2TO:
FROM:
DATE:
SUBJECT:
BACKGROUND:
CITY OF SOUTH MIAMI
OFFICE OF THE CITY MANAGER
INTER-OFFICE MEMORANDUM
The Honorable Mayor & Members of the City Commission
Steven Alexander, Interim City Manager
South Miami
hOd
AD-America City
'1111.'
2001
January 8, 2013 Agenda Item No.:-=-_
A resolution authorizing the City Manager to execute a fiscal year 2013 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.
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 I, 2012 and ends on
September 30, 2013.
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
ACCOUNT NUMBER: I 14-3604-541-1310
GRANT PERIOD: October I, 2012 through September 30, 2013
ATTACHMENTS: Miami-Dade County FY 2013 Contract for the After School House Program
( 13-SMIA-CB)
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
RESOLUTION NO. __ _
A Resolution authorizing the City Manager to execute a fiscal year 2013
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.
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, 2012 and ends on September 30,
2013.
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 __ , day of ___ , 2013.
ATTEST:
CITY CLERK
READ AND APPROVED AS TO FORM
LANGUAGE, LEGALITY AND
EXECUTION THEREOF:
CITY ATTORNEY
APPROVED:
MAYOR
COMMISSION VOTE:
Mayor Stoddard:
Vice Mayor Liebman:
Commissioner Harris:
Commissioner Newman:
Commissioner Welsh:
CB
AGREEMENT
13-SMIA-CB
FY 2012-2013 County General
Funds
Ordinance # 12-70 AND 12-72
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. 1 st 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
WHEREAS, the County has appropriated 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") or the Director's designee, or the duly authorized
representative designated to manage the Contract.
c) The word "Days" shall mean Calendar Days, unless ot~erwise 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
Page 1 of 23
CB
13-SMIA-CB
satisfactory to, equal or necessary in the sole discretion of the County's Contract
Manager.
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.
ARTICLE 2. AMOUNT PAYABLE.
Subject to available funds, the maximum provisional amount payable for services rendered
under this contract shall not exceed:
South Miami Senior Meals
The After School House Program (Tutoring)
$ 18,400
$ 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, 2012 through September
30, 2013. Both parties expressly acknowledge funding under this contract is at the County's
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.
Page 2 of 23
CB
13-SMIA-CB
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.
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 S. The Provider will
also submit an agency-wide budget that displays its total revenue by funding source at the time
that Attachment A and Attachment B are submitted and as requested in the award letter.
The Provider may shift funds between existing line items: 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. Please note: In no event shall expenditures in any
approved budget line item exceed fifteen (15) percent of that line item. The approved Budget
Revision shall replace Attachment B in its entirety.
In no event shall the budget include a line item for indirect costs in excess of fifteen 'percent
(15%) of the total budget.
The Provider may request a budget revision to amend the budget 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.
ARTICLE 5. EFFECTIVE TERM
Both parties agree that the effective term of this Agree"ment shall commence on October
1, 2012 and terminate at the close of business on September 30, 2013.
ARTICLE 6. INDEMNIFICATION BY PROVIDER
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
Page 3 of 23
CB
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 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.
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, clo Office of Management and Budget (OMB), 111
N.W. 1st 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
Page 4 of 23
CB
below:
13-SMIA-CB
A. All insurance certificates must list the COUNTY as "Certificate Holder" in the
following manner:
Miami-Dade County
111 N.W. 1 sl Street, Suite 2340
Miami, Florida 33128
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
Insurance, and must be a member of the Florida Guaranty Fund.
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.
Page 5 of 23
CB
13-SMIA-CB
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 Article XI of this Agreement affects SERVICE PROVIDERS
whose combined total award for all services funded under this Agreement
exceed a $25,000 threshold. In the event that the SERVICE PROVIDER whose
original total combined award in less than $25,000, but receives additional
funding during the contract period which makes the total combined award exceed
$25,000, then the requirements in Article XI shall apply.
J. 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. 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 bac~ground 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 form time to time), regulations, ordinances and resolutions, regarding background
screening of those who may work with vulnerable persons, as defined by section 435.02, Florida
Statutes, as may be amended from time to time.
Page 6 of 23
CB
13-SMIA-CB
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 (Le.,
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
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.
