEREAS, the Provider provides or will develop services of value to the County and has demonstrated an ability or desire to provide these services; and WHEREAS, the County is desirous of assisting the Provider in providing those services and the Provider is desirous of providing such services; and F WHEREAS, the County has appropriated grant funds for the proposed services; NOW, THEREFORE, in consideration of the mutual covenants and agreements herein contained, the parties hereto agree as follows: ARTICLE 1. DEFINITIONS The following words and expressions used in this Agreement shall be construed as follows, except when it is clear from the context that another meaning is intended: a) The words "Agreement" "Contract" or "Contract Documents" shall mean collectively these terms and conditions, the Scope of Services (Attachment A) and the Budget Documents (Attachment B) and all other attachments hereto, as well as all amendments or budget revisions issued hereto. b) The words "Contract Manager" shall mean Miami -Dade County's Director of the Office of Management and Budget ( "OMB -GC ") or the Director's designee, or the duly authorized representative designated to manage the Contract. C) The word "Days" shall mean Calendar Days, unless otherwise specifically noted. d) The word "Deliverables" shall mean all documentation and any items of any nature submitted by the Provider to the County's Contract Manager for review and approval pursuant to the terms of this Agreement. e) The words "directed ", "required ", "permitted ", "ordered ", "designated ", "selected ", "prescribed" or words of like import to mean respectively, the direction, requirement, permission, order, designation, selection or prescription of the County's Contract Manager; and similarly the words "approved ", acceptable ", "satisfactory ", "equal ", "necessary ", or words of like import to mean respectively, approved by, or acceptable or satisfactory to, equal or necessary in the sole discretion of the County's Contract Page 1 of 26 ME Manager. 14- SMIA -CB f) The words "Effective Term" shall mean the date on which this Agreement is effective, including start date and end date. g) The words "Extra Work" or "Change Order" or "Additional Work" shall mean resulting in additions or deletions or modifications to the amount, type or value of the Work and Services as required in this Agreement, as directed and /or approved by the County. h) "HIPAA" means Health Insurance Portability and Accountability Act of 1996. i) The words "Scope of Services" shall mean the document appended hereto as Attachment A, which details the work to be performed by the Provider. j) The word "subcontractor" or "subconsultant" shall mean any person, entity, firm or corporation, other than the employees of the Provider, who furnishes labor and /or materials, in connection with the Work, whether directly or indirectly, on behalf and /or under the direction of the Provider and whether or not in privity of Agreement with the Provider. k) The words "Work ", "Services ", "Program ", or "Project" shall mean all matters and things required to be done by the Provider in accordance with the provisions of this Agreement. 1) The word "review" shall mean inspection of original documentation and retention of copies of such documents associated with the administrative, fiscal, and programmatic functions of the program(s) supported by Miami -Dade County General Funds, m) The term "administrative budget" shall refer to costs that are not tied to the direct provision of services funded under this agreement. These costs may include: 1) the portion of payroll of Provider's salaried administrative personnel and compensation of Provider's subcontracted administrative personnel (i.e., executive directors, agency heads, management and business consultants, information technology (IT) consultants, clerical or other administrative personnel), payment for the administrative (non - program) portion of their duties; 2) overhead costs not related to the direct provision of services (i.e., administrative office space and related maintenance, utilities, and supplies, insurance, advertising, marketing and fundraising costs, staff training, accounting and tax preparation services, and audit fees). n) The term "arm's length transaction" shall refer to any transaction in which the buyers and sellers of a product act independently and have no relationship to each other to ensure that both parties in the transaction are acting in their own self - interest and are not subject to any pressure or duress from the other party. o) The term "related party transaction" shall refer to a business deal or arrangement between two parties who are joined by a special relationship (family member or relative, stockholder, related corporation) prior to the deal. p) The term "program income" shall refer to the income received by the Provider directly from the activities funded under this agreement, or generated as a result of the use of the County's General Fund award. Page 2 of 26 CB 14- SMIA -CB ARTICLE 2. AMOUNT PAYABLE Subject to available funds, the maximum amount payable for services rendered under this contract shall not exceed: Elderly Services - South Miami Senior Meals $ 18,400 The After School House Program (Tutoring) $ 26,775 Both parties agree that should, in the County's sole discretion, available County funding be reduced, the amount payable under this Contract may be proportionately reduced at the sole discretion and option of the County. All services undertaken by the Provider before the County's execution of this Contract shall be at the Provider's risk and expense. Both parties agree that this is a twelve month contract from October 1, 2013 through September 30, 2014. Both parties expressly acknowledge availability of funding under this contract is at the County's sole discretion. It is the ongoing responsibility of the Provider to maintain sufficient financial resources to meet the expenses incurred during the period between the provision of services and payment by the County. ARTICLE 3. SCOPE OF SERVICES The Provider shall render services in accordance with the Scope of Services incorporated herein and attached hereto as Attachment A. The Scope of Services must clearly indicate the time frames for the delivery of each of the proposed services. The Provider shall implement the Scope of Services as described in Attachment A in a manner deemed satisfactory to the County. Any modification or amendment to the Scope of Services shall not be effective until approved by the County and Provider in writing. The Provider will not use products or foods containing "pink slime," as defined in Resolution 478 -12 of the Board of Miami -Dade County Commissioners, in food that is provided or served pursuant to this agreement. For congregate and home - delivered meal programs, the Provider agrees to furnish proof that it is meeting all applicable local,. State, and Federal food safety and hygiene requirements. ARTICLE 4. BUDGET SUMMARY The Provider agrees that all expenditures or costs shall be made in accordance with the Budget, which is attached herein and incorporated hereto as Attachment B. Pursuant to Board of Miami -Dade County Commissioners Resolution 630.13, the Provider will also submit a detailed project budget, and sources and uses statement as Attachment B -1, which shall be Page 3 of 26 C 14- SMIA -CB sufficiently detailed to show (i) the total project cost, (ii) the amount of funds to be used for administrative and overhead costs, (iii) whether the County funds will be 'gap' funds meaning that they would be the last remaining funds needed to ensure funding for the total project cost, (iv) any profit to be made by the Provider, and (v) the amount of funds devoted toward the provision of the desired services or activities. The Provider will also submit an agency -wide budget as Attachment B -2. The agency -wide budget shall display all projected agency revenues by funding source(s), including but not limited to funds from this Miami -Dade County General Fund Agreement, any other Miami -Dade County General Fund revenues, the projected administrative costs across all funding sources, and the total agency revenue for FY 2013 -14. The Provider will continually disclose any changes in funding — County or non - County — through the submission of an updated Agency -Wide Budget to the OMB -GC within thirty (30) days after such changes occur. The Provider may request a budget revision to amend -the budget in Attachment B no more than twice during the term of this Agreement. A request for a budget revision must be submitted to OMB no later than thirty (30) days prior to the expiration of this Agreement. The Provider may shift funds between existing line items in Attachment B: 1) without a budget revision, if the change to the line item does not exceed fifteen percent (15 %); or 2) with a budget revision requested by the Provider's President, Vice President, Executive Director, or other designated representative as stated on the Authorized Signature Form attached hereto, and approved by the OMB, if the changes to a line item exceed fifteen percent (15 %). A budget revision is also required in order to add new line items. In no event shall the budget under this agreement include total administrative costs in excess of fifteen percent (15 %) of each program allocation under this agreement. In addition, pursuant to Board of Miami -Dade County Commissioners Resolution 700 -13, in no event shall County General Funds, whether under this contract or other county contracts, be used to fund more than twenty -five percent (25 %) of the Provider's total administrative budget. ARTICLE 5. EFFECTIVE TERM Both parties agree that the effective term of this Agreement shall commence on October 1, 2013 and terminate at the close of business on September 30, 2014, ARTICLE 6. INDEMNIFICATION BY PROVIDER A. If the Provider is a Government Entity. Government entity shall indemnify and hold harmless the County and its officers, employees, agents and instrumentalities from any and all liability, losses or damages, including attorneys' fees and costs of defense, which the County or its officers, employees, agents. or instrumentalities may incur as a result of claims, demands, suits, causes of actions or proceedings of any kind or nature arising out of, relating to or resulting from the performance of this Agreement by the government entity or its employees, agents, servants, partners, principals or subcontractors. Government entity shall pay all claims and losses in connection therewith and shall investigate and defend all claims, suits or actions of any kind or nature in the name of the County, where applicable, including appellate proceedings, and shall pay all costs, judgments, and attorney's fees which may issue thereon. Provided, however, this indemnification shall only be to the extent and within the limitations of Section 768.28, Fla. Stat., subject to the provisions of that Statute, as may be amended, whereby the government entity shall not be held liable to pay a personal injury or property damage claim or judgment by a party which exceeds the statutory cap for personal injury or Page 4 of 26 CB 14- SMIA -CB property damage claims, liabilities, losses or causes of action which may arise as a result of the negligence of the government entity. Provider expressly understands and agrees that any insurance protection required by this Agreement or otherwise provided by Provider or self - insurance shall in no way limit the responsibility to indemnify, keep and save harmless and defend the County or its officers, employees, agents and instrumentalities as herein provided. B. All Other Providers. Provider shall indemnify and hold harmless the County and its officers, employees, agents and instrumentalities from any and all liability, losses or damages, including attorneys' fees and costs of defense, which the County or its officers, employees, agents or instrumentalities may incur as a result of claims, demands, suits, causes of actions or proceedings of any kind or nature arising out of, relating to or resulting from the performance of this Agreement by the Provider or its employees, agents, servants, partners principals or subcontractors. Provider shall pay all claims and losses in connection therewith and shall investigate and defend all claims, suits or actions of any kind or nature in the name of the County, where applicable, including appellate proceedings, and shall pay all costs, judgments, and attorney's fees which may issue thereon. Provider expressly understands and agrees that any insurance protection required by this Agreement or otherwise provided by Provider shall in no way limit the responsibility to indemnify, keep and save harmless and defend the County or its officers, employees, agents and instrumentalities as herein provided. F C. Term of Indemnification. The provisions of Article 6 shall survive the expiration or termination of this Contract. ARTICLE 7. INSURANCE If the total dollar value of all County contracts with the Provider exceeds $25,000 then the following insurance coverage is required: A. Government Entity. If the Provider is the State of Florida or an agency or political subdivision of the State as defined by section 768.28, Florida Statutes, the Provider shall furnish the County, upon request, written verification of liability protection in accordance with section 768.28, Florida Statutes. Nothing herein shall be construed to extend any party's liability beyond that provided in section 768.28, Florida Statutes. The provider shall also furnish the County, upon request, written verification of Workers Compensation protection in accordance with Florida Statutes, Chapter 440. B. All Other Providers. 1. Minimum Insurance Requirements: Certificates of Insurance. The Provider shall submit to Miami -Dade County, c/o Office of Management and Budget (OMB), 111 N.W. 16t Street, 19th Floor, Miami, Florida 33128 -1994, original Certificate(s) of Insurance indicating that insurance coverage has been obtained which meets the requirements as outlined below: A. All insurance certificates must list the COUNTY as "Certificate Holder" in the following manner: Miami -Dade County 111 N.W. 1St Street, Suite 2340 Miami, Florida 33128 Page 5 of 26 CB 14- SMIA -CB B. Worker's Compensation Insurance for all employees of the SERVICE PROVIDER as required by Florida Statutes, Chapter 440, C. Commercial General Liability Insurance in an amount not less than $300,000 combined single limit per occurrence for bodily injury and property damage. Miami -Dade County must be shown as an additional insured with respect to this coverage. D. Automobile Liability Insurance covering all owned, non - owned, and hired vehicles used in connection with the Work provided under this Agreement, in an amount not less than $300,000'" combined single limit per occurrence for bodily injury and property damage. *NOTE: For SERVICE PROVIDERS supplying vans or mini -buses with seating capacities of fifteen (15) passengers or more, the limit of liability required for Auto Liability is $500,000. E. Professional Liability Insurance in the name of the SERVICE PROVIDER, when applicable, in an amount not less than $250,000. F. All insurance policies required above shall be issued by companies authorized to do business under the laws of the State of Florida, with the following qualifications: 1. The company must be rated no less than "B" as to management, and no less than "Class V" as to financial strength, according to the latest edition of Best's Insurance Guide published by A.M. Best Company, Oldwick, New Jersey, or its equivalent, subject to the approval of the COUNTY's Risk Management Division. OR 2. The company must hold a valid Florida Certificate of Authority as shown in the latest "List of All Insurance Companies Authorized or Approved to Do Business in Florida," issued by the State of Florida Department of Financial Services. G. Compliance with the foregoing requirements shall not relieve the SERVICE PROVIDER of its liability and obligations under this Section or under any other section of this Agreement. H. The COUNTY reserves the right to inspect the SERVICE PROVIDER'S original insurance policies at any time during the term of this Agreement. I. Applicability of this section of the Agreement affects SERVICE PROVIDERS whose combined total award for all services funded under this Agreement exceed a $25,000 threshold. If the SERVICE PROVIDER's original total combined award is less than $25,000, but the SERVICE PROVIDER receives additional funding during the contract period which makes the total combined award exceed $25,000, then the requirements in this section shall apply. Page 6 of 26 CB 14- SMIA -CB Failure to Provide Certificates of Insurance. The Contractor shall be responsible for assuring that the insurance certificates required in conjunction with this Section remain in force for the duration of the effective term of this Agreement (October 1, 2013 through September 30, 2014). If insurance certificates are scheduled to expire during the effective term, the Provider shall be responsible for submitting new or renewed insurance certificates to the County prior to expiration. In the event that expired certificates are not replaced with new or renewed certificates which cover the effective term, the County may suspend the Agreement until such time as the new or renewed certificates are received by the County in the manner prescribed herein; provided, however, that this suspended period does not