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_Add-on (B)To: From: Date: CITY OF SOUTH MIAMI OFFICE OF THE CITY MANAGER INTER-OFFICE MEMORANDUM The Honorable Mayor & Members of the City Commission Steven Alexander, City Manager March 19, 2013 2001 Agenda Item No.: • 0 It (b) --------------------------------------------------------------~~~~------ SUBJECT: BACKGROUND: A Resolution authorizing the City Manager to memorialize the month to month arrangement with Construction Catering for the weekend meals delivery service. The City of South Miami Parks and Recreation Department manages the Senior Program that takes place at the Senior Center located at 670 I SW 62 Avenue South Miami, FL 33143. The City has been awarded a grant from Miami-Dade County, Office of Management and Budget for FY 2013 in the amount of $18,400 to supply senior citizens enrolled in the Senior Program with weekend meals. The meals are delivered to each resident unit on Friday to be used for weekend meals (Saturday and Sunday). Beginning October I, 2012, the City has continued to utilize Construction Catering to supply meals for the weekend senior meals program on a month-to- month verbal contract. To comply with the grant agreement, the City is memorializing this month-to-month contract in the attached resolution. While service continued on a month-to-month basis, the City conducted a competitive bid for the weekend senior meals program to replace this month-to-month agreement and will award the remainder of the fiscal year to the most responsive and responsible bidder to provide weekend meals for the weekend senior meals program. EXPENSE $18,400.00 FUND & ACCOUNT I 14-3604-541-3450, Grants ATTACHMENTS: Resolution Signed Construction Catering Contract Grant Contract with Miami-Dade County Add-On Item (b) City Commission Meeting of 3-19-13 Sponsored by: City Manager-Parks & Recreation 1 RESOLUTION NO. ____ _ 2 3 A Resolution authorizing the City Manager to memorialize the month 4 to month arrangement with Construction Catering for the weekend 5 meals delivery service. 6 7 WHEREAS, the Parks and Recreation Department manages the Senior Program located at 8 6701 SW 62 Avenue; and, 9 10 WHEREAS, Construction Catering has been supplying weekend meals to seniors enrolled in 11 the Seniors Program beginning October 1, 2012 on Fridays to be used for Saturdays and Sundays 12 (weekend meals); and, 13 14 WHEREAS, Construction Catering has been operating on a month-to-month verbal 15 agreement to provide weekend delivery meals service; and, 16 17 WHEREAS, the County grant program that pay for the senior's weekend delivery meal 18 service requires a written agreement to memorialize the expenditure; and, 19 20 WHEREAS, the City has solicited bids for the weekend delivery meals service for the 21 Seniors Program and will be recommending the most responsive and responsible bidder; and, 22 23 WHEREAS, the City will utilize grant funds to purchase the senior's weekend delivery meal 24 service with a current allocation of$18,400 during FY2013. 25 26 NOW, THEREFORE, BE IT RESOLVED BY THE MAYOR AND CITY 27 COMMISSION OF THE CITY OF SOUTH MIAMI, FLORIDA THAT: 28 29 Section 1. The City Manager is hereby authorized to execute a written agreement 30 memorializing the verbal month-to-month agreement memorization of the month-to-month 31 agreement between the City and Construction Catering for the City'S Senior Program weekend 32 meal delivery service located at the Seniors Center. A copy of the agreement is attached. 33 34 Section 2. Severability. If any section clause, sentence, or phrase of this resolution is for 35 any reason held invalid or unconstitutional by a court of competent jurisdiction, the holding shall 36 not affect the validity of the remaining portions of this resolution. 37 38 Section 3. Effective Date. This resolution shall become effective immediately upon 39 adoption by vote of the City Commission. 40 41 42 43 44 45 46 PASSED AND ADOPTED this __ day of ,2013. ATTEST: APPROVED: CITY CLERK MA YOR 47 48 49 50 51 52 53 54 READ AND APPROVED AS TO FORM, COMMISSION VOTE: LANGUAGE, LEGALITY AND Mayor Stoddard: EXECUTION THEREOF Vice Mayor Liebman: Commissioner Newman: Commissioner Harris: CITY ATTORNEY Commissioner Welsh: Construction Catering, Inc Construction Catering Inc, will provide the following services to the City of South Miami at 6701 SW 62 Avenue, Miami, FL 33143. Contract Meals are based on the four-cycle four-week menus attached which are designed for the nutrition of adults by a licensed nutritionist, meeting the usual, one-third RDA required. Construction Catering will