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 County shall not disburse any further funds and this Contract may be subject to termination
at the sole discretion of the County.
ARTICLE 9. CONFLICT OF INTEREST
A. The Provider agrees to abide by and be governed by Miami-Dade County Ordinance No. 72-
82 (Conflict of Interest Ordinance codified at Section 2-11.1 et al. of the Code of Miami-Dade
County), as amended, which is incorporated herein by reference as if fully set forth herein, in
connection with its contract obligations hereunder.
B. No person under the employ of the COUNTY, 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, any personal financial interest, direct or indirect, in this
Agreement.
C. No person, including but not limited to any officer, member of a board of directors, m'anager,
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 2-11.1 et al. of the Code of Miami-Dade County.
ARTICLE 10. CIVIL RIGHTS
The Provider agrees to abide by Chapter 11 A 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
Page 7 of 23
CB
13-SMIA-CB
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 ~, 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 seq. 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
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 §
11 A-60 et seq. 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 and the Miami-Dade County Privacy Standards
Administrative Order. 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
bylaw;
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 tathe 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
Page 8 of 23
CB
13~SMIA-CB
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
It is understood and agreed between the parties that any written notice addressed to OMB,
which is delivered by U.S. Mail or emailed to OMB 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.
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
ATTENTION;
Phone;
Fax:
Email:
(2) To the Provider
Phone:
Fax:
Email:
Felipe M. Rivero III
(305) 375-4765
(305) 375-4049
rivero@miamidade.gov
(305) 668-2514
(305) 668-7388
J Korth@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.
Page 9 of 23
CB
13-SMIA~CB
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
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 licensure/certification 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 County to monitor, evaluate and review the Provider's program; (8) the
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, reP9rts 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
Page 10 of 23
CB
13-SMIA-CB
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
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 sale 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.
Page 11 of 23
CB
13~SMIA~CB
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.
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. 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 OMB-GC Director as the Mayor's Designee or the Mayor.
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
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. PaY.ment to approved subcontractors
shall be made by 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. The OMB must receive the
Monthly Summary of Expenditures Report and the Monthly Performance Report no later than
the 21 st 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
Page 12 of 23
CB
13~SMIA~CB
month services were rendered and documented in the Monthly Performance Report. Upon
submission of satisfactory required monthly reports, the OMB 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 shall accept originals of invoices, receipts and other
evidence of indebtedness as proof of expenditures. When original documents cannot be
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 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 documentation/invoices are properly 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 21 st 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 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 Provider's program perfoql1ance, the Contract Year-End
Closeout Report, and the Property Inventory Report. If after receipt of these documents, the
OMB determines that the Provider has been paid funds not in accordance with the Contract,
and to which it 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
Page 13 of 23
CB
13-SMIA-CB
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.
C. Commingling Funds. The Provider shall not commingle funds provided under
this Agreement with funds received from any other funding sources. The Provider shalt
establish a separate account exclusively for receipt of the funds received pursuant to 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 insure 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 service categories 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.
C. Proof of Tax Status. The Provider is required to submit to the County the
following docum~ntation: (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.
E. Section 2-11.1 (d) of Miami-Dade County Code as amended by Ordinance 00-1,
requires any county employee or any member of the employee's immediate family who has a
controlling financial interest, direct or indirect, with Miami-Dade County or any person or agency
acting for Miami-Dade County from competing or applying for any such contract as it pertains to
Page 14 of 23
CB
13~SMIA~CB
this solicitation, must first request a conflict of interest opInion from the County's Ethic
Commission prior to their or their immediate family member's entering into any contract or
transacting any business through a firm, corporation, partnership or business entity in which the
employee or any member of the employee's immediate family has a controlling financial
interest, direct or indirect, with Miami-Dade County or any person or agency acting for Miami-
Dade County and that any such contract, agreement or business engagement entered in
violation of this subsection, as amended, shall render this Agreement voidable. For additional
information, please contact the Ethics Commission hotline at (305) 579-9093.