exceed thirty (30) calendar days. Thereafter, the County may, at its sole discretion, terminate this Agreement. ARTICLE 8. PROOF OF LICENSURE AND BACKGROUND SCREENING A. Licensure. If the Provider is required by the State of Florida or Miami -Dade County or any law or regulation to be licensed or certified to provide the services or operate the facilities outlined in the Scope of Services (Attachment A), the Provider shall furnish to the County a copy of all required current licenses or certificates. Examples of services or operations requiring such licensure or certification include but are not limited'to childcare, day care, nursing homes, and boarding homes. If the Provider fails to furnish the County with the licenses or certificates required under this Section, the County shall not disburse any funds until it is provided with such licenses or certificates. Failure to provide the licenses or certificates within sixty (60) days of execution of this Agreement may result in termination of this Agreement at the County's discretion. B. Background Screening. The Provider agrees to comply with all applicable laws, regulations, ordinances, and resolutions regarding background screening of employees, subcontracted personnel, and volunteers. Provider's failure to comply with any applicable laws, regulations, ordinances, and resolutions regarding background screening of employees, subcontracted personnel, and volunteers is grounds for a material breach and termination of this contract at the sole discretion of the County. The Provider agrees to comply with all applicable laws (including but not limited to Chapters 39, 402, 409, 394, 408, 393, 397, 984, 985, and 435, Florida Statutes, as may be amended from time to time), regulations, ordinances, and resolutions regarding background screening for those who may work with. vulnerable persons, as defined by section 435.02, Florida Statutes, as may be amended from time to time. In the event criminal background screening is required by law, the State of Florida and/or the County, the Provider will permit only employees, subcontractors, and volunteers with a satisfactory national criminal background check through an appropriate screening agency (i.e., the Florida Department of Juvenile Justice, Florida Department of Law Enforcement, or Federal Bureau of Investigation) to work in direct contact with vulnerable persons. The Provider agrees to ensure that employees, subcontracted personnel, and volunteers who work with vulnerable persons satisfactorily complete and pass Level 2 background Page 7 of 26 CB 14- SMIA -CB screening before working with vulnerable persons. Provider shall furnish the County with proof that employees, subcontracted personnel, and volunteers who work with vulnerable persons, satisfactorily passed Level 2 background screening, pursuant to Chapter 435, Florida Statutes, as may be amended from time to time. The Provider agrees to update the background checks of its staff, subcontractors, and volunteers at least once every five (5) years. If the Provider fails to furnish to the County proof that an employee, subcontractor, or volunteer's Level 2 background screening was satisfactorily passed and completed prior to that employee, subcontractor, or volunteer working with a vulnerable person or vulnerable persons, the ('ni inty shall not rligH imp. arnr fi Ahar fi inrk and this ("nnfrnnt may ha si !hunt to tarminatinn at the sole discretion of the County. ARTICLE 9. CONFLICT OF INTEREST A. The Provider agrees to abide by and be governed by the Miami -Dade County Conflict of Interest and Code of Ethics Ordinance codified at Section 2 -11.1 et al. of the Code of Miami - Dade County, as amended, as well as with section 617.0832, Florida Statutes, regarding director conflict of interests, which are incorporated herein by reference as if fully set forth herein, in connection with the Provider's contract obligations hereunder. Additionally, the Provider agrees to: Prohibit members of the Provider's board of directors from voting on matters relating to this Agreement which may result in the board member directly or indirectly receiving funds paid by the Provider under this Agreement. 2. Prohibit members of the Provider's board of directors from voting on any matters in which they are related to the person or entity seeking a benefit as 1) an officer, director, partner, of counsel, consultant, employee, fiduciary, beneficiary, or 2) a stockholder, bondholder, debtor, or creditor. 3. Prohibit members of the Provider's board of directors from directly or indirectly receiving any funds paid by the County to the Provider under this Agreement. 4. Prohibit employees of the Provider from directly or indirectly receiving any funds paid by the County to the Provider under this Agreement, with the exception of the employee's salary and fringe benefits or portion of the employee's salary and fringe benefits included in Attachment B. a. "Indirectly" for purposes of this section includes payment of funds paid by the County to the Provider under this Agreement to an organization in which the employee or board member has a "controlling financial interest," referring to ownership, directly or indirectly, to ten (10) percent or more of the outstanding capital stock in any corporation or a direct or indirect interest of ten (10) percent or more in a firm, partnership, or other business entity or nonprofit organization. 5. Maintain a written conflict of interest policy that applies to hiring, providing services to clients, and procuring supplies or equipment. Page 8 of 26 1 4-SM IA -C B 6. Immediately disclose and justify in writing to the OMB -GC any business transactions between the Provider, on one side, and Board members or staff, on another side, as well as all related -party transactions with shareholders, partners, officers, directors, or employees of any entity that is doing business with the Provider. 7. If the County determines the Provider has breached this section, the County shall suspend payment until the matter has been resolved to the County's satisfaction. 8.The County may request an opinion from the Miami -Dade Commission on Ethics and Public Trust regarding questions arising under this section. B. No person, including but not limited to any officer, member of a board of directors, manager, or supervisor employed by the Provider, who is in the position of authority, and who exercises any function or responsibilities in connection with this Agreement, has at the time this Agreement is entered into, or shall have during the term of this Agreement, received any of the services funded under this agreement, or direct or instruct any employee under their supervision to provide such services as described in this Agreement. Notwithstanding the before mentioned provision, any officer, member of a board of directors, manager or supervisor employed by the Provider, who is eligible to receive any of the services described herein may utilize such services if he or she can demonstrate that he or she does not have direct supervisory responsibility over the Provider's employee(s) or service program and that such utilization is permissible pursuant to Section 2 -111 et al. of the Code of Miami -Dade County. C. All transactions associated with this agreement that do not meet the criteria of an Arm's Length Transaction must be immediately disclosed and justified in writing to the OMB -GC. The Provider is required to immediately disclose to the OMB -GC any related party transactions that occur throughout the duration of this agreement. ARTICLE 10. CIVIL RIGHTS The Provider agrees to abide by Chapter 11A of the Code of Miami -Dade County ( "County Code "), as amended, which prohibits discrimination in employment, housing and public accommodations on the basis of race, creed, religion, color, sex, familial status, marital status, sexual orientation, pregnancy, age, ancestry, national origin or handicap; Title VII of the Civil Rights Act of 1968, as amended, which prohibits discrimination in employment and public accommodation; the Age Discrimination Act of 1975, 42 U.S.C. §6101, as amended, which prohibits discrimination in employment because of age; the Rehabilitation Act of 1973, 29 U.S.C, §794, as amended, which prohibits discrimination on the basis of disability; the Americans with Disabilities Act, 42 U.S.C. §12101 et secl., which prohibits discrimination in employment and public accommodations because of disability; the Federal Transit Act, 49 U.S.C. §1612, as amended; and the Fair Housing Act, 42 U.S.C. §3601 et se g. It is expressly understood that the Provider must submit an affidavit attesting that it is not in violation of the Acts. If the Provider or any owner, subsidiary, or other firm affiliated with or related to the Provider is found by the responsible enforcement agency, the Courts or the County to be in violation of these acts, the County will conduct no further business with the Provider. Any contract entered into based upon a false affidavit shall be voidable by the County. If the Provider violates any of the Acts during the term of any contract the Provider has with the Page 9 of 26 C 14 -SM IA -C B County, such contract shall be voidable by the County, even if the Provider was not in violation at the time it submitted its affidavit. The Provider agrees that it is in compliance with the Domestic Violence Leave, codified as § 11A -60 et seg, of the Miami -Dade County Code, which requires an employer, who in the regular course of business has fifty (50) or more employees working in Miami -Dade County for each working day during each of twenty (20) or more calendar work weeks to provide domestic violence leave to its employees. Failure to comply with this local law may be grounds for voiding or terminating this Agreement or for commencement of debarment proceedings against Provider. ARTICLE 11. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT: Any person or entity that performs or assists Miami -Dade County with a function or activity involving the use or disclosure of "individually identifiable health information (IIHI)" and /or "Protected Health Information (PHI)" shall comply with the Health Insurance Portability and Accountability Act ( HIPAA) of 1996, the Miami -Dade County Privacy Standards Administrative Order and any other applicable laws regarding confidential information. HIPAA Mandates for privacy, security and electronic transfer standards include but are not limited to: 1. Use of information only for performing services required by the contract or as required by law; 2. Use of appropriate safeguards to prevent non- permitted disclosures; 3. Reporting to Miami -Dade County of any non - permitted use or disclosure; 4. Assurances that any agents and subcontractors agree to the same restrictions and conditions that apply to the Provider and reasonable assurances that IIHI /PHI will be held confidential; 5. Making Protected Health Information (PHI) available to the customer; 6. Making PHI available to the client for review and amendment; and incorporating any amendments requested by the client as may be required by law; 7. Making PHI available to Miami -Dade County for an accounting of disclosures; and 8. Making internal practices, books, and records related to PHI available to Miami -Dade County for compliance audits. PHI shall maintain its protected status regardless of the form and method of transmission (paper records and /or electronic transfer of data). The Provider must give its clients written notice of its privacy information practices, including specifically, a description of the types of uses and disclosures that would be made with protected health information. Provider must post, and distribute upon request to service recipients, a copy of the County's Notice of Privacy Practices. ARTICLE 12. NOTICE REQUIREMENTS The Provider agrees to notify the County of any changes that may affect the County supported program(s) under this Agreement within ten (10) days from the date of such a change's occurrence. It is also understood and agreed between the parties that any written notice addressed to the OMB -GC, which is delivered by U.S. Mail or emailed to the OMB -GC and any written notice addressed to the Provider, which is delivered by U.S. Mail or by email shall constitute sufficient notice to either party. Page 10 of 26 W 14- SMIA -CB All notices required or permitted under this Agreement which are delivered by U.S. Mail shall be deemed sufficiently served if delivered by Registered or Certified Mail, with return receipt requested; or delivered personally; or delivered via fax or by email. All notices to the County shall be delivered to the following address: (1) To the County, Miami -Dade County Office of Management and Budget — Grants Coordination 111 NW 1st Street, 19`" Floor, Miami, FL 33128 ATTENTION: Felipe M. Rivero, 111 Grants and Contracts Administrator Phone: (305) 375 -4765 Fax: (305)375 -4049 Email: rivero @miamidade.gov (2) To the Provider Phone: (305) 668 -2514 Fax: (305) 668 -7388 Email: JKorth;@- southmiamifl.gov Either party may at any time designate a different mail or email address and /or contact person by giving written notice as provided above to the other party. ARTICLE 13. AUTONOMY Both parties agree that this Agreement recognizes the autonomy of the contracting parties and implies no affiliation between the contracting parties. It is expressly understood and intended that the Provider is only a recipient of funding support and is not an agent or instrumentality of the County. Furthermore, the Provider's agents and employees are not agents or employees of the County. ARTICLE 14. SURVIVAL The parties acknowledge that any of the obligations in this agreement, including but not limited to Provider's obligation to indemnify the County, will survive the term, termination, and cancellation hereof. Accordingly, the respective obligations of the Provider under this agreement, which by nature would continue beyond the termination, cancellation or expiration thereof, shall survive termination, cancellation or expiration hereof. ARTICLE 15. BREACH OF AGREEMENT: COUNTY REMEDIES A. Breach. A breach by the Provider shall have occurred under this Agreement if: (1) the Provider fails to provide the services outlined in the Scope of Services (Attachment A) or Page 11 of 26 1 4 -SM IA -C B meet expected performance levels within the effective term of this Agreement; (2) the Provider ineffectively or improperly uses the County funds allocated under this Agreement; (3) the Provider does not furnish the Certificates of Insurance required by this Agreement or as determined by the County's Risk Management Division; (4) if applicable, the Provider does not furnish upon request by the County proof of licensurelcertification or proof of background screening required by this Agreement; (5) the Provider fails to submit, or submits incorrect or incomplete, proof of expenditures to support disbursement requests or advance funding disbursements or fails to submit or submits incomplete or incorrect detailed reports of expenditures or final expenditure reports; (6) the Provider does not submit or submits incomplete or incorrect required reports or reports that indicate that expected performance levels are not being met; (7) the Provider refuses to allow the County access to records or refuses to allow the C ot_inty to monitor, evaluate. and reviOW the PmN/irier'g nrnr mm- (M tha Provider discriminates under any of the laws outlined in Article 10 of this Agreement; (9) the Provider, attempts to meet its obligations under this Agreement through fraud, misrepresentation, or material misstatement; (10) the Provider fails to correct deficiencies found during a monitoring, evaluation, or review within the specified time as described and defined in a Corrective Action Plan (CAP); (11) the Provider fails to issue prompt payments to small business subcontractors or follow dispute resolution procedures regarding a disputed payment; (12) the Provider fails to submit the Certificate of Corporate Status, Board of Directors requirement, or proof of tax status; and (13) the Provider fails to fulfill in a timely and proper manner any and all of its obligations, covenants, agreements, and stipulations in this Agreement.; (14) the Provider fails to meet any of the terms and conditions of the Miami -Dade County Affidavits (Attachment D) or the State Affidavit (Attachment E); (15) the Provider falsifies or violates the provisions of the Drug Free Workplace Affidavit (Attachment D); or (16) the Provider fails to fulfill in a timely and proper manner any and all of its obligations, covenants, agreements, and stipulations in this Contract. Waiver of breach of any provisions of this Contract shall not be deemed to be a waiver of any other breach and shall not be construed to be a modification of the terms of this Agreement. B. County Remedies. If the Provider breaches this Agreement, the County may pursue any or all of the following remedies: 1. The County may terminate this Agreement by giving written notice to the Provider of such termination and specifying the effective date thereof. In the event of termination, the County may: (a) request the return of all finished or unfinished documents, data studies, surveys, drawings, maps, models, photographs, reports prepared and secured by the Provider with County funds under this Agreement; (b) seek reimbursement of County funds allocated to the Provider under this Agreement; (c) terminate or cancel any other contracts entered into between the. County and the