F. Accounting Records. The Provider shall keep accounting records which
conform to generally accepted accounting principles. 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 accountants opinion and related financial statements, the Provider agrees to provide
these documents to the OMB 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. The Provider
shall provide access to all of its records which relate to this Agreement at its place of business
during regular business hours. The Provider agrees to provide such assistance as may be
necessary to facilitate their review or audit by the County to insure compliance with 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 I 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 exeiration 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
Page 15 of 23
CB
13-SMIA-CB
client records and electronic exchange of confidential information. The policies and procedures
must ensure that:
(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 OMS 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 report~ that indicate that the Provider is
not meeting its expected service goals or expected perfonnance 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 OMS shall monitor both fiscal and
programmatic compliance with all the terms and conditions of the Agreement. The Provider
shall permit the OMB to conduct site visits, client assessment surveys, and other techniques
deemed reasonably necessary to fulfill the monitoring function. A report of the OMB's findings
Page 16 of 23
CB
13-SMIA-CB
will be delivered to the Provider and the 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, the County may suspend payments or terminate this Agreement. The OMB 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 evaluation
conclusions by the County.
N. Client Records. The Provider shall maintain a separate individual client chart
for each client/family served, where appropriate. This client chart shall include all pertinent
information regarding case activity. At a minimum, the client chart 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 charts shall be subject to the audit and
inspection requirements under Article 19, Sections F, G, and H of this Agreement.
O. Disaster Plan/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 1 st 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 file at the Provider's site.
ARTICLE 20. 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 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.
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 % of 1 % of the total contract amount.
Page 17 of 23
CB
13-SMIA-CB
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.
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 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
Page 18 of 23
CB
13-SMIA-CB
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
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 hereunder as more fully described herein.
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 I. 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 a'nd 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,
Page 19 of 23
CB
13-SMIA-CB
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 payor 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 over the work setting forth
the provisions of the nondiscrimination law.
c) "Conflicts of Interest" Section 2-11 of the Code of Miami-Dade County, and
Ordinance 01-199;
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.
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 Contractor, constitute a violation of any
law or regulation to which Contractor is subject, including but not limited to laws and regulations
requiring that Contractor 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,
Page 20 of 23
CB
13-SMIA-CB
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
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 Mayor or the Mayor's designee is authorized to make modifications 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.
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. 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.
G. Totality of Agreement I 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 E: State Public Entities Crime Affidavit
Attachment F: Monthly Payment Request
Attachment G: Monthly Progress Report
Attachment H: Final Year-End Closeout Report
Page 21 of 23
CB
13-SMIA-CB
Attachment I: List of Subcontractors and Suppliers (NOTE: Attachment I must be completed and
included with this Agreement only if the accompanying contract award totals $100,000 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 22 of 23
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:
Title:
Date:
Attest:
Print Name:
Title:
Authorized Person OR
Notary Public
MIAMI-DADE COUNTY
By:
Name:
Title:
Date:
Attest: HARVEY RUVIN, Clerk
Board of County Commissioners
By:
Print Name:
Corporate Seal OR Notary Seal/Stamp:
Arft~tJ. c~ f..
et&cM~
Page 23 of 23
ATTACHMENT A (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: jkorth@southmiamifl.gov
Fiscal Contact Person: Alfredo RiveroL CFO
Phone Number: 305-663-6343 Fax Number: 305-668-7388
E-mail Address: ariverol@southmiamifl.gov
Contract Amount: $18,400 Contract Period: October 1. 2012 -September 30. 2013
SECTION II: PROGRAM NARRATIVE
Descriptive Program Name: South Miami Senior Meals Program
Describe the program goals:
The Senior Meals Program will provide positive sociaL culturaL educationaL and recreational
opportunities for seniors residing in the City of South Miami. In addition, the program will create a
healthy environment for our senior population by encouraging physical activities. and providing
nutritional meals, which will lead to a healthier lifestyle for the targeted population. Services will be
provided to residents at the HUD Senior Center for participants regardless of race, religion, gender. or
family income level that are 60 years and older.
Describe the program and services and how program funding will be used:
Through our Parks and Recreation Department, the City Clt$oLjthJYliami will provide prepared meals
to sixty-three (63) residents that participate in activities at the HUD Senior Center located in South
Miami.
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) [Le., 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)]:
Page 1 of 2
ATTACHMENT A (A)
The Senior Meals Program will provide two (2) pre-packaged meals (cantina-style) to approximately
sixty-three (63) residents at the HUD Senior Center every Friday. The program will provide 126 meals
per week (63 seniors X 2 meals per week) for 43 weeks, which totals 5.418 meals (43 weeks X 126
meals) during the contract period.
Unit Cost (Define the unit(s) of service and detail the unit cost(s) for the service):
Each meal will cost approximately $3.40 (based on the previous contracted year) which equals
$18.421.20 The general unit cost was calculated as follows: $18,400/63 clients = $292.06 per client.
Location of Service Site(s) and Hours of Service at each Site: (List all sites including the physical
street address with zip codes 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.
SECTION IV: STATEMENT OF OBJECTIVES: (Define measurable and specific program objectives.
Please quantify and note timeframe for completion of each objective [Le.,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]).
• 100% of the elderly participants that receive weekend meals will satisfy one of their basic
needs.
• 90% of the elderly participants will gain sufficient nutrition from the meals provided which will
be measured by the type of menu provided.
• 90% of the elderly participants will be satisfied with the services provided which will be
measured by surveys.
SECTION V: ORGANIZATIONAL SUPPORT ACTIVITIES
Describe how your organization will do outreach and public awareness of program activities:
Public announcements will made during televised City Commission meetings, and on the City's Web.
SECTION VI: PERSONNEL
I understand that while this information represents a performance projection, I must receive approval
from the Office of Management and Budget prior to any operational or performance variations.
Signature and Title of Person Completing Form Print Name and Title
Page 2 of 2
Ib;:d%~~B
',;.). ,',<;i," "';',:Olilatiizati6n: Niime:,',::,'":,";;;Xi,;;;,,,,/.; "~;T:'::S;;,;::;:;';::;?"h,;,
of South Miami Parks and Recreation Department
. , II.
[§;)2':·i'i?;']Y: •• ii !jjN'E'IT:EM'i3tiD~dRM1n;'0'g§EV; [;\'0:<01
L~' --, .. c--;':;",'<; ~ram'Narii';f;:""',;;:,, ;:;~';"[j:" ;i»i (;"L,
South Miami Senior Meals
III. . IV., V. '.,
Total Cost to Agency by Revenue Source
Personnel ----1. Position
Fringes
2.~
Fringes
3, Position
Fringes
4, Position
Fringes
5. Position
... Fringes
6. Position
Fringes
7, Position
Fringes
Travel (describe in narrative)
Supplies (describe in narrative)
Equipment(de,,<:ribe in narrative)
Contractual Services (Construction Catering, Inc.)
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
Indirect Costs (describe in narratIve)
Indirect Costs (describe in narrative)
County
This Award All Other
County Funding I County Funding
$ 18,400
Federal City/State
Total Total
Federal Funding City/State Funding
All Other
Total
Other Funding
, ,'TOTAL: I.':V. "
Total Cost to Agenc
Of Each Line Item
For the Budget Period
$
$
$ 18,400
Attachment B (A)
C:3\:'o~~1
11/8/2012
"'Btidget.Peri()d ;:',:"
OCLi, 201Z-Sept. 30,2013
•
% of Total
Percent of Total
Charged to
This Award
100%
TOTAL AWARD: I $ 18,400 I 1$ -I S 1$ 18,400 I
Requested By: Alfredo Riverol, CFO
Executive Directorl Agency Designee Name
Executive Director I Agency Oesignee Signature
Reviewed By: _________________ _
OMS Contracts Officer Signature
111712012
Date
Date
Approved By: ________________________ _
Board President I Vice President Name
Board President I Vice President Signature
Approved By: ______________ _
OMB Contracts & Grants Administrator Date
Date
Fiscal Approval (if needed)
Accountant:
Supervisor:
City of South Miami
South Miami Senior Meals Program
Miami~Dade County
October 1, 2012 -September 30, 2013
DIRECT COSTS
Contractual Services
Senior Meals ($18,400.00):
Beginning December 1, 2012 -September 30, 2013, The City of South Miami Parks and
Recreation Senior Program will provide two (2) prepackaged meals (cantina~style) to sixty~three
(63) residents at the HUD Senior Center every Friday. The program will provide 126 meals per
week (one meal for Saturday and Sunday) for participants in the program. In total, the program
will provide 126 meals to 63 seniors (residents) at the HUD Senior Center every Friday for 43
weeks; which totals 5,418 meals during the contract period.