Provider. The Provider shall be responsible for all direct and indirect costs associated with such termination, including attorney's fees. The County may also, in the County's sole discretion, recapture a proportionate amount of funding if expected performance levels under this Agreement are not met by Provider in the County's sole discretion; 2. The County may suspend payment in whole or in part under this Agreement by providing written notice to the Provider of such suspension and specifying the effective date thereof, at least five (5) days before the effective date of suspension. If payments are suspended, the County shall specify in writing the actions that must be taken by the Provider as condition precedent to resumption of payments and shall specify a reasonable date for compliance. The County may also suspend any payments in whole or in part under any other contracts entered into between the County and the Provider. The Provider shall be Page 12 of 26 CB 14- SMIA -CB responsible for all direct and indirect costs associated with such suspension, including attorney's fees. The County may also, in the County's sole discretion, recapture a proportionate amount of funding if expected performance levels under this Agreement are not met by Provider in the County's sole discretion; 3. The County may seek enforcement of this Agreement including but not limited to filing an action in a court of appropriate jurisdiction. The Provider shall be responsible for all direct and indirect costs associated with such enforcement, including attorney's fees; 4. The County may debar the Provider from future County contracting; 5. If, for any reason, the Provider should attempt to meet its obligations under this Agreement through fraud, misrepresentation, or, material misstatement, the County shall, whenever practicable terminate this Agreement by giving written notice to the provider of such termination and specifying the effective date thereof at least five (5) days before the effective date of such termination. The County may terminate or cancel any other contracts which such individual or entity has with the County. Such individual or entity shall be responsible for all direct and indirect costs associated with such termination or cancellation, including attorney's fees. Any individual or entity who attempts to meet its contractual obligations with the County through fraud, misrepresentation, or material misstatement may be debarred from county contracting for up to five (5) years; 6. Any other remedy available at law or equity. C. Authorization to Terminate Agreement. The Mayor or the Mayor's designee is authorized to terminate this Agreement on behalf of the County. D. Failures or waivers to insist on strict performance of any covenant, condition, or provision of this Contract by the County shall not be deemed a waiver of any rights or remedies, nor shall it relieve the Provider from performing any subsequent obligations strictly in accordance with the term of this Contract. No waiver shall be effective unless in writing and signed by the parties. Such waiver shall be limited to provisions of this Contract specifically referred to therein and shall not be deemed a waiver of any other provision. No waiver shall constitute a continuing waiver unless the writing states otherwise. E. Damages Sustained. Notwithstanding the above, the Provider shall not be relieved of liability to the County for damages sustained by the County by virtue of any breach of the Agreement, and the County may withhold any payments to the Provider until such time as the exact amount of damages due the County is determined. The County may also pursue any remedies available at law or equity to compensate for any damages sustained by the breach. The Provider shall be responsible for all direct and indirect costs associated with such action, including attorney's fees. ARTICLE 16. TERMINATION BY EITHER PARTY Both parties agree that this Agreement may be terminated by either party hereto by written notice to the other party of such intent to terminate at least thirty (30) days prior to the effective date of such termination. The Mayor or the Mayor's designee is authorized to terminate this Agreement on the behalf of the County. Page 13 of 26 C 14- SMIA -CB ARTICLE 17. PAYMENT PROCEDURES The County agrees to pay the Provider for services rendered under this Agreement based on the payment schedule, the line item budget, or both, which are incorporated herein and attached hereto as Attachment B for services provided under the attached Scope of Services. Payment shall be made in accordance with procedures outlined below and if applicable, the Sherman S. Winn Prompt Payment Ordinance (Ordinance 94 -40). A. Reimbursement and Advances. The parties agree that this is a cost -basis Agreement and that the Provider shall be paid through reimbursement payment based on the budget approved under this Contract (see Attachment B) and when complete and proper documentation of service delivery and incurred expenses are provided to the County: If the actual performance levels of the program(s) covered by this agreement are less than the expected performance levels, then the County may adjust payments, recapture the funded award, or seek repayment based on the level of performance. Upon proper and complete execution of this Contract (to include proof of insurance), the County may provide the Provider with twenty -five percent (25 %) of the Contract amount in advance. The Provider's request for this advance payment must be submitted in writing and must specify the reasons and justifications for such advance payment. It need not be accompanied by a detailed expenditure report. The County shall have the sole discretion in choosing whether or not to provide any advance payments and is not obligated to do so under any circumstances. Advance payments in excess of 25% of the contract amount may be approved by the Mayor or the OMB -GC Director as the Mayor's Designee for this purpose. B. Monies Owed to the County. The County reserves the right, in its sole discretion, to reduce payments to the Provider in order to recapture any monies owed to the County. In accordance with County Administrative Order No. 3 -29, the Provider that is in arrears to the County is prohibited from obtaining new County contracts or extensions of contracts until such time as the arrearage has been paid in full or the County has agreed in writing to an approved re- payment plan. C. No Payment of Subcontractors. In no event shall County funds be advanced or paid by the County directly to any subcontractor hereunder. Payment to approved subcontractors shall be made by the Provider following requirements and limitations as detailed in Article 21 of this Agreement. D. Requests for Payment. The County agrees to pay all budgeted costs incurred by the Provider that are allowable under the County guidelines. In order to receive payment for allowable costs, the Provider shall submit a Monthly Summary of Expenditures Report and a Monthly Performance Report on forms provided by the OMB -GC. The OMB -GC must receive the Monthly Summary of Expenditures Report and the Monthly Performance Report no later than the 21st day of the month following the month in which services were provided. The Monthly Summary of Expenditures Report shall reflect the expenses incurred by the Provider for the month in which services were rendered and documented in the Monthly Performance Report. Upon submission of satisfactory required monthly reports, the OMB -GC shall make payment. If the Provider is not meeting its expected expenditure rates, then a corrective action plan must accompany the Provider's Monthly Summary of Expenditures Report. The County will not approve payments for in -kind or volunteer services provided by the Provider on behalf of the project. The OMB -GC shall accept originals of invoices, receipts, and other evidence of indebtedness as proof of expenditures. When original documents cannot be Page 14 of 26 14- SMIA -CB produced, the Provider must adequately justify their absence in writing and furnish copies as proof of the expenditures. E. Processing the Request for Payment. After the OMB -GC staff reviews and approves the payment request, the OMB will submit a payment request to the County's Finance Department, The County's Finance Department will issue payment via Automated Clearing House (ACH) or mail the check directly to the Provider at the address listed in Article 12 of this Agreement, unless otherwise directed by the Provider in writing. The parties agree that the processing of a payment request from date of submission by the Provider shall take a maximum of forty -five (45) days from receipt of a complete and accurate payment request, pursuant to the County's Sherman S. Winn Prompt Payment Ordinance (Ordinance 94 -40), Section 2 -8.1.4 of the Code of Miami -Dade County; Administrative Order No. 3 -19, and the Florida Prompt Payment Act, if supporting documentationfinvoices are property documented as determined by the County in its sole discretion. It is the responsibility of the Provider to maintain sufficient financial resources to meet the expenses incurred during the period between the provision of services and payment by the County. Failure to submit monthly reimbursement requests with supporting documentation in a manner deemed correct and acceptable by the County, by the 21st day of each month following the month in which the service was delivered, shall be considered a breach of this Agreement and may result in termination of this Agreement. F. Final Request for Payment. A final request for payment from the Provider will be accepted by the OMB -GC up to thirty (30) days after the expiration of this Agreement. If the Provider fails to comply, all rights to payment shall be forfeited. The request for the final payment may include accruals of the personnel costs listed in Attachment B, which the Provider is obligated to pay after the close of the period for services provided within the term of the Agreement. G. Closeout Reporting Process /Recapture of Funds. Upon the expiration of this Contract, the Provider shall submit Closeout Report documents to the OMB no more than thirty (30) days after the expiration of this Contract. These documents shall include a cumulative contract year -end summary of the Provider's program performance, the Contract Year -End Closeout Report, and the Property Inventory Report. If after receipt of these documents, the OMB -GC determines that the Provider has been paid funds not in accordance with the Contract, and to which the Provider is not entitled, the Provider shall return such funds to the County or submit appropriate documentation. The County shall have the sole discretion in determining whether the Provider is entitled to such funds and the County's decision on this matter shall be binding. Additionally, any unexpended or unallocated funds shall be recaptured by the County. ARTICLE 18. PROHIBITED USE OF FUNDS A. Adverse Actions or Proceeding. The Provider shall not utilize County funds to retain legal counsel for any action or proceeding against the County or any of its agents, instrumentalities, employees, or officials. The Provider shall not utilize County funds to provide legal representation, advice, or counsel to any client in any action or proceeding against the County or any of its agents, instrumentalities, employees, or officials. B. Religious Purposes. County funds shall not be used for religious purposes. Page 15 of 26 CB 14- SMIiA -CB C. Commingling Funds. The Provider shall not commingle funds provided under this Agreement with funds received from any other funding sources. The Provider shall establish a separate account exclusively for receipt of the funds received pursuant to this Agreement. D. Program Income, The Provider shall not use any program income to cover expenses other than those budgeted for payment by program income under this agreement. The Provider shall track, record, and disclose any program income generated from the program(s) funded under this agreement. ARTICLE 19. REQUIRED DOCUMENTS. RECORDS. REPORTS. AUDITS. MONITORING AND REVIEW A. Certificate of Corporate Status. The Provider must submit to the OMB, within thirty (30) days from the date of execution of this Agreement, a certificate of corporate status in the name of the Provider, which certifies the following: that the Provider is organized under the laws of the State of Florida; that all fees and penalties have been paid; that the Providers most recent annual report has been filed; that its status is active; and that the Provider has not filed Articles of Dissolution. B. Board of Director Requirements. The Provider shall ensure that the Provider's Board of Directors is apprised of the programmatic, fiscal, and administrative obligations under this agreement funded through County Funds by passage of a formal resolution authorizing execution of this Agreement with the County. A current list of the Provider's Board of Directors and officers must be included with the submission. Said resolution shall at a minimum list the name(s) of the Board's President, Vice President and any other persons authorized to execute this Agreement on behalf of the Provider, and reference the program(s) and dollar amounts in the award, as may be amended. A copy of this corporate resolution must be submitted to the County prior to contract execution. Through the official minutes of its Board meetings, the Provider must also maintain proof that it has been sharing the results of all County monitoring reports with its Board. Additionally, the Provider will furnish the County with copies of the minutes of those Board meetings (where a properly constituted quorum was achieved). In order to meet Board meeting requirements a quorum must be achieved. The Provider will furnish the County with a current listing of the members of the agency's Board that includes the title and contact information, including home and e-mail addresses for each Board member. C. Proof of Tax Status. The Provider is required to submit to the County the following documentation: (a) The I.R.S. tax exempt status determination letter; (b) the most recent I.R.S. Form 990 or I.R.S. Form 990 -N; (c) the annual submission of I.R.S. Form 990 or I.R.S. Form 990 -N within (6) months after the Provider's fiscal year end; (d) IRS form 941 - Quarterly Federal Tax Return Reports within thirty -five (35) days after the quarter ends and if the form 941 reflects a tax liability, proof of payment must be submitted within forty -five (45) days after the quarter ends. D. Business Application. The Provider shall be a registered vendor with the County's Department of Procurement Management, for the duration of this Agreement. It is the responsibility of the Provider to file the appropriate Vendor Application and to update the Application file for any changes for the duration of this Agreement, including any option years. Page 16 of 26 14- SMIA -CB F. Accounting Records. The Provider shall keep accounting records which conform to Generally Accepted Accounting Principles (GAAP) in the United States. All such records will be retained by the Provider for not less than five (5) years beyond the term of this Agreement, and shall be made available for review upon request from County authorized personnel. G. Financial Audit. If the Provider has or is required to have an annual certified public accountant's opinion and related financial statements, the Provider agrees to provide these documents to the OMB -GC no later than one hundred eighty (180) days following the end of the Provider's fiscal year, for each year during which this Agreement remains in force or until all funds received pursuant to this Agreement have been so audited, whichever is later. H. Access to Records: Audit. The County reserves the right to require the Provider to submit to an audit by an auditor of the County's choosing or approval and to review any independent audit performed on the Provider for reasons of compliance with funding requirements of any other governmental agency or financial institution. The Provider shall provide access to all of its records which relate to this Agreement at its place of business during r6gular business hours. The Provider agrees to provide such assistance as may be necessary to facilitate the review or audit by the County to ensure compliance with all applicable accounting and financial standards. I. Quarterly Reviews of Expenditures and Records. The County Commission Auditor may perform quarterly reviews of Provider expenditures and records. Subsequent payments to the provider shall be subject to a satisfactory review of Provider records and expenditures by the County Commission Auditor, including but not limited to, review of supporting documentation for expenditures and the existence of sufficient documentation to support eligible expenditures. The Provider agrees to reimburse the County for ineligible expenditures as determined by the County Commission Auditor. J. Quality Assurance / Recordkeeping. The Provider shall maintain, and shall require that the Provider's subcontractors and suppliers maintain, complete and accurate program and fiscal records to substantiate compliance with the requirements set forth in the Attachment A, Scope of Services, of this Agreement. The Provider and its subcontractors and suppliers, shall retain such records, and all other documents relevant to the Services furnished under this Agreement for a period of five (5) years from the expiration date of this Agreement. The Provider agrees to participate in evaluation studies, quality management activities, Corrective Action Plan activities, and analyses carried out by or on behalf of the County to evaluate the effectiveness of client service(s) or the appropriateness and quality of care /service delivery. Accordingly, the Provider shall permit authorized staff involved in such efforts the right of access to the Provider's premises and records K. Confidentiality Requirements. The Provider shall establish and implement policies and procedures that ensure compliance with the following security standards and any and all applicable State and Federal statutes and regulations for the protection of confidential client records and electronic exchange of confidential information. "Confidential" shall be used in this section to describe information that is confidential under applicable law. The policies and procedures must ensure that: Page 17 of 26 C 14- SMIA -CB (1) There is a controlled and secure area for storing and maintaining active confidential information and files, including but not limited to medical records; (2) Confidential records are not removed from the Provider's premises, unless otherwise authorized by law or upon written consent from the County; (3) Access to confidential information is restricted to authorized personnel of the Provider, the County, and /or the United States Office of the Inspector General; (4) Records are not left unattended in areas accessible to unauthorized individuals; (5) Access to electronic data is controlled; (6) Written authorization, signed by the client, is obtained for release of copies of client records and /or information. Original documents must remain on file at the originating provider site; (7) An orientation is provided to new staff persons, employees, and volunteers. All employees and volunteers must sign a confidentiality pledge, acknowledging their awareness and understanding of confidentiality laws, regulations, and policies; (8) Procedures are developed and implemented that address client chart and medical record identification, filing methods, storage, retrieval, organization and maintenance, access and security, confidentiality, retention, release of information, copying, and faxing. L. Progress Reports. The Provider shall furnish the OMB -GC with monthly progress /performance reports in accordance with the activities and goals detailed in Attachments A and F of this Agreement. The reports shall explain the Provider's progress for the month and, in the event that its activities are seasonal, must clearly indicate when specific services and related expenditures will occur. The data should be quantified when appropriate. A corrective action plan must accompany all progress reports that indicate that the Provider is not meeting its expected service goals or expected performance levels. The final progress report shall be due no later than thirty (30) days after the expiration or termination of this Agreement. M. Monitoring: Management Evaluation and Performance Review. The Provider agrees to permit County authorized personnel to monitor, review, and evaluate the program /work which is the subject of this Agreement. The OMB -GC shall monitor fiscal, administrative, and programmatic compliance with all the terms and conditions of the Agreement. The OMB -GC will also have the right to inspect original documentation regarding administrative, fiscal, and programmatic matters and may retain copies of that documentation for verification purposes. The Provider shall permit the OMB -GC to conduct site visits, client assessment surveys, and other techniques deemed reasonably necessary to fulfill the monitoring function. A report of the OMB -GC's findings will be delivered to the Provider and the Page 18 of 26 CB 14- SMIA -CB Provider will rectify all deficiencies cited within the period of time specified in the report. If such deficiencies are not corrected within the specified time frame noted in the monitoring report, the County may suspend payments or terminate this Agreement. The OMB -GC may conduct one or more formal management evaluation and performance reviews of the Provider. Continuation of this Agreement or future funding is dependent upon satisfactory monitoring of follow -up and corrective action, if warranted, by the Provider. N. Client Records. The Provider shall maintain a separate individual client file for each client/family served, where appropriate. This client file shall include all pertinent information regarding case activity. At a minimum, the client file shall contain referral and intake information, treatment plans, and case notes documenting the dates services were provided and the type of service provided. These client files shall be subject to the audit, monitoring and inspection requirements under Article 19, Sections F, G, H, and M and any other relevant provisions of this Agreement. O. Disaster Flan /Continuity of Operations Plan (COOP). The Provider shall develop and maintain an Agency Disaster Plan /COOP. At a minimum, the Plan will describe how the Provider establishes and maintains an effective response to emergencies and disasters, and must comply with any Emergency Management related Florida Statutes applicable to the Provider. The Disaster Plan /COOP must be submitted to the OMB no later than January 1st of the contract term and is also subject to review and approval of the County in its sole discretion. The Provider will review the Plan annually, revise it as needed, and maintain a written copy on fife at the Provider's site. P. Public Records. Pursuant to Section 119.0701 of the Florida Statutes, if the Provider meets the definition of "Contractor" as defined in Section 119.0701(1)(a), the Provider shall: (a) Keep and maintain public records that ordinarily and necessarily would be required by the public agency in order to perform the service; (b) Provide the public with access to public records on the same terms and conditions that the public agency would provide the records and at a cost that does not exceed the cost provided in this chapter or as otherwise provided by law; (c) Ensure that public records that are exempt or confidential and exempt from public records disclosure requirements are not disclosed except as authorized by law; and (d) Meet all requirements for retaining public records and transfer to the County, at no County cost, all public records created, received, maintained and or directly related to the performance of this Agreement that are in possession of the Provider upon termination of this Agreement. Upon termination of this Agreement, the Provider shall destroy any duplicate public records that are exempt or confidential and exempt from public records disclosure requirements. All records stored electronically must be provided to the County in a format that is compatible with the information technology systems of the County. For purposes of this Article, the term "public records "` shall mean all documents, papers, letters, maps, books, tapes, photographs, films, sound recordings, data processing software, or other material, regardless of the physical form, characteristics, or means of transmission, made or received pursuant to law or ordinance or in connection with the transaction of official business of the County. Page 19 of 26 ME 14- SMIA -CB Provider's failure to comply with the public records disclosure requirement set forth in Section 119.0701 of the Florida Statutes shall be a breach of this Agreement. In the event the Provider does not comply with the public records disclosure requirement set forth in Section 119.0701 of the Florida Statutes, the County may, at the County's sole discretion, avail itself of any of the remedies for breach set forth under this Agreement or available at law or equity. ARTICLE 20. Audits and Internal Reviews by the Office of Management and Budget, Office of Miami -Dade County Inspector General, and the Commission Auditor The Provider understands that it may be subject to an audit, random or otherwise, by the Office of the Miami -Dade County Inspector General or an Independent Private Sector Inspector General retained by the Office of the Inspector General, or the County Commission Auditor. The Provider may also be subject to an internal review, random or otherwise, by the OMB -GC. Independent Private Sector Inspector General Reviews. The attention of the Provider is hereby directed to the requirements of Miami -Dade County Code Section 2 -1076; in that the Office of the Miami -Dade County Inspector General (IG) shall have the authority and power to review past, present and proposed County programs, accounts, records, contracts and transactions. The IG shall have the power to subpoena witnesses, administer oaths and require the production of records. Upon ten (10) days written notice to the Provider from IG, the Provider shall make all requested records and documents available to the IG for inspection and copying. The IG shall have the power to report and /or recommend to the Board of County Commissioners whether a particular project, program, contract or transaction is or was necessary and, if deemed necessary, whether the method used for implementing the project or program is or was efficient both financially and operationally. Monitoring of an existing project or program may include reporting whether the project is on time, within budget and in conformity with plans, specifications, and applicable law. The IG shall have the power to analyze the need for, and reasonableness of, proposed change orders. The IG may, on a random basis, perform audits on all County contracts throughout the duration of said contract (hereinafter "random audits "). This random audit is separate and distinct from any other audit by the County. Grant recipients are exempt from paying the cost of the audit which is normally' /4 of 11% of the total contract amount. The IG shall have the power to retain and coordinate the services of an independent private sector inspector general (IPSIG) who may be engaged to perform said random audits, as well as audit, investigate, monitor, oversee, inspect, and review the operations, activities and performance and procurement process including, but not limited to, project design, establishment of bid specifications, bid submittals, activities of the contractor, its officers, agents and employees, lobbyists, County staff and elected officials in order to ensure compliance with contract specifications and detect corruption and fraud. Nothing in this Agreement shall impair any independent right of the County to conduct audit or investigative activities. The provisions of this section are neither intended nor shall they be construed to impose any liability on the County by the Provider or third parties. Page 20 of 26 CB 14- SMIA -CB ARTICLE 21. SUBCONTRACTORS and ASSIGNMENTS A. Subcontracts. The parties agree that no assignment or subcontract will be made or let in connection with this Agreement without the prior written approval of the OMB -GC in its sole discretion, which shall not be unreasonably withheld, and that all subcontractors or assignees shall be governed by all of the terms and conditions of this Agreement. The Provider will obtain three quotes for all proposed subcontracts valued at $1,000 and above and maintain documentation of all three (3) quotes on file. 1) If the Provider will cause any part of this Agreement to be performed by a Subcontractor, the provisions of this Agreement will apply to such Subcontractor and its officers, agents and employees in all respects as if it and they were employees of the Provider; and the Provider will not be in any manner thereby discharged from its obligations and liabilities hereunder, but will be liable hereunder for all acts and negligence of the Subcontractor, its officers, agents, and employees, as if they were employees of the Provider. The services performed by the Subcontractor will be subject to the provisions hereof as if performed directly by the Provider. 2) The Provider, before making any subcontract for any portion of the services, will state in writing to the County the name of the proposed Subcontractor, the portion of the Services which the Subcontractor is to perform, the place of business of such Subcontractor, and such other information as the County may require. The County will have the right to require the Provider not to award any subcontract to a person, firm, or corporation disapproved by the County in its sole discretion. 3) Before entering into any subcontract hereunder, the Provider will inform the Subcontractor fully and completely of all provisions and requirements of this Agreement relating either directly or indirectly to the Services to be performed. Such Services performed by such Subcontractor will strictly comply with the requirements of this Agreement. 4) In order to qualify as a Subcontractor satisfactory to the County in its sole discretion, in addition to the other requirements herein provided, the Subcontractor must be prepared to prove to the satisfaction of the County that it has the necessary facilities, skill and experience, and ample financial resources to perform the Services in a satisfactory manner. To be considered skilled and experienced, the Subcontractor must show to the satisfaction of the County in its sole discretion that it has satisfactorily performed services of the same general type which is required to be performed under this Agreement. 5) The County shall have the right to withdraw its consent to a subcontract if it appears to the County that the subcontract will delay, prevent, or otherwise impair the performance of the Contractor's obligations under this Agreement. All Subcontractors are required to protect the confidentiality of the County's and County's proprietary and confidential information. Provider shall furnish to the County copies of all Page 21 of 26 CB 14- SMIA -CB subcontracts between Provider and Subcontractors and suppliers hereunder. Within each such subcontract, there shall be a clause for the benefit of the County permitting the County to request completion of performance by the Subcontractor of its obligations under the subcontract, in the event the County finds the Contractor in breach of its obligations, the option to pay the Subcontractor directly for the performance by such subcontractor. Notwithstanding, the foregoing shall neither convey nor imply any obligation or liability on the part of the County to any subcontractor. B. If this Agreement involves the expenditure of $100,000 or more by the County and the Provider intends to use subcontractors to provide the services listed in the Scope of Service (Attachment A) or suppliers to supply the materials, the Provider shall provide the names of the subcontractors and suppliers on the form attached as Attachment 1. The Provider agrees that it will not change or substitute subcontractors or suppliers from those listed in Attachment I without prior written approval of the County. C. Prompt Payments to Subcontractors. The Provider shall issue prompt payments to subcontractors that are small businesses (annual gross sales of $750,000 or less With its principal place of business in Miami -Dade County) and shall have a dispute resolution procedure in place to address disputed payments. Pursuant to the County's Sherman S. Winn Prompt Payment Ordinance (Ordinance 94 -40), Section 2 -8.1.4 of the Code of Miami -Dade County, Administrative Order No, 3 -19, and the Florida Prompt Payment Act, payments must be made within thirty (30) days of receipt of a proper invoice. Failure to issue prompt payments to small business subcontractors or adhere to dispute resolution procedures may be grounds for suspension or termination of this Agreement or debarment. ARTICLE 22. LOCAL STATE AND FEDERAL COMPLIANCE REQUIREMENTS Provider agrees to comply, in accordance with applicable professional standards, with the provisions of any and all applicable Federal, State and the County orders, statutes, ordinances, rules and regulations which may pertain to the Services required under this Agreement, including but not limited to: a) Miami -Dade County Florida, Department of Business Development Participation Provisions, as applicable to this Agreement. b) Miami -Dade County Code, Chapter 11A, Article 3. All Providers and subcontractors performing work in connection with this Agreement shall provide equal opportunity for employment and services without regard to race, creed, religion, color, sex, familial. status, marital status, sexual orientation, pregnancy, age, ancestry, national origin or handicap, The aforesaid provision shall include, but not be limited to, the following: employment, upgrading, demotion or transfer, recruitment advertising; layoff or termination; rates of pay or other forms of compensation; and selection for training, including apprenticeship. The Provider agrees to post in a conspicuous place available for employees and applicants for employment, such notices as may be required by the Dade County Equal Opportunity Board or other authority having jurisdiction. C) "Conflicts of Interest" Section 2 -11 of the Code of Miami -Dade County, and Ordinance 01 -199, as well as the Miami -Dade County False Claims Ordinance. Page 22 of 26 CB 9 4 -S MIA -CB d) Miami -Dade County Code Section 10 -38 "Debarment ". e) Miami -Dade County Ordinance 99 -5, codified at 11A -60 et. seq. Code of Miami - Dade County pertaining to complying with the County's Domestic Leave Ordinance. Failure to comply with this local law may be grounds for voiding or terminating this Agreement or for commencement of debarment proceedings against Provider. f) Part III, Ch. 2, Art. 1 and Ch. 11A of the Miami -Dade County Code, and any payment and performance bond requirements if applicable under the Florida Statutes and F.A.R. 52.222 if applicable. g) Miami -Dade County Ordinance 99 -152, prohibiting the presentation, maintenance, or prosecution of false or fraudulent claims against Miami -Dade County. h) Provider shall also develop and implement a written Code of Business Ethics and Conduct that will consist of a training program and an internal control system that: 1. Are suitable to the size of the Provider and extent of its involvement in government contracting, 2, Facilitate timely discovery and disclosure of improper conduct in connection with government contracts, and 3. Ensure corrective measures are promptly instituted and carried out. Notwithstanding any other provision of this Agreement, Provider shall not be required pursuant to this Agreement to take any action or abstain from taking any action if such action or abstention would, in the good faith determination of the Provider, constitute a violation of any law or regulation to which Provider is subject, including but not limited to laws and regulations requiring that Provider conduct its operations in a. safe and sound manner. ARTICLE 23, MISCELLANEOUS A. Publicity. It is understood and agreed between the parties hereto that this Provider is funded by Miami -Dade County. Further, by the acceptance of these funds, the Provider agrees that events funded by this Agreement shall recognize and adequately reference the County as a funding source. The Provider shall ensure that all publicity, public relations, advertisements and signs recognizes and references the County for the support of all contracted activities. This is to include, but is not limited to, all posted signs, pamphlets, wall plaques, cornerstones, dedications, notices, flyers, brochures, news releases, media packages, promotions, and stationery. The use of the official County logo is permissible for the publicity purposes stated herein. Provider shall submit sample or mock up of such publicity or materials to the County for review and approval. The Provider shall ensure that all media representatives, when inquiring about the activities funded by this contract, are informed that the County is its funding source. B. Governing Law and Venue. This Agreement is made in the State of Florida and shall be governed according to the laws of the State of Florida. Venue for this Agreement shall Page 23 of 26 CB 14- SMIA -CB be Miami -Dade County, Florida. C. Modifications. Any alterations, variations, modifications, extensions, or waivers of provisions of this Agreement including, but not limited to, amount payable and effective term shall only be valid when they have been reduced to writing, duly approved and signed by both parties and attached to the original of this Agreement. The County and Provider mutually agree that modification of the Scope of Service, schedule of payments, billing and cash payment procedures, set forth herein and other such revisions may be made as a written amendment to this Agreement executed by both the parties. The AAANinr nr the M,7 nr'c Mlaci imao is niiithnrized to make modificatinns to this Agreement as described herein on behalf of the County. The Office of the Inspector General shall have the power to analyze the need for, and the reasonableness of proposed modifications to this Agreement. D. Counterparts, This Agreement is executed in three (3) counterparts, and each counterpart shall constitute an original of this Agreement. v E. Headings, Use of Singular and Gender. Paragraph headings are for convenience only and are not intended to expand or restrict the scope or substance of the provisions of this Agreement. Wherever used herein, the singular shall include the plural and plural shall include the singular, and pronouns shall be read as masculine, feminine, or neuter as the context requires. F. Pre- condition to County's Execution of this Agreement. The Provider acknowledges that prior to the County Mayor or Mayor's designee executing this Agreement, the OMB -GC shall engage in a due diligence effort and review ( "the Due Diligence Effort and Review ") which includes but is not limited to researching background information on the Provider, ensuring the Provider is not in non - compliance with other County contracts, and reviewing the Provider's scope of services, budget, affidavits, responses to affidavits and any other proposed or required attachments to this Agreement. If the County through the OMB -GC in consultation with the County Mayor or Mayor's designee is concerned regarding findings of the Due Diligence Effort and Review, the County Mayor or Mayor's designee shall present findings of the Due Diligence Effort and Review to the Board of Miami -Dade County Commissioners with the County Mayor or Mayor's designee's recommendation as to how to proceed, and the Board of Miami -Dade County Commissioners shall then direct the County Mayor or Mayor's designee whether or not to execute this Agreement with the Provider by taking action on the recommendation. All services undertaken by the Provider before the County's execution of this Agreement shall be at the Provider's risk and expense. G. No Third Parties.The parties expressly agree there are no intended or unintended third party beneficiaries to this Agreement. H. Sovereign Immunity. Nothing in this contract shall be considered a waiver of sovereign immunity. Page 24 of 26 C fi M►+llEe -_ I. Review of this Agreement. Each party hereto represents and warrants that they have consulted with their own attorney concerning and participated in the drafting of each of the terms contained in this Agreement. No inference, assumption, or presumption shall be drawn from the fact that one party or its attorney prepared this Agreement. It shall be conclusively presumed that each party participated in • the preparation and drafting of this Agreement. J. Totality of Agreement / Severability of Provisions. This Agreement and Attachments, with it recitals on the first page of the Agreement and with its attachments as referenced below contain all the terms and conditions agreed upon by the parties: Attachment A: Scope of Services Attachment B: Budget Attachment C: Collusion Affidavit Attachment D: Miami -Dade County Affidavits Attachment D -1: Due Diligence Affidavit Attachment E: State Public Entities Crime Affidavit Attachment F: Monthly Payment Request Attachment G: Monthly Progress Report Attachment H: Final Year -End Closeout Report Attachment 1: List of Subcontractors and Suppliers (!VOTE: Attachment I must be completed and included with this Agreement only if the accompanying contract award totals $900,000 or more.) Attachment J: Authorized Signature Form No other Agreement, oral or otherwise, regarding the subject matter of this Agreement shall be deemed to exist or bind any of the parties hereto. If any provision of this Agreement is held invalid or void, the remainder of this Agreement shall not be affected thereby if such remainder would then continue to conform to the terms and requirements of applicable law and ordinance. SIGNATURES ON THE FOLLOWING PAGE Page 25 of 26 CB 14- SMIA -CB IN WITNESS WHEREOF, the parties have executed this Agreement effective as of the contract date herein above set forth. CITY OF SOUTH MIAMI By: Name: n J. Alexander Title: City Manager Date' 1/7/2014 Attest: r �, `,-�Uthonze `son OR G Notary Public Print Name: Maria M. Menendez Title: City Clerk Corporate Seal OR Notary Seal /Stamp: MIAMI -DADE COUNTY By" ��J t✓ �' V V I �� y r Name: Title: County Mayor or Mayor's Designee Date: Attest: HARVEY RUVIN, Clerk Board of County Commissioners By: Print Name: �Oi� Page 26 of 26 ATTACHMENT A MIAMI -DADE COUNTY OFFICE OF MANAGEMENT AND BUDGET GRANTS COORDINATION SCOPE OF SERVICE NARRATIVE SECTION I: GENERAL INFORMATION Name of Organization: City of South Miami, Parks and Recreation Department Address. 6130 Sunset Drive South Miami Florida 33143 Program Contact Person: Jennifer E. Korth Grants and Sustainable Initiatives Administrator Phone Number: 305 - 668 -2514 Fax Number: 305 - 663 -6345 E -mail Address: ikorth _southmiamifl,aov Fiscal Contact Person: Alfredo Riverol, CFO Phone Number: 305 - 663 -6343 Fax Number: 305 -668 -7388 9 E -mail Address: ariverol(cr�.southmiamifl.gov Board President /Chair: N/A Phone Number: N/A Fax Number: NIA E -mail Address: N/A i — Non- Profit Entity 0 For -Profit Entity Contract Amount: $18,400 Contract Period: October 1, 2013 – September 30, 2014 SECTION II: PROGRAM NARRATIVE Descriptive Program Name: South Miami Senior Meals Program Describe the program goals: The Senior Meals Proaram will provide positive social, cultural, educational, and recreational opportunities for seniors residing in the City of South Miami. In addition, the program will create a healthy environment for our senior population by encouraging physical activities, and providing nutritional meals, which will lead to a healthier lifestyle_ for the targeted population. Services will be provided to residents at the HUD Senior Center for participants regardless of race, religion, gende_r_,or, family income level that are 60 years and older. Describe the program and services and how program funding will be used: Page 1 of 3 ATTACHMENT A (A) Through our Parks and Recreation Department the City of South Miami will provide prepared meals to sixty -nine (69) residents that participate in activities at the HUD Senior Center located in South Miami. Identify what Commission District(s) will be served: District 7 Identify the target population that will be served (i.e., children /students, seniors, adults, families, general population, businesses etc.): Seniors Identify the total number of the target population served (if more than one service, define for each): 69 SECTION III: PROFILE OF SERVICES Annual workload measures (for each type of service to be provided including the number of clients to be served in the program) [i.e., 3 hours of after school care for twenty -five (25) children ages 5 — 10, one home delivered meal for 50 seniors every day (18,250 meals)]: The Senior Meals Program will provide two (2) pre - packaged meals (cantina - style) to sixty -nine (69) residents at the HUD Senior Center every Friday. The program will provide approximately 138 meals per week (69 seniors X 2 meals per week) for 52 weeks, for a maximum of 7.104 meals during the contract period. Unit Cost (Define the unit(s) of service and detail the unit cost(s) for the service): $18,400/69 clients = $266.67 per client. Identify the period of service delivery for program component(s) that WILL NOT be provided year- round: N /A. Total number of unduplicated clients that will be served during the .program year is: 69. Total number of clients receiving ongoing services: 69. Total number of new clients will be: 10. A typical client will be in the program for: 0 day(s) 12 month(s) --p—week(s) 0 hour(s) What is the defined workload measure (meals provided, therapy, tutoring, or after - school care hours, program completion, employment, etc.): meals provided. The total number of workload measures that will be provided during the program year: 7,104 meals Location of Service Site(s) and Hours of Service at each Site: (List all administrative and program sites including the physical street address with zip codes, contact information and the hours of operation for each site): The City of South Miami Senior Center is located at 6701 SW 62nd Avenue South Miami, Florida 33143. The hours of operation are Monday- Friday from 7:00 am -- 3:00 pm. The service site phone number is: (305)663 -6319; email: gpough rl.southmiamifi.gov. Page 2 of 3 ATTACHMENT A (A) SECTION IV: STATEMENT OF OBJECTIVES: (Define measurable and specific program objectives. Please quantify and note timeframe for completion of each objective [i.e.,75% of children attending after school tutoring program will increase their reading score by a full letter grade as measured by pre and post - testing during the contract year]). • One hundred percent (100 %) of the elderly participants that receive weekend meals will satisfy one of their basic needs. • Ninety percent (90 %) of the elderly participants will gain sufficient nutrition from the meals provided which will be measured by the type of menu provided. • Ninety percent 90 %n of the elderly participants will be satisfied with the services provided which will be measured by surveys. BACKGROUND SCREENING INFORMATION The program(s) is serving "at- risk" population: Yes ...X... No...... NIA.......... The minimum age for a client is: 65 years. The maximum age for a client is: NIA years. Staff or volunteers working directly with seniors for more than 10 hours: Yes...X... No .... N/A ....... SECTION V: ORGANIZATIONAL SUPPORT ACTIVITIES Describe how your organization will do outreach and public awareness of program activities: Public announcements will made durina televised Citv Commission meetinas. and on the Citv's Web. Describe how your organization will complete a self- assessment of its services throughout the program year (i.e., client satisfaction questionnaires, online surveys, independent organization audit review, etc.): Annual survey SECTION VI: CERTIFICATION I certify that the Scope of Services of the program will be carried out as described above. I also understand that I must receive prior formal approval from Miami -Dade County Office of Management and Budget— Grants Coordination for any variations from the operations and performance described ahoy Quentin Pough, Assistant Director of Parks & Recreations Signature and Title of Person Completing Form Print Name and Title Page 3 of 3 oucwn� woct :;, . ]su GECMOOIcwiu 8i. LINE ITEM BL1t1GET FOEthi , �BUI�i'NgeIFIGY2UN d2 OrgamzatroriiName" Program =Name South Miami Senior Meats Attachment 81 Date;; 12!5!203 3 -.: Budget:Pi3riod Oct 1,2013 - Sep. 30, 2014 Ob)ect Glass Categories Total Cost to Agency by Revenue Source Total Cost to A enc % of Total Counfy Federal CitylState All Other Of Each Line Item For the Budget Period Percent of Total Charged to This Award This Award County Funding I Ali Other County Funding Total Federal Funding Total State Funding Tota! Other Funding DIRE6T; COSTS„ ,: Personnel 1. Position Fringes 2. Position Fringes 3. Position Fringes 4. Position Fringes 5. Position Fringes 6. Position Y Fringes _ 7. Position Fringes Travel (describe in narrative) - Supplies (describe in narrative) - Equipment (describe in narrative) - Contractual Services (describe in narrative) 18,400 18,400 100% Other Direct Costs (describe in narrative) Other Direct Costs (describe in narrative) Other Direct Costs (describe in narrative) Other Direct Costs (describe in narrative) INDI)2ECT COS -T5 Personnel 1. Position Fria es 2, Position T Fringes Indirect Costs (describe in narrative) Indirect Costs (describe in narrative) TOTAL AWARD: 18,4001 18,400 Requested By: Aifr do River I ! CFO Approved Ex cutive ec r / Age esignee N e 1/7/2014 a-W47 281.3 Exe r ency Designee Sign Date Reviewed By: Approved OMB Contracts Officer Signature. Date BY: Qncl� C . l,Ji ox\ 0, Board Pre ' t! resident Nam (` /: /IR0 T Board P e ice President Signature Date Fiscal Approval (if needed) By' Accountant: OMB Contracts 8 Grants Administrator Date Supervisor: City of South Miami South Miami Senior Meals Program Miami -Dade County October 1, 2013 — September 30, 2014 DIRECT COSTS Contractual Services Attachment 131 Senior Meals ($18,400.00): Beginning October 1, 2013 through September 30, 2014, the City of South Miami Parks and Recreation Department Senior Program will provide two (2) prepackaged meals (cantina - style) to approximately sixty -nine (69) residents at the HUD Senior Center every Friday. The program will provide 138 meals per week (one meal for Saturday and Sunday) for participants in the program. In total, the program will provide approximately138 meals (residents) at the HUD Senior Center every Friday for 52 weeks; for a maximum of 7,104 meals during the contract period. The Senior Site Manager and the Recreational Leaders I are the staff persons responsible for the administrative functions related to this program. Their salaries and all other costs related to the program are covered by the City of South Miami. TOTAL AWARD: $8,400 Page 1of1 ATTACHMENT A (B) MIAMI -DADE COUNTY OFFICE OF MANAGEMENT AND BUDGET GRANTS COORDINATION SCOPE OF SERVICE NARRATIVE SECTION I: GENERAL INFORMATION Name of Organization: City of South Miami, Parks & Recreation Department Address: 6130 Sunset Drive South Miami Florida 33143 Program Contact Person: Jennifer E. Korth Grants and Sustainable Initiatives Administrator Phone Number: 305 - 668 -2514 Fax Number: 305 - 663 -6345 E -mail Address: ikorthq'Dsouthmiamifl.gov Fiscal Contact Person: Alfredo Riverol, CFO Phone Number: 305 - 663 -6343 Fax Number: 305 - 668 -7388 9 E -mail Address: Ariverol@southmiamifl,gov Board President /Chair: N/A Phone Number: N/A Fax Number: N/A E -mail Address: N/A Non - Profit Entity © For - Profit Entity M Contract Amount: $26,775 Contract Period: October 1, 2013 — September 30, 2014 SECTION 11: PROGRAM NARRATIVE Descriptive Program Name: The After - School House Program (Tutoring) Describe the program goals: The goal of the After - School House Program is to provide positive social, cultural, educational, and recreational opportunities for children residing in the City of South Miami. The program will also create a friendly environment and essential after - school services to participants regardless of race, { religion, gender, family income, and/or ability to pay for children ages 5 —16 years. Describe the program and services and how program funding will be used: The After - School House Program operates from August — June. Funding will be used to provide tutoring services which will include reading and math curricula, homework assistance. Identify what Commission District(s) will be served: District 7 Page 'I of 4 ATTACHMENT A (B) Identify the target population that will be served (i.e., children /students, seniors, adults, families, general population, businesses etc.): Children, apes 5 - 16. Identify the total number of the target population served (if more than one service, define for each): Two hundred (200) children. SECTION III: PROFILE OF SERVICES Annual workload measures (for each type of service to be provided including the number of clients to be served in the program) (i.e., 3 hours of after school care for twenty -five (25) children ages 5 — 10, one home delivered meal for 50 seniors every day (18,250 meals)]: The program takes place 39 weeks throughout the year and two hundred (200) children grades K through 12 will participate in the program. Unit Cost (Define the unit(s) of service and detail the unit cost(s) for the service): The unit cost to serve two hundred participants (200) is $133.88. Identify the period of service delivery for program component(s) that WILL NOT be provided year- round: Winter Recess (December 23rd - January 3rd), Spring Recess (One week in March), Summer Recess (June through August). Total number of unduplicated clients that will be served during the program year is: 200. Total number of clients receiving ongoing services: 200. Total number of new clients will be: 20. A typical client will be in the program for: days) _ month(s) 40 week(s) _hour(s) What is the defined workload measure (meals provided, therapy, tutoring, or after - school care hours, program completion, employment, etc.): After - school care hours /tutoring 1.5 hours per day 0 hour of homework, 30 minutes reading). The total number of workload measures that will be provided during the program year: 60,000 hours of after - school care /tutoring assistance (200 children x 1.5 hours per day x 5 days per week x 40 weeks). Location of Service Site(s) and Hours of Service at each Site: (List all administrative and program sites including the physical street address with zip codes, contact information and the hours of operation for each site): e The After - school House Program is located at the Gibson - Bethel Community Center, Murray Park - 5800 SW 66th Street South Miami Florida 33143. Page 2 of 4 ATTACHMENT A (B) • Hours of Operation for the Center are Monday — Friday, 5:00 am — 10:00 pm, Saturday, 9:00 am — 6:00 pm, and Sunday, 10:00 am. — 2:00 pm and services will be provided from 2:00 pm -- 6:04_ pm, Monday - Friday. The service site phone number is: (305)663 -6319; email: gpoughCa7southmiamifl.gov. SECTION IV: STATEMENT OF OBJECTIVES: (Define measurable and specific program objectives. Please quantify and note timeframe for completion of each objective [i.e.,75% of children attending after school tutoring program will increase their reading score by a full letter grade as measured by pre and post - testing during the contract year]). • Eighty percent (80 %) of the children will increase their reading fluency and comprehension as measured' Ileasur ed by various tests. • Ninety percent (90 %) of the students will complete their homework assignments as measured by report cards. ® Ninety -five percent (95 %) of the children will participate in educational activities as measured by the participation log_ , BACKGROUND SCREENING INFORMATION The program(s) is serving "at- risk" population: Yes ...X... No...... NIA.......... The minimum age for a client is: 5 years. The maximum age for a client is: 16 years. Staff or volunteers working directly with children for more than 10 hours: Yes ... X... No .... N/A ....... SECTION V: ORGANIZATIONAL SUPPORT ACTIVITIES Describe how your organization will do outreach and public awareness of program activities: Public awareness and outreach will be communicated through public announcements during televised City_ Commission meetings, City's website, and flyers. Describe how your organization will complete a self - assessment of its services throughout the program year (i.e., client satisfaction questionnaires, online surveys, independent organization audit review, etc.): Parent Surveys which are conducted once a year and report cards which are collected four (4) times a year. . Page 3 of 4 ATTACHMENT A (S) SECTION VI: CERTIFICATION I certify that the Scope of Services of the program will be carried out as described above. I also understand that I must receive prior formal approval from Miami -Dade County Office of Management and Budget — Grants Coordination for any variations from the operations and performance described above. Quentin Pough, Asst. Director of Parks & Recreations Signature and Title of Person Completing Form Print Name and Title Page 4 of 4 7779 ;`]fluocz:Y'nioorr�car"iory a2 City of South Miami Afterschool Housefrutoring Program Attachment B1 1 21512 01 3 Oct. 1, 2013 - Sep. 30, 2014 ero Total Cost to Agency by Revenue Source Total Cost to Age cy % Of Total Object I county Federal City/State All Other Of Each Line Item Percent of Total Charged to This Award This Award C All Other Total Total CitylState Funding Total tother Funding Forthe Budget Period DIRECT CASTS Personnel 1. Position Teachers/Instructors $ 8,925 8,925 100% Fringes - 2. Position Teachers /Instructors $ 8,925 8,925 100% Fringes 3. Position TeacherslInstructors $ 8,925 8,925 100% Fringes - 4, Position Fringes 5. Position Fringes 6. Position Fringes 7. Position Fringes !Travel (describe in narrative) ISupplies (describe in narrative) Equipment (describe in narrative) Contractual Services (describe in narrative) Other Direct Costs (describe in narrative) Other Direct Costs (describe in narrative) Other Direct Costs (describe in narrative) Other Direct Costs (describe in narrative) Personnel 1. Position Fringes 2. Position Fringes [iind,rtt Costs (describe in narrative) Indirect Costs (describe in narrative) T07AL AWARD: 26,775 - 26,775 ero Requested By: (redo - I CFO[ e utiv Dire {Orf A! 1/7/2014 Exec-u the 'Ti-rector i AVncy Designee Signature Date Reviewed By: OMB Contracts Officer Signature Date Approved By: Board Ppwid-ent I Vice President Name :Board President , i ent Signature Dafe- Fiscal Approval (if needed) Approved Accountant OMB Contracts & Grants Administrator Date Supervisor: City of South Miami After - School House Program Miami -Dade County October 1, 2013 — September 30, 2014 DIRECT COSTS Personnel: Salaries Teacherslinstructors ($26,775): These line items represent the salaries of three (3) part -time instructors. These instructors will dedicate 100% of their time to students enrolled in the After- School House Program. These instructors will provide tutoring and homework assistance for children participating in the program. Grant funds are being charged 100% of these positions' salaries for the period of 18 — 25 weeks, depending on the hours worked per week. After County funds are expended, the City of South Miami will continue to pay for their salaries until the program is completed. The staff person responsible for the administration of this program is the Director of Parks and Recreation and his salary and all other additional costs (i.e. utilities) are covered by the City of South Miami and participant fees. TOTAL. AWARD: 2 7 Page 1 of 1 �•},, Pf1'�%%�j South Miami �'�a � ,, d AI!•MtEtlaaGti� 99tt ,515 toe PARKS AND RECREATION DEPARTMENT k01 w n 3 CITY OF SOUTH MIAMI BUDGET FY 2013 -2014 176 South Miami 2001 PARKS & RECREATION ORGANIZATIONAL CHART Parks & Rec, Director Lorenzo Woodley Ad min. Assist II (PR) Martha Cortes Rec. Leader Parks Supervision' (CC) Hannah Benard kec, Aide Rec, Super 11 i Afterschool (CC)(PT) House J at Comm, Ctr. Rec. Aide Rec. Aide Rec. Leader PT) Leader Instructor (cc)(PT) CC)(PT), (CC) (PT) Rec. Aid. i, R- Leader (Cc) (P1') InstrUrtor (CC) (PT) -T— - Re, Afde (CC) Instructor (CC) (PT) rhClIct, or -5,( —, 1ntuct;1 CC) (PT) Rec, Aide (CC) (PT) Rec. Aldo (CP(p'T)— Rec. Aide (cc) (T, Rec. Aide (CC) (PT) Rec, Aide Rec. Assist. Director (PR) Quentin Pough Gibson- 10,101 I, 'Senior Gtr, Supervisor a landscaping (CP)VO M Division Kec. Leader Senior I CC)_ Mg, ( ) rucffp} (PT ST Aria Larzabal Rec, Lend Leader Worker CC) rnny Rec. _gler Leader (PR)- N R L. ma�nl Leader Leader Worker III " (-C C W Alex Rec. Aide Lugones (?R) (PT) d Re,. Aide 0 ( CCC� (V M CC) PT) (CC)(FT Malnt� Supervisor iI gouetas Baker Worker 11 _Eddy Rlvas Rec. Me Rec, Aide (CC) (FT) c (CC) VQ MaInt. Worker I F. Williams Rec, Aide (M) (PT) Maim Worker I Earnest ummur Kirkland Roc. Aid"' (CG) CC) (PT) - CITY OF SOUTH MIAMI BUDGET FY 2013-2014 177 0 CD lTJ :3 i South Miami zoos PARKS AND RECREATION DEPARTMENT 001- 2000-572 MISSION To provide the highest quality in educational, cultural, and recreational programs by inspiring, developing, and empowering the men, women, and children of our community. "Each one reach one, each one teach one" PARKS AND RECREATION DEPARTMENT FUNCTION Planning and developing parks and facilities that are environmentally sensitive, provide diverse leisure -time opportunities, support the community's vision and desires, and will maintain their 'Value over time. Providing high quality, high impact recreation experiences by organizing, promoting, and delivering programs and services to our community. Responding to our customers needs through trust and communication. Promoting collaborative efforts with other agencies and businesses to help obtain the vision of the community and providing the quality of life for residents, businesses, and visitors that make people choose South Miami over other areas, PARKS AND RECREATION DEPARTMENT ACCOMPLISHMENTS FOR FY 2013 ■ Solicited more vendors which increased participation at park sites. Increased expenditures to improve park aesthetics. ■ Increased registration numbers by receiving funds from the Community Redevelopment Agency (CRA), which allowed underprivileged children to participate in our Summer Camp Program. M renovated Computer Lab with funds received from the Community Redevelopment Agency (CRA). Twenty three (23) computers are now available to the community. ■ Staff participated in various seminars on how to stay green. ■ Completed all fighting projects at Murray and Palmer Par[(. ■ Completed grant project for Dante Fascell Park. ■ In our effort to enhance recruitment of professional staff, interviews were D conducted to fill out the position of Assistant Director. =' 3 cl5 ■ Upgraded Palmer Park maintenance building to be in compliance with code standards. CITY OF SOUTH MIAMI BUDGET FY 2013 -2014 178 S -`, South Miami .... �;,...- • 2001 PARKS AND RECREATION DEPARTMENT OBJEC'T'IVES FOR FY 2014 • Commence operations at Murray Park a Increase advertising efforts of programs Pool. and activities being offered by the Parks and Recreation Department. • Begin renovations to Marshall Williams Part. X Provide training opportunities for staff development. • Provide improvements to 50% of City parks, a Commence operations at Dante Fascell Park for the walking/ running rubberized • Research funding opportunities to trail. provide snacks for children in our After - school program. N In order to bring the community together, the Paris and Recreation • Enhance and provide programs to the Department will offer a monthly ' community that will provide educational breakfast at the Gibson - Bethel and recreational opportunities. Community Center. • Seek sponsorships, donations and /or in- P1 Ensure that the Computer Lab is kind donations that will enhance service property used by the seniors and the offerings, children in the community, that the Lab is well- staffed and remains open six days a week, t v a 3 N CITY OF SOUTH MIAMI BUDGET FY 2013 -2014 179 n South Miami !f : �'� j `� '1 All•Attter�a Gil } ; i� q- 4: '�`.• � �..G F - �,�'r� �(�� f1F�'�% _ . -.. r.r3.> Day Camp Participants 140 `,. /• l> it (l�i!"> G ISO 2007 PARKS AND RECREATION DEPARTMENT ACTIVITY REPORT LCF�jt' - ��'igY'4S.lti'.21L� "` ;t:. tt�,, .�(...Y. li:,•��:ii!a< ..:5... ...5 ;��.�f . {iY 'GS{�"� ,.a+J,`J.,i >v ti b - ♦ 2�''.� ♦� � 1 «��s N f3:na >�S�:s.;.�'�._`A .�. �?:3"y� -� y� 3 1 _ A.I ;�x r, :X5:1 �� %E`� 4':ulS\GI<ul'ly l� .0 ".t p��'� ��iA ,S�.,�, .��••� -... f• . f`>G. �ft"Y', � T k 1e` .� .. .. ::a +srF� -sY^•` s'3{ .3:.0 '.l'I.•C ♦')•�61 � i` "� 1� n�'4 ��,t',�i�.'��Yii�{n��,,,,',,,,!! o .CRS z♦..4es `T ^ \'7 "_ :C8 ' ti'>�. �•��1` � .5 fi 8C }t'.r_5, _7 7'' ✓�"�• ">Gfs��2r .:�. q- 4: '�`.• � �..G F - �,�'r� �(�� f1F�'�% _ . -.. r.r3.> Day Camp Participants 140 88 90 ISO ISO Spring Camp Participants 38 22 30 50 50 Winter Camp Participants 31 34 30 30 30 Summer Camp Participants 60 157 150 ISO 150 After School House Participants 116 114 65 120 120 Football Players 3 36 40 120 120 Cheerleaders 2 20 20 60 60 Track i5 33 45 45 45 Soccer Players 300 0 0 0. 0 Basketball Players 60 54 55 55 55 Baseball Players 21 0 0 0 0 Flag Football Players NIA 10 Is 0 0 T-Ball Players 60 19 40 0 0 Fitness Center Members 153 180 180 140 140 Fuchs Pavilion Rental 38 50 45 45 45 Dante Fascell Park Rental 70 100 120 120 120 Senior Hat Meals Served 7345 11460 12000 13000 1 3000 Senior Home Delivery Meals 4186 6006 7000 7000 7000 Senior High Risk Box Lunch Meals 2880 3402 3402 3402 3402 to 0 co D t� N CITY OF SOUTH MIAMI BUDGET FY 2013 -2014 180 Attachment B2 South Miami Agti�AmerioaCOV PARKS AND RECREATION BUDGET FY 2014 0012000 -572 „(H•�Lt,9/i. 1t�e'3� ''� f�`I�rf7tishld�val t��LYS�c,H T �3-�53 �"t 4� -�t t��l�. ii'�4:.� ,�S �Y. 1J�.�1 i 0012000 5721210 SALARIES - REGULAR 0012000 5721310 SALARIES - PART TIME 0012000 5722110 F.I,C,A, 0012000 5722210 PENSION PLAN CONTRIBUTION 0012000 5722220 ICMA 0012000 5722310 GROUP HEALTH INSURANCE 0012000 5722410 WORKER'S COMPENSATION TOTAL PERSONNEL SERVICES 0012000 5723450 CONTRACTUAL SERVICES 0012000 5724070 TRAVEL & CONFERENCE 0012000 5724080 EMPLOYEE EDUCATION 0012000 5724110 POSTAGE 0012000 5724120 COMMUNICATION 0012000 5724350 ELECTRICITY -CITY PARKS 0012000 5724515 LIABILITY INSURANCE- AUTO 0012000 5724632 INTERNET SERVICE 0012000 5724634 MAINTENANCE - INTERNET SERVICE 0012000 5724670 MAINT & REP -PARK FACILITIES 0012000 5724690 MAINT & REP - TENNIS 0012000 5724710 COPY MACHINE 0012000 5724820 SPECIAL EVENTS 0012000 5725205 COMPUTER EQUIPMENT 0012000 5725210 SUPPLIES 0012000 5725220 UNIFORMS 0012000 5725230 FUEL 0012000 5725410 MEMBERSHIP & SUBSCRIPTION 0012000 5725630 FOOTBALL 0012000 5725631 CHEERLEADERS 0012000 5725635 DANCEIMODELING 0012000 5725650 SOCCER PROGRAM 0012000 5725665 CONCESSION STAND 0012000 5725670 SPECIAL RECREATION PROGRAMS 0012000 5725680 SENIOR CITIZENS PROGRAMS TOTAL OPERATING EXPENSES TOTAL RECREATION 326,244 266,136 304,281 304,281 298,088 25,340 966 13,181 13,181 15,034 26,027 18,950 23,877 23,877 23,954 51,020 35,483 25,236 25,236 25,948 0 1,280 8,485 8,485 8,253 41,845 :28,278 37,436 37,436 39,310 14,512 12,331 11,704 11,704 12,807 484,988 363,424 424,200 424,200 423,394 2,763 2,899 4609 2,609 2,235 874 218 298 298 298 0 630 1,255 1,255 11525 100 86 100 100 100 3,120 2,122 3,240 3,240 3,060 663 877 4,800 4,800 4,800 1,935 0 3,870 3,870 4,870 0 0 1,620 1,620 1,620 0, 0 188 188 188 1,431 3,702 1,800 1 ,800 2,800 0 864 3,250 3,250 2,360 5,003 4,350 5,003 5,003 5,003 5,929 13,676 250 250 16,500 0 0 9,315 9,315 91315 5,957 7,215 3,097 3,097 3,597 1,484 1,058 1,507 1,507 3,155 10,795 15,117 15,117 15,117 15,120 1,909 1,902 1,880 1,880 2,460 21,876 38,636 20,335 20,335 19,085 ' 9,105 9,279 7,619 7,619 6,626 0 1,755 2,250 2,250 3,825 0 0 11000 1,000 1,000 2,972 0 0 0 0 10,147 6,813 6,227 6,227 5,607 11,749 13,660 16,970 16,970 17,746 97,813 124,059 113,600 113,600 132,894 582,801 488,283 537,800 537,800 556,288 CITY OF SOUTH MIAMI BUDGET FY 2013 -2014 181 South Miami e 1 f6 2005 PARKS AND RECREATION DEPARTMENT BUDGET HIGHLIGHTS 3450 Contractual Services - Provides year -round portable bathroom facilities for South Miami Park. The remaining funds are for fumigation at Palmer Park and MDC Fire & Elevator Inspections at the Community Center, 4350 Electricity — City Parks — Estimated electricity expense for bay four at the Mobley Building, 4670 Maintenance & Repair -- Park Facility — Provides for emergency hardware supplies for all City Parks, 4690 Maintenance & Repair — Tennis Facilities - $3,250 is budget for windscreens at Brewer Park Tennis Courts, 4820 Special Events — This line item funds miscellaneous events held at the Community Center. Fidditionally, contributes funding to the Fourth of July and State of the City Address events. as well as 5205 Computer Equipment — Desktop Computers 5,427 HP Laser Printer 3015dn 699 HP Color LaserJet CP4025dn 1,300 HP OfFlceJet 8600 Pro Pius 299 Netgear 4TB NAS 519 Yosemite 299 Trlpplite UPS 522 Annual Deep Freeze Maintenance 250 TOTAL 9,315 5210 Supplies — Barcode key tags for the fitness component. 215 Office supplies for the Center. 3,000 4 folding tables at $82.99 each= $331.96 plus shipping. 382 TOTAL. 3,597 5410 Memberships & Subscriptions -- Florida Recreation Parks & Association Membership. 720 National Recreation & Park Association (NRPA) 360 Direct T.V. 11080 Bollinger Insurance 300 TOTAL 2,460 CITY OF SOUTH MIAMI BUDGET FY 2013 -2014 182 n� ri 3 m ca ro 5635 Dance 1 Modeling - $3,825 cover the cost for the teacher of this class that is held in the Mobley Building. CITY OF SOUTH MIAMI BUDGET FY 2013 -2014 183 R 0 n S 3 cry EV South Miami ��i��,Si�Z '#{ �h7meticaCifY 2601 5630 Football Football League dues 900 Football & Cheerleading Banquet 300 participants at $4.10. 1,230 Homecoming and banquet (Bounce house, tents, etc,) 1,000 Trophies for players, parents, commissioners & coaches 1,262 Football scale yearly calibrated and certified 250 Fingerprinting & background check for 30 football volunteers at $55 each 1,650 Riddell Football practice uniforms (short sets) 150 participants at $13,95 each. 2,093 Riddell 7 piece pads sets @ $8 for 150 participants 1,200 Riddell Shoulder pads @ $29 for 60 participants 11500 Referees' fees 5 home games @ $900 1each. 4,500 Transportation to and from football games 3,500 TOTAL 19,085 5631 Cheerteading Football League 2014 dues & Insurance 900 Cheerleading uniforms for 30 participants at $126 ea. 3,780 Fingerprinting & Background check for 25 cheerieading ,volunteers at $55 ea. 1,375 68 cheerleading trophies at approximately $4,50 each 306 Women Cap Sleeve jersey Embroidered 14 coaches at $18.90 ea. 265 TOTAL 6,626 5635 Dance 1 Modeling - $3,825 cover the cost for the teacher of this class that is held in the Mobley Building. CITY OF SOUTH MIAMI BUDGET FY 2013 -2014 183 R 0 n S 3 cry EV 5680 Senior Citizen Program Massage Therapy $120 monthly for 12 months Cable Service at Senior Center Avg, $43 mo. for 12 months Pest Control Maint, Senior Building $30 mo. for 12 months, DJ Services for events at Senior Center: Valentine's Day, Easter, Mothers day, Fathers Day, Halloween, Black History month, Christmas $210 ea. for 7 events. AT &T Monthly phone service at Senior Center averaging $65 mo. Miscellaneous Purchases, Supplies for 7 events; Monthly birthday parties for seniors; "theatre for 20 seniors monthly; Coffee and Cream for Center Cosgrove Cleaning Supplies $65 for 12 months Fields Trips 6 plays at $30.00 each for 20 seniors $600.00 for 6 plays. Trip to Orlando (Epcott Animal Kingdom) at $3,000.00, TOTAL 1,440 516 360 1,470 780 5,800 780 6,600 17,746 D w n 3 D w N CITY OF SOUTH MIAMI BUDGET FY 2013 -2014 184 South Miami l+ 1i 1 s iwamennacnr - zoot 1 5670 Special Recreation Program Track & T -Ball Trophies 540 Easter Egg hunt at the Community Center 544 Party Planet - Easter egg hunt event at the Comm, Center 400 Gopher Track Equipment 1,500 Riddell Track & Field Jersey with matching shorts uniforms (35 x $24.95) 874 Miscellaneous Field trips for the children. 11750 TOTAL 5,607 5680 Senior Citizen Program Massage Therapy $120 monthly for 12 months Cable Service at Senior Center Avg, $43 mo. for 12 months Pest Control Maint, Senior Building $30 mo. for 12 months, DJ Services for events at Senior Center: Valentine's Day, Easter, Mothers day, Fathers Day, Halloween, Black History month, Christmas $210 ea. for 7 events. AT &T Monthly phone service at Senior Center averaging $65 mo. Miscellaneous Purchases, Supplies for 7 events; Monthly birthday parties for seniors; "theatre for 20 seniors monthly; Coffee and Cream for Center Cosgrove Cleaning Supplies $65 for 12 months Fields Trips 6 plays at $30.00 each for 20 seniors $600.00 for 6 plays. Trip to Orlando (Epcott Animal Kingdom) at $3,000.00, TOTAL 1,440 516 360 1,470 780 5,800 780 6,600 17,746 D w n 3 D w N CITY OF SOUTH MIAMI BUDGET FY 2013 -2014 184 BID NO.: BiD TITLE: COLLUSION AFFIDAVIT (Code of Miami -Dade County Section 2 -8.1.1 and 10 -33,1) (Ordinance No. 08 -11311) BEFORE ME, A NOTARY PUBLIC, personally appeared afl i� Can4tr who being duly sworn states: (insert name of aff!ant) I am over 18 years of age, have personal knowledge of the facts stated in this affidavit and i am an owner, officer, director, principal shareholder and /or i am otherwise authorized to bind the bidder of this contract. I state that the bidder of this contract: [� is not related to any of the other parties bidding in the competitive solicitation, and that the contractor's proposal is genuine and not sham or collusive or made in the interest or on behalf of any person not therein named, and that the contractor has not, directly or indirectly, induced or solicited any other proposer to put in a sham proposal, or any other person, firm, or corporation to refrain from proposing, and that the proposer has not in any manner sought by collusion to secure to the proposer an advantage over any other proposer. OR is related to the following parties who bid in the solicitation which are identified and listed below: Note: Any person or entity that fails to submit this executed affidavit shall be ineligible for contract award. In the event a recommended contractor identifies related parties in the competitive solicitation its bid shall be presumed to be collusive and the recommended �- contractor shall be ineligible for award unless that presumption is rebutted by presentation of evidence as to the extent of ownership, control and management of such related parties in the preparation and submittal of such bids or proposals. Related parties shall mean bidders or proposers or the principals, corporate officers, and managers 0 thereof which have a direct or indter4 ownership interest in another bidder or proposer for the same agreement or i tch 4parent company or the principals thereof of one (1) bidder or proposer h a direct or indirect ownership interest in another bidder or proposer for the greement. Bids roposals found to be collusive shall be rejected. By: 1/7 20 14 pnature of Affiant Date Steven under, City Manager 5 / 9 - 6 / 0 / 0 / 0 / 4 / 3 / 1 / Printed Name of A€fiant and Title Federal Employer identification Number City of South Miami Printed Name of Firm 6130 Sunset Drive, South Miami, FL 33143 Address of Firm BID NO.: BID TITLE: SUBSCRIBED AND SWORN TO (or affirmed) before me this day of 20L_� _BetShe ist�ers �Isnc�w to me or has presented as identification. Type of identification 1 u -1i ture otary Print or S amp Name of Notary Notary Public •- State of oz. NE erial Num per E-V i ation Date Notary SPA __•� MARIA L GARCIA MY COMMISSION # FF 063778 EXPIRES: October 16, 2017 7hru Wtery Public Underwriters Bonded NE Miami -Dade County MIAMI- DAdE VENDOR AFFmAvas FORM U. MS (Uniform County Affidavits) Department of Procurement Management Vendor Services Section 111 NW 1" Street, Suite 1300, Miami, Florida 33128 -1974 Telephone; 30S -375 -5773 www.miamidade.gov/`dpm The completion of the Vendor Affidavits Form allows vendors to comply with affidavit requirements outlined in Section 2 -8.1 of the Code of Miami -Dade County. Vendors are required to have a complete Vendor Registration Package on file, including required affidavits, prior to the award of any County contract. .1t is the vendor's responsibility to keep all affidavit information up to date and accurate by submitting any updates to the Department of Procurement Management, Vendor Services Section. City of South Miami A) Name of Entity, Individual(s), Partners or Corporation 6130 Sunset Drive South Miami Street Address (P.O. Box Number is not permitted) City FEDERAL EMPLOYER IDENTIFICATION NUMBER (FEIN) In order to establish a file for your firm, you must enter your firm's FEIN. This number becomes your "County Vendor Number`. Please enter your Federal Employee Identification Number (FEIN) ar if none, then enter the owners Social Security Number (SSN). FEIN 59- 6000431 NORTH AMERICAN INDUSTRY CLASSIFICATION SYSTEM (NAICS The North American industry Classl0cation System (NAICS) Is the standard used by the federal statistical agencies in classifying business establishments for the purpose of collecting, analyzing and publishing statistical data related to the U.S. business economy. ❑ NAICS Code 8) Doing Business As (If same as line A, leave blank) FL USA 33143 State (U.S.A.) Country Zip Code 1, MIAMI -DADE COUNTY OWNERSHIP DISCLOSURE AFFIDAVIT (Sec. 2 -8,1 of the Miami -Dade County Code) Firms registered to do business with Mlami -Dade County, shall require the person contracting or transacting such business with the County to disclose under oath his or her full legal name, and business address. Such contract or transaction shall also require the disclosure under oath of the full legal name and business address of all individuals having any interest (legal, equitable, beneficial or otherwise) in the contract other than subcontractors, materialmen, suppliers, laborers or lenders. Post office box addresses shall not be accepted hereunder. If the contract or business transaction is with a corporation the foregoing information shall be provided for each officer and director and each stockholder holding, directly or indirectly, five (5) percent or more of the outstanding stock in the corporation. If the contract or business transaction is with a partnership, the foregoing information shall be provided for each partner. If the contract or business transaction is with a trust, the foregoing information shall be provided for the trustee and each beneficiary of the trust: The foregoing disclosure requirements shall not apply to contracts with publicfy- traded corporations, or to contracts with the United States or any department or agency thereof, the State or any political subdivision or agency thereof, or any municipality of this State. Use duplicate page if needed for additional names. If no officer, director or stockholder owns (5 %) or more of stock, please write "None" below PRINCIPALS FULL LEGAL NAME NONE TITLE ADDRESS OWNERS CHECK BOXES BELOW FULL LEGAL NAME NONE TITLE 1 / 0Y.7lEREH! ADDRESS GENDER RACE / ETHNICITY A� Nf. F � fi s u C pf a o Z ' 4, $ E z a a ac o If a percentage of the firm is owned by a publicty traded corporation or by another corporation, indicate below in the space "Other Corporations" OTHER CORPORATIONS OF aWNERS{11p _ NONE _ _ 9/28/2011 Pagel -i -i A 0 2 M Z --4 ffl 2. MIAMI -DADE COUNTY EMPLOYMENT DISCLOSURE AFFIDAVIT (County Ordinance No. 90 -133, amending Section 2.8- 1(d)(2) of the Miami -Dade County Code) The following information is for compliance with all items in the aforementioned Section: 1 Does your firm have a collective bargaining agreement with its employees? Yes X _ No 2. Does your firm provide paid health care benefits for its employees? Yes _X_ No _ 3. Provide a current breakdown (number of persons) in your firm's work force indicating race, national origin and gender. NUMBER OF EMPLOYEES White Black Hispanic Asian /Pacific Islander Native American /Alaskan Native of E Total Employees 3. MIAMI -DADE COUNTY EMPLOYMENT DRUG -FREE WORKPLACE CERTIFICATION (Section 2- 8.7.2(b) of the Miami- Dade County Code) All persons and entities that contract with Miami -Dade County are required to certify that they will maintain a drug -free workplace and such persons and entities are required to provide notice to employees and to impose sanctions for drug violations occurring in the workplace, In compliance with Ordinance No. 92 -15 of the Code of Miami -Dade County, the above named firm is providing a drug -free workplace. A written statement to each employee shall inform the employee about: 1. Danger of drug abuse in the workplace 2. The firms' policy of maintaining a drug -free environment at all workplaces 3. Availability of drug counseling, rehabilitation and employee assistance programs 4. Penalties that may be imposed upon employees for drug abuse violations The firm shall also require an employee to sign a statement, as a condition of employment that the employee will abide by the terms of the drug -free workplace policy and notify the employer of any criminal drug conviction occurring no later than five (5) days after receiving notice of such conviction and impose appropriate personnel action against the employee up to and including termination. Firms may also comply with the County's Drug Free Workplace Certification where a person or entity is required to have a drug -free workplace policy by another local, state or federal agency, or maintains such a policy of its own accord and such policy meets the intent of this ordinance. 4. MIAMI -DADE COUNTY DISABILITY AND NONDISCRIMINATION AFFIDAVIT (Article 1, Section 2 -8.1.5 Resolution R182 -00 Amending R- 385 -95 of the Miami -Dade County Code) Firms transacting business with Miami -Dade County shall provide an affidavit indicating compliance with all requirements of the Americans with Disabilities Act (A.D.A.). I, state that this firm, is in compliance with and agrees to continue to comply with, and assure that any subcontractor, or third party contractor shall comply with all applicable requirements of the laws including, but not limited to, those provisions pertaining to employment, provision of programs and services, transportation, communications, access to facilities, renovations, and new construction. The American with Disabilities Act of 1990 (A.D.A.), Pub. L. 101 -336, 104 Stat 327, 42 U.S.C. Sections 225 and 611 including Titles 1, 11, lit, IV and V. The Rehabilitation Act of 1973, 29 U.S.C. Section 794 The Federal Transit Act, as amended, 49 U.S.C. Section 1612 The Pair Housing Act as amended, 42 U.S.C. Section 3601 -3631 1, hereby affirm that I am in compliance with the below sections: Section 2- 10.4(4)(a) of the Code of Miami -Dade County (Ordinance No. 82 -37), which requires that all properly licensed architectural, engineering, landscape architectural, and land surveyors have an affirmative action plan on file with Miami -Dade County. Section 2 -8.1.5 of the Code of Miami -Dade County, which requires that firms that have annual gross revenues in excess of five (5) million dollars have an affirmative action plan and procurement policy on file with Miami -Dade County. Firms that have a Board of Directors that are representative of the population make -up of the nation may be exempt. 9/28/2011 Page 2 5. MIAMI -DADE COUNTY DEBARMENT DISCLOSURE AFFIDAVIT (Section 10.38 of the Miami -Dade County Code) Firms wishing to do business with Miami -Dade County must certify that its contractors, subcontractors, officers, principals, stockholders, or affiliates are not debarred by the County before submitting a bid. I, confirm that none of this firms agents, officers, principals, stockholders, subcontractors or their affiliates are debarred by Miami - Dade County, 6, MIAMi -DADE COUNTY VENDOR OBLIGATION TO COUNTY AFFIDAVIT (Section 2 -8.1 of the Miami -Dade County Code) Firms wishing to transact business with Miami -Dade County most certify that all delinquent and currently due fees, taxes and parking tickets have been paid and no individual or entity in arrears in any payment under a contract, promissory note or other document with the County shall be allowed to receive any new business. I, confirm that all delinquent and currently due fees or taxes including, but not limited to, real and personal property taxes, convention and tourist development taxes, utility taxes, and Local Business Tax Receipt collected in the normal course by the Miami -Dade County Tax Collector and County issued parking tickets for vehicles registered in the name of the above firm, have been paid. 7. MIAMI -DADE COUNTY CODE OF BUSINESS ETHICS AFFIDAVIT (Article 7, Section 2 -8, 7 (i) and 2 -7 7 (b)(7) of the Miami -Dade County Code through (6) and (9) of the County Code and County Ordinance No 00 -1 amending Section 2.1 1.1(c) of the County Code) Firms wishing to transact business with Miami -Dade County must certify that it has adopted a Code that complies with the requirements of Section 2 -8.1 of the County Code. The Code of Business Ethics shall apply to all business that the contractor does with the County and `shall, at a minimum; require the contractor to comply with all applicable governmental rules and regulations. I confirm that this firm has adopted a Code of business ethics which complies with the requirements of Sections 2 -8.1 of the County Code, and that such code of business ethics shall apply to all business that this firm does with the County and shall, at a minimum, require the contractor to comply with all applicable governmental rules and regulations. 8. MIAMI -DADE COUNTY FAMILY LEAVE AFFIDAVIT (Article V of Chapter 11, of the Miami -Dade County Code) Firms contracting business with Miami -Dade County, which have more than fifty (50) employees for each working day during each of twenty (20) or more work weeks in the current or preceding calendar year, are required to certify that they provide family leave to their employees. Firms with less than the number of employees indicated above are exempt from this requirement, but must indicate by letter (signed by an authorized agent) that it does not have The minimum number of employees required by the County Code. I confirm that if applicable, this firm complies with Article V of Chapter i 1 of the County Code, which requires that firms contracting business with Miami -Dade County which have more than fifty (50) employees for each working day during each of twenty (20) or more work weeks in the current or preceding calendar year are required to certify that they provide family leave to their employees. 9. MIAMI -DADE COUNTY LIVING WAGE AFFIDAVIT (Section 2 -8.9 of the Miami -Dade County Code) All applicable contractors entering into a contract with the County shall agree to pay the prevailing living wage required by this section of the County Code. I confirm that if applicable, this firm complies with Section 2 -8.9 of the County Code, which requires that all applicable employers entering a contract with Miami -Dade County shall pay the prevailing living wage required by the section of the County Code. 10, MIAMI -DADE COUNTY DOMESTIC LEAVE AND REPORTING AFFIDAVIT (Article 8, Section 1 1 A -60 - 1 1 A -67 of the Miami -Dade County Code) Firms wishing to transact business with Miami -Dade County must certify that it is in compliance with the Domestic Leave Ordinance. I confirm that if applicable, this firm complies with the Domestic Leave Ordinance. This ordinance applies to employers that have, in the regular course of business, fifty (50) or more employees working in Miami -Dade County for each working day during the current or preceding calendar year. 9/28/2011 Page 3 AFFIRMATION 1, being duly sworn, do attest under pen of perjury that the entity is in compliance with all requirements outlined in these Miami -Dade County Vendor Affidavits. I also attest that I will c ply w' and keep current all statements sworn to in the above affidavits and registration application. I will notify the Miami -Dade County en ervices Section immediately if any of the statements attested hereto are no longer valid. (Signature of Affiant) Alexander, City Manager "rrinied Name 1/7/2014 Title (Date) ' NOTARY PUBLIC INFORMATION Notary Public f: 9�'eState of: State County of SUBSCRIBED AND SWORN TO (or affirmed) before me this day of 20 by C �-ae Ne or she is personalty knotan to me a -- 'Or has produced identification ❑ Type of Identification Produced AS' n % afore of Notary Public (Serial Plumber) d r t� �'�� L 0"/z 6 b � Print or Stamp of Notary Public Efpirati n Date Notary Public Seal (When applicable) MARIA L GARCIA MY COMMISSION 0 FF 0637 " EXPIRES: October 16, 2( Bonded Thm Notary Public Under. 9/28/2011 Page 4 a a kr, 4r,.,�,�.. ;; i AFFIDAVIT D -1 Applicant Name: City of South Miami Address: 6130 Sunset Drive, South Miami, FL 33143 Telephone Number: 305- 668 -2514 Pursuant to Miami -Dade County Resolution No. R- 630 -13, the undersigned certifies, to the best of his or her knowledge and belief, that: 1. Within the past five (5) years, neither the Agency nor its directors, partners, principals, members or board members: (i) have been sued by a funding source for breach of contract or failure to perform obligations under a contract; (IE) have been cited by a funding source for non - compliance or default under a contract; (iii) have been a defendant in a lawsuit based upon a contract with a funding source. Please list any matters which prohibit the Agency from making the certifications required and explain how the matters are being resolved (use separate sheet if necessary): This is -perti ied by my signature: Steven J. Alexander ,�AppEic s Signature Print Applicant's Name Date Subscribed and sworn to (or affirmed) before me this T day of 20 by ,oG .,N6/she is1.4ersonaliy known to me Vhas presented as identification number., (Print or Stamp of Notary): Notary Public -- State of Expiration Date: 110_11_11,,11Z Notary Seal: ;;� ""Y "y ''• MARIA L GARCIA MY COMMISSION A FF 063778 p p Bonded XPrRE October 16, 2017 ary Public Undewjters ATTACHMENT E SWORN STATEMENT PURSUANT TO SECTION 287.133 (3) (a}, FLORIDA STATUTES, ON PUBLIC ENTITY CRIMES THIS FORM MUST BE SIGNED AND SWORN TO IN THE PRESENCE OF A NOTARY PUBLIC OR OTHER OFFICIAL AUTHORIZED TO ADMINISTER OATHS This sworn statement is submitted to` Miami -Dade by Steven J. Alexander, City Manager (Print individual's name and title) for City of South Miami (Print Name of entity submitting sworn statement) whose business address is 6130 Sunset Drive, South Miami, FL 331743 and if applicable its Federal Employer Identification Number (FEIN) is 59- 6000 -431 If the entity has no FEIN, include the Social Security Number of the individual signing this sworn statement: 2. 1 understand that a "public entity crime" as defined in paragraph 287.133 (1)(g), Florida Statutes, means a violation of any state or federal law by a person with respect to and directly related to the transactions of business with any public entity or with an agency or political subdivision of any other state or with the United States, including, but not limited to, any bid or contract for goods or services to be provided to public entity or agency or political subdivision of any other state or of the United States and involving antitrust, fraud, theft, bribery, collusion, racketeering, conspiracy, or material misinterpretation. 3. 1 understand that "convicted" or "conviction" as defined in Paragraph 287.133 (1)(b), Florida Statutes, means a finding of guilt or a conviction of a public entity crime, with or without an adjudication of guilt, in any federal or state trial court of record relating to charges brought by indictment or information after July 1, 1989, as a result of a jury verdict, non jury trial, or entry of a plea of guilty or nolo contendere. 4. 1 understand that an "affiliate" as defined in paragraph 287.133(1)(a), Florida Statutes, means: A. A predecessor or successor of a person convicted of a public entity crime; or B. An entity under the control of any natural person who is active in the management of the entity and who has been convicted of a public entity crime The term "affiliate" includes those officers, directors, executives, partners, shareholders, employees, members, and agents who are active in the management of an affiliate. The ownership by one person of shares constituting a controlling interest in another person, or a pooling of equipment or income among persons when not for fair market value under an arm's length agreement, shall be a prima facie case that one person controls another person. A person who knowingly enters into a joint venture with a 1 of 2 person who has been convicted of a public entity crime in Florida during the preceding 36 months shall be considered an affiliate. 5. 1 understand that a "person" as defined in Paragraph 287.133(1)(e), Florida Statutes, means any natural person or entity organized under the laws of any state or of the United States within the legal power to enter into a binding contact and which bids or applies to bid on contracts for the provision of goods or services let by a public entity, or which otherwise transacts or applies to transact business with a public entity. The term "person" includes those officers, executives, partners, shareholders, employees, members, and agents who are active in management of an entity. 6. Based on information and belief, the statement which i have marked below is true in relation to the entity submitting this sworn statement. (Please indicate which statement applies.) X Neither the entity submitting this sworn statement, nor any of its officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, nor any affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989, The entity submitting this sworn statement, or one or more of its officers, directors, executives, partners, shareholders, employees, members, or agents who are active in the management of the entity, nor any affiliate of the entity has been charged with and convicted of a public entity crime subsequent to July 1, 1989. However, there has been a subsequent proceeding before a Hearing Officer of the State of Florida, Division of Administrative Hearings and the Final Order entered by the Hearing Officer determined that it was not in the public interest to place the entity submitting this sworn statement on the convicted vendor list. (attach a copy of the final order). I UNDERSTAND THAT THE SUBMISSION OF THIS FORM TO THE CONTRACTING OFFICER FOR THE PUBLIC ENTITY IDENTIFIED IN PARAGRAPH 1 (ONE) ABOVE IS FOR THAT PUBLIC ENTITY ONLY AND, THAT THIS FORM IS VALID THROUGH DECEMBER 31 OF THE CALENDAR YEAR IN WHICH IT IS FILED. I ALSO UNDERSTAND THAT I AM REQUIRED TO INFORM THAT PUBLIC ENTITY PRIOR TO ENT "' ,iNq)NTO A CONTRACT IN EXCESS OF THE THRESHOLD AMOUNT PROVIDE SECTION 287.017 FLORIDA STATUTES FOR CATEGORY TWO OF ANY CHAN N THE INFORMATION CONT}11NED IN THIS FORM. _ Sworn to and subscribed before m 204. rsonally kn� OR Produced Identification (Type of Identification) 2of2 (Signature) name of notary public) MIAMI -DADE COUNTY OFFICE OF MANAGEMENT AND BUDGET COST -BASED CONTRACT MONTHLY SUMMARY OF EXPENDITURES REPORT. ATTACHMENT F S u Asa Agency Name: Allocation Amount ::.: Agency Address: .: Contract NUM berr Remit to Address:. Agreement Period- 10/1/2013 - 9/30/2014 Contact Person:.: Telephone: Ordinance Number::. 0 -13 -88 and 0 -13 -90 Program Name ::: Today's Date; - November 25, 2013 Actual operating expenses covering the Month of: are outlined in Column II below:. III, j Approved Budget Line items Approved Budget OMB Ube Qnly Monthly Expenses DiRECT:COSTS.' Amount (Do nof;wr 6 In thcs cotumnj ........ Personnel 1, Position Fringes 2. Position Fringes 3. Position Fringes. 4. Position Fringes 5. Position Fringes 6. Position Fringes Other Direct Costs (describe in narrative) Other Direct Costs describe in narrative) Other Direct Costs (describe in narrative) Other Direct Costs describe in narrative) Other Direct Costs (describe in narrative Other Direct Costs describe in narrative Other Direct Costs describe in narrative Other Direct Costs (describe in narrative) INWRECT COSTS Personnel 1. Position Fringes 2. Position Fringes Indirect Costs (describe in narrative Indirect Costs (describe in narrative Indirect Costs describe in narrative Indirect Costs (describe in narrative) TOTALS: $ $ - To avoid delays in payment, provide complete back -up documentation for all expenses listed in Column it and provide appropriate authorization on the signature page (Page 2, over) CB (rev. 11/16109) Page 1 of 2 AUTHORIZATION I botchy certify that this expense report submitted by (he undersigned constitutes approved budget expenses during the period listed above, and that no expenses for which reimbursement is requested has been or will be reimbursed by any other funding sources. Executive Director! Agency Designee Print Name Executive Director t Agency Designee Signature November 25, 2013 Print Title Date CountylDepartment Use Only C.O. NOTE: VOUCHER # FISCAL PREPARED BY; INVOICE # DATE: VENDOR # INDEX CODE FISCAL_ APPROVED BY: SUB - OBJECT DATE: AMOUNT 70 PAY C8 (rev. 11116/09) Page 2 of 2 Attachment G OFFICE aF ::MANAGEMENT "AND BUDGET ' GRANTS COORDINATION t�tlaM MH . PROGRESS REPORT Agdncq Name:` . Oct -13 Nov -13 Allocation Amount Jan -14 Agency Address Mar -14 Apr-14 Contract Number Jun -14 Telephone Aug -14 Sep -14 Contract Pe tl 10/1/2013 - 9/30/2014 Completed Repoftmg Pei i0. (NameT e). Program Name: Date <The questions below are sample questions ( #1 -9), specific reports will be emalled later.> Oct -13 Nov -13 Dec -13 Jan -14 Feb -14 Mar -14 Apr-14 May -14 Jun -14 Jul -14 Aug -14 Sep -14 ;'totals' :Target: 1. If applicable, total number of participants transferred from previous contract year. Q 0 2. Total Number of new participants served this reporting period. 0 Q 3. Total number of participants served this reporting period. 4. Total number of participants served to date. 5. Total number of staff. 0 Q 6. How many radio/TV spots were used this reporting period. 7. How many participants completed a consumer satisfaction survey. - 00 __ 8. Of those completing the survey, what percentage were satisfied with the services provided. I A 0 9. How many promotional brochures /flyers were distributed to promote services throughout the community. 0 0 Page 1 of 2 OGC 025 (rev. 10119109) Program Problems Encountered this Month: Is Technical Assistance Needed? If Yes, Please Explain: Comments: Attachment G Authorized Signature Date Page 2 of 2 OGC 025 (rev. 10119(09) ATTACHMENT H MIAMI -DADE COUNTY OFFICE OF MANAGEMENT AND BUDGET - GRANTS COORDINATION QUARTERLY SUMMARY OF ACTUAL, EXPENDITURES AWARD INFORMATION (complete all sections noted with * ) Agency Name -: Project Name: Total Award Amount: Address -: Agreement Period: 10101/2013 - 9/30/2014 Ordinance No: Contact Person -: Index Code No: Telephone -: Today's Date -: BUDGETED AMOUNT / QUARTERLY ACTUAL EXPENDITURES Check Quarter Relow: Actual expenses for the © 9st Quarter (Oct, Nov, Dec) Q 3rd Quarter (Anr. May. Junl are outlined in the appropriate Column below: C! 2nd Quarter (Jan, Feb, Mar) 0 4th Quarter (Jul, Aug, Sep) 1 6 7 8 DIRECT COSTS: Personnel 1. Position Fringes 2. Position Fringes 3. Position Fringes 4. Position Fringes 5. Position Fringes 6. Position Fringes 7. Position Fringes Travel Supplies Equipment Contractual Services 1. Contractor #1 2. Contractor #2 3. Contractor #3 Other Direct Costs Other Direct Costs Other Direct Costs Other Direct Costs Subtotal Direct Costs Approved Budget Amount Revised Budget (if any) (This Column Is for Dept/ County Use only) 1st Quarter (Oct, Nov, Dec) Actual Expenses 2nd Quarter (Jan, Feb, Mar) Actual Expenses 3rd Quarter (Apr, May, .fun) Actual Expenses 4th Quarter (Jul, Aug, Sep) Actual Expenses Y.T.D. Total Expended Contract Balances $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.001 $0.001 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0.00 $0.00 $0.00 $0.00 •$0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 :x0.00 $0.00 $0.00 $0.00 0.001 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 :$0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 :$0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 :$0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 1$0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 :$0.00 $0.00 $0,00 $0.00 $0.00 $0.00 $0.00 $0.00 :60.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 0.00 $0.00 $0.00 $0.00 $0.00 $0.0DI $a.00 $0.00, $0.00 $0.00 $0.00 $0.00 $0.00 '50.001 $o.oa $o.oa $0,00 $0.00 $0.00 $o.00 $a.oa INDIRECT COSTS: Personnel I- Position Fringes 2. Position Fringes 3. Position Frinaes Other Indirect Costs Other Indirect Costs Other Indirect Costs Subtotal Indirect Costs: Total Operating Expenses: AUTHORIZATION I hereby certify that this expense report submitted by the undersigned constitutes approved budget expenses during the period listed above: PRINT NAME AND TITLE SIGNATURE DATE $0.00 $0.00 $0.00 $0.00 $0,00 $0.00 $0.00 $0.00 $0.00 $0,00 $0.00 $0.00 $0.00 $0.00 $0,00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 WOO $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.001 $0.001 $0.001 $0.00 $0.00 $0.00 $0.001 $0.00 $0.001 $0.001 $0.00 $0.00 AUTHORIZATION I hereby certify that this expense report submitted by the undersigned constitutes approved budget expenses during the period listed above: PRINT NAME AND TITLE SIGNATURE DATE ATTACHMENT PROVIDER'S DISCLOSURE OF SUBCONTRACTORS AND SUPPLIERS (Ordinance 97 -104) Name of Organization: City of South Miami Address: 6130 Sunset Drive, South Miami, FL 33143 REQUIRED LISTING OF SUBCONTRACTORS ON COUNTY CONTRACT In compliance with Miami -Dade County Ordinance 97 -104, the Community Based Organization must submit the list of first_ their StlhContrnctorg or solh- rnnsifltnnk Whn Will perform any part of the Scope of Services Work, if this Agreement is for $100,000 or more. The Community Based Organization must complete this information. If the Community Based Organization will not utilize subcontractors, then the Community Based Organization must state "No subcontractors will be used"; do not state "N/A". NAME OF SUBCONTRACTOR OR SU13- CONSULTANT ADDRESS CITY AND STATE N/A - No subcontractors will be used. REQUIRED LIST OF SUPPLIERS ON COUNTY CONTRACT In compliance with Miami -Dade County Ordinance 97 -104, the Community Based Organization must submit a list of suppliers who will supply materials for the Scope of Services to the Community Based Organization, if this Contract Agreement is $100,000 or more. The Community Based Organization must fill out this information. If the Community Based Organization will not use suppliers, the Community Based Organization must state "No suppliers will be used ", do not state "NIA ". NAME OF SUPPLIER ADDRESS CITY AND STATE N/A - No suppliers will be used. I hereby certify that the foregoing information is t , correct and complete: Signature of Authorized Representative: Title: City Manager Date: 1/7/2014 Firm Name: City of South Miami Fed. 1D No. 59- 6000 -431 Address: 6130 Sunset Drive City/State/Zip: South Miami, FL 33143 Telephone: J305 ) 668 -2510 Fax: ( 305 ) 668 -6348 E -mail: SAlexander @southmiamifl.gov Page 1 of 1 e&l of s"dh � AUTHORIZED SIGNATURE FORM ATTACHMENT) DATE: 1/7/2014 This form certifies the names, titles and signatures of individuals authorized by the Provider to sign contracts, checks, budget revisions, payment requests, and other requests that may be requested by the Office of Management and Budget — Grants Coordination (OMB -GC) for disbursement of funds. Attached hereto and incorporated herein is a certified copy of a duly authorized and executed resolution passed by the Provider's Board that provides for this authorization. These signature authorizations are retained by the OMB -GC for auditing purposes. Should the Provider desire to change the information on this document, a certified and authorized and executed Resolution describing the desired changes should be submitted to the OMB -GC. NAME (please type) TITLE (please type) SIGNATURE I. BPrime Contracts and Subcontracts Steven Alexander Alfredo Riverol IL Checks (List amount limits) Steven Alexander Alfredo Riverol Ill. Budget Revision Requests Steven Alexander Alfredo Riverol IV. Payment Requests Steven Alexander Alfredo Riverol City Manager Chief Financial Officer City Manager Chief Financial Officer City Manager Chief Financial Officer City Manager Chief Financial Officer VA South Miami A1kb kaC Y 2001 6130 Sunset Drive South Miami, Florida 33143 -5093 • Tel: (305) 663 -2514 • Fax: (305) 663 -6345 www.southmiamifl.gov