TOTAL AWARD: $18.400
Page 1 of 1
ATTACHMENT A (8)
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: jkorth@southmiamifl.gov
Fiscal Contact Person: Alfredo Rivero!, CFO
Phone Number: 305-663-6343 Fax Number: 305-668-7388
E-mail Address: Ariverol@southmiamifl.gov
Contract Amount: $26,775 Contract Period: October l 2012 -September 30,2013
SECTION II: 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 October -September excluding a ten week Summer
Camp Program (June -August). Funding will be used to provide tutoring services which will include
reading and math curricula, homework assistance,.,9ndJ~§L_ preparation for the Florida
Comprehensive Assessment Test (FCAT). Funding will also be used to provide age appropriate
socialization and cultural activities, such as field trips and curricula activities.
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) [Le., 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)]:
Page 1 of 2
ATTACHMENT A (8)
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.
Location of Service Site(s) and Hours of Service at each Site: (List all sites including the physical
street address with zip codes and the hours of operation for each site):
• The After-school House Program is located at the Gibson-Bethel Community Center, Murray
Park -5800 SW 66th Street. South Miami, Florida 33143.
• 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 -
6:00 pm, Monday -Friday.
SECTION IV: STATEMENT OF OBJECTIVES: (Define measurable and specific program objectives.
Please quantify and note timeframe for completion of each objective [Le.,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]).
• 80% of the children will increase their reading fluency and comprehension as measured by
various tests.
• 90% of the students will complete their homework assignments as measured by report cards.
o 95% of the children will participate in educational activities as measured by the participation
!Qfh
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.
SECTION VI: PERSONNEL
I understand that while this information represents a performance projection, I must receive approval
from the Office of Management and Budget -Grants Coordination prior to any operational or
performance variations.
Signature and Title of Person Completing Form Print Name and Title
Page 2 of 2
[fTI6fu~~2Sl
;'}('J;;"',:: .!):":;<~":: ;:Ol'gji,fijZiitfon\Narrt~'7::"; ::;: . "., """'··:·;:,;;r;:;;:\\{);;::;'8"::{;';'.;'.+1
of South Miami Parks and Recreation Department
Requested By: Alfredo Rivero!, CFO
Executive Director J Agency Designee Name
ExecutNe Director f Agency Oesignee Signature
Reviewed By: ___________________________ _
OMS Contracts Officer Signature
1117/2012
Date
Date
W,~'~;~E;:~iiilllNm~u6~T:@~~;i;':Dii,;;:j!t~2,;'7;i&.J
'::"i!;{.',::"::;'·: ;:;.;:~i:::::-:·;
, III., . TOTAL: I.-V. '
ApprovedBy: _____________________________________________ __
Board President ( Vice President Name
Board President / Vice President Signature
Approved By: ______________________ _
OMS Contracts & Grants Administrator Date
Attachment B (B)
r;",!·C:;fOiite,-::?·;,<:rj
11/8/2012
:"."., "P:'Btldge'tFeriod:":\;:7,"
Oct 1, 2012-Sept. 30, 2013
This Award
Date
Fiscal Approval (if needed)
Accountant:
Supervisor:
DIRECT COSTS
Personnel: Salaries
City of South Miami
After-School House Program
Miami-Dade County
October 1, 2012 -September 30, 2013
Teachers/Instructors ($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.
TOTAL AWARD: $26,775
Page 1 of 1
Attachment C
SID NO.:
BID TITLE:
COLLUSION AFFIDAVIT
(Code of Miami-Dade County Section 2-8.1.1 and 10-33.1) (Ordinance No. 08-113)
BEFORE ME, A NOTARY PUBLIC, personally appeared _---::-_...,.-__ -:--:::-:--..,.,--
who being duly sworn states: (Insert name of affiant)
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:
o 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 IT 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
thereof which have a direct or indirect ownership interest in another bidder or proposer
for the same agreement or In which a parent company or the principals thereof of one (1)
bidder or proposer have a direct or indirect ownership interest in another bidder or
proposer for the same agreement. Bids or proposals found to be collusive shall be
rejected.
By:
Signature of Affiant
Printed Name of Affiant and Title
______ ~~ __ --__ 20
Date
Printed Name of Firm
Address of Firm
SID NO.:
SID TITLE:
SUBSCRIBED AND SWORN TO (or affirmed) before me this ___ day of __ _
20_
He/She is personally known to me or has presented -------::::---:-:-:----c;:-:-...,..,----
as identification. Type of identification
Signature of Notary Serial Number
Print or Stamp Name of Notary Expiration Date
Notary Public -State of __ _
Notary Seal
-.
1'1laml-Uaae county
VENDOR AFFIDA VITS FORM
(Uniform County Affidavits)
Department of Procurement Management
Vendor Services Section
111 NW 1st Street, Suite 1300, Miami, Florida 33128-1974
Telephone: 305-375-5773
www.miamidade.qovldnm
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. It 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.
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 (rEIN) QI. If none, then enter the owner's Social
Security Number (SSN).
o FEIN
NORTH AMERICAN INDUSTRY
CLASSIFICATION SYSTEM (NAICS)
The North American Industry Classification 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.
o NAICS Code
A) Name of Entity, Individual(s), Partners or Corporation 8) Doing Business As (If same as line A, leave blank)
Street Address (P.O. Box Number Is not permitted) City
1. MIAMI-DADE COUNTY OWNERSHIP DISCLOSURE AFFIDAVIT
(Sec. 2-8.7 of the Miami-Dade County Code)
State (U.S.A.) Country ZIp Code
Firms registered to do business with Miami-Dade County, shall require the person contracting or transacting such busIness with the County to
disclose under oath his or her full legal nome, 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 publicly-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.
"no officer, director or stockholder owns (5%) or more 01 stock, please wrife "None" befow.
PRINCIPALS I
FULL LEGAL NAME TITLE ADDRESS
---
-
OWNERS I CHECK BOXES BELOW
GENDER RACE f ETHNICITY
" % Ha .i!:
FULL LEGAL NAME TITLE ADDRE.~S ~ '-
-~ Of M F 1 § " OWNfRsHt ?~ Q,l.~ I) '-,.g ii ,. ... -" OJ .g j '-OJ i3 a ~ .!1 .!2 ~~~ "" :t: «-"1
-» -I
-I »
(")
::I:
If a percentage 01 the firm is owned by a publicly traded corporation or by another corporation, indicate below in the space "Other Corporalions". :is: m z
OTHER CORPORATIONS % -I
OF 0 OWNERSftlP
--_I
9/28/2011 Page 1
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.
2.
3.
Does your firm have a collective bargaining agreement with its employees? Yes _____ _ No ______ _
Does your firm provide paid health care benefits for its employees? Yes No
Provide a current breakdown (number of persons) in your firm's work force indicating race, national origin and g"~~";T~-;::--"----
NUMBER OF EMPLOYEES
Males Fem"ales
White
Black
Hispanic
Asian/Pacific Islander
Native American/Alaskan Native
Other
Total Number of Employees I
Tolal Employees
3. MIAMI-DADE COUNTY EMPLOYMENT DRUG-FREE WORKPLACE CERTIFICATION
(Section 2-8.1.2(b) of the Miami-Dade Counfy Code)
All persons and entitles that contract with Miami-Dade County are required to certify that they will maintain a drug-free workplace
and such persons and entitles 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 sholl 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 occlJrring no later than five (5) days after
receiving notice of such conviction and impose appropriate personnel action against the employee lJP 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, slate 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 indicoting compliance with all requirements of the
Americans with Disabilities Act (AD.A.).
I, state that this firm, is in compliance with and agrees to continue to comply with, and aSSlJre 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 ond services, transportatIon, communications, access to facilities, renovations, and new construction.
The American with Disabilities Act of 1990 (AD.A.), Pub. L. 101-336, 104 Stat"'317, 42 U.S.c. Sections 225 and 611 including
Titles I, II, 111, 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 Fair Housing Act as amended, 42 U.S.c. Section 3601-3631
I, hereby affirm that I am in ~ompliance with the below sections:
Section 2-1 0.4(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 on 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 AFFIDA VIr
(Section 10.38 of the Miami-Dade County Code)
Firms wishing to do business with Miami-Dade County must certify that its contractors, subcontractors, offlcers, principals, stockholders,
or afflilates 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 OBt/GATlON TO COUNTY AFFIDAVIT
(Section 2-8.1 of the Miami-Dade County Code)
Firms wishing to transact business with Miami-Dade County must 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 Co~nty shall be allowed to receive any new business.
I, confirm that all delinquent ond currently due fees or to xes including, but not limited to, real and personal property taxes, convention
ond tourist development taxes, utility taxes, and Loco I 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 nome of the above firm, have been paid.
7. MIAMI-DADE COUNTY CODE OF BUSINESS ETHICS AFFIDA VIT
(Article I, Seelion 2-8.1 (i) and 2-11 (b) (1 ) of the Miami-Dade County Code through (6) and (9) of the County Code and County Ordinance No
00-1 amending Section 2-11.1 (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 011 business that Ihls 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 FAMIL Y 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 11 of the County Code, which requires that firms controcting
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 Corle, which requires that all applicable employers
entering a contract with Miami-Dade County sholl pay the prevailing living wage required by the section of the County Code.
10. MIAMI-DADE COUNTY DOMESTIC LEA VE AND REPORTING AFFIDA VIT
(Article 8, Section 11 A-60 -1 1 A-67 of the Miami-Dade County Code)
9/28/2011
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.
Page 3
AFFIRMATION
I, being duly sworn, do attest under penalty 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 comply with and keep current all statements sworn to in the above affidavits and registration application. I will notify the
Miami-Dade County, Vendor Services Section immediately if any of the statements attested hereto are no longer volid.
(Signature of Affiant) (Date)
Printed Name of Affiant and Title
NOTARY PUBLIC INFORMATION
Notary Public -
State of: __ ~ ________________ _
State County of
SUBSCRIBED AND SWORN TO (or offirmed) before me this day of 20 ____ _
by ________________ __ He or she is personally known to me D Or has produced identification D
Type of identification Produced _______________________________________ _
Signature of Notary Public
Print or Stamp of Notary Public
9/28/2011 Page 4
(Serial Numbet")
Expiration Dale Notary Public Seal
(When applicable)
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
1. This sworn statement is submitted to __________________ _
by ________ -=~--__ --~-----~---------------
(Print individual's name and title)
for
------------=~~~-~~~~~~------~~---.---------(Print Name of entity submitting sworn statement)
whose business address is _________________________ _
and if applicable its Federal Employer Identification Number (FEIN) is __ -,-----, ___ ~
If the entity has no FEIN, include the Social Security Number of the individual signing
this sworn statement:
2. I 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. I 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. I 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 I:?,een convicted of a public entity
crime
The term "affiliate" includes tho,se 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
10'2
person who has been convicted of a public entity crime in Florida during the
preceding 36 months shall be considered an affiliate.
5. I 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.)
__ 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 ENTERING INTO A CONTRACT
IN EXCESS OF THE THRESHOLD AMOUNT PROVIDED IN SECTION 287.017 FLORIDA
STATUTES FOR CATEGORY TWO OF ANY CHANGE IN THE INFORMATION CONTAINED
IN THIS FORM.
(Signature)
Sworn to and subscribed before me this _____ day of ________ _
20 __ , Personally known _______________________ _
OR Produced Identification _________ Notary Public -State of _____ _
______ ..,--___________ My commission expires ______ _
(Type of Identification)
(Printed typed or stamped commissioned name of notary public)
20'2
Agency Name: .'
""" .:. . ··.c
. .. .
Agency Address: .:.
Remit to Address:
Contact Person:
Telephone:
Prograin Naine:
MIAMI-DADE COUNTY
OFFICE OF MANAGEMENT AND BUDGET.
COST .. BASED CONTRACT
Print Month Below:
Approved Budget
Amount
. .' . . ",
Allocation Ainount: , ,"
Contract Number:
: '.'" ',..... "
Agreement Period: .
>:
ordinarice Number:
Today's Date:.
ATTACHMENT F
MIAMI
rmm'l
10/1/2012 -9/30/2013
0-12-70 and 0-12-72
December 10, 2012
are outlined in Column II below:
, II.,
Monthly Expenses
TOTALS:~$~ __________ ~$ __________ ~ ______________ ~
To avoid delays In payment, provide complete back-up documentation for all expenses listed in Column 1\
and provide appropriate authorization on the signature page (Page 2, over)
CB (rev, 11/16/09) Page 1 of 2
AUTHORIZATION
[ hereby certify that this expense report submitted by the undersigned constitutes approved budget expenses during the period listed above, and Ihat no expenses for which
reimbursement is requested bas been 01' will be reimbmsed by any olher funding sources.
Executive Director 1 Agency Designee Print Name Executive Director I Agency Designee Signature
December 10,2012
P";ntTitle Date
County/Department Use Only
C.O. NOTE;
VOUCHER#;
FISCAL PREPARED BY:
INVOICE#:
DATE; VENDOR#:
INDEX CODE:
FISCAL APPROVED BY:
SUB-OBJECT:
DATE: AMOUNT TO PAY:
CB (rev. 11/16/09) Page 2 0(2
Attachment G
"OFFrCE'OF.MANAGEMENtAND·SUDGET:;,····
;~:,;:!.·;;:::;~GI~~~~~~'~~~~f;::,······",:i.
~:;r~>/\: !~~~·<~Pt:~;(}?::,,::; .. :.';',:" ::.~<~~.:: :::t:}:: : ~.:; : ,: .. :: :,: :':: :": .. ::": ' . "', ):::::p:::\,::>; : :::::}(.: ::~:::": f ({:.~; .. ):> ~:; .:
10/1f2012 -9f30/2013
~~n;1~~~~r§2
Oct-12! Nov-12! Dec-12! Jan-131 Feb-13! Mar-13! Apr-13j May-131 Jun-131 Jul-131 Aug-131 Sep-1
distributed to
Page 1 of2 OGe 025 (rev. 10/19/09)
Attachment G
Program Problems Encountered this Month:
Auth Date
Page 2 of2 OGe 025 (rev. 10/19/09)
Approved Budget
Amount
. II.
Actual expenses from
Oct. 1, 2012 through
Sep. 30, 2013
ATTACHMENT H
MIAMI·
!!Blllii'l
10/1/2012 -9/30/2013
0-12-69,0-12-70,
0-12-71 &0-11-72
11/27/2012
III.
TOTALS;~ __________ ~~ __________ ~ ____________ ~
I hereby certify that this expense report submitted by the 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 other funding
Executive Director I Agency Designee Print Print Title
11/27f2012
Executive Director I Agency Designee Signature Date
CLS 09/10 (rev. 11/16/09) Page 1 of2
County/Department Use Only
CONTRACTS & GRANTS MANAGEMENT UNIT SECTION
C.O.
ALe BG c EHe SSe OTHER c
AFe CPe MLc TSe OTHER c
AN c DOc NRc YMc OTHER e
BS c DGc SJ c OTHERc OTHER c
C.O. NOTE:
FISCAL UNIT SECTION
PREPARED BY:
VOUCHER#:
DATE:
INVOICE#:
APPROVED BY: ___________ _
VENDOR#:
DATE: INDEX CODE:
SUB·OBJECT:
AMOUNT TO PAY:
CLS 09110 (rev. 11116109) Page 20f2
ATTACHMENT I
PROVIDER'S DISCLOSURE OF SUBCONTRACTORS AND SUPPLIERS
(Ordinance 97-104)
Name of Organization: ________________ _ Address: --------------------
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 subcontractors or sub-consultants who 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 SUB-CONSULTANT ADDRESS CITY AND STATE
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 "N/A",
NAME OF SUPPLIER ADDRESS CITY AND STATE
I hereby certify that the foregoing information is true, correct and complete:
Signature of Authorized Representative: _________________ _
Title: ___________________ _ Date: _____________ _
Firm Name: _____________ _ Fed. ID No:..... _______ _
Address: City/ StatelZip: _________ _
Telephone: --'-----J)'---_______ Fax: ,l,....{ _..l-________ E-mail: ____________ _
Page 1 of 1
ATTACHMENT J
AUTHORIZED SIGNATURE FORM
DATE:
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 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
Office of Management and Budget -Grants Coordination 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 -Grants Coordination.
NAME (please type) TITLE (please type) SIGNATURE
I. Prime Contracts and Subcontracts
II. Checks (List amount limits)
III. Budget Revision Requests
IV. Payment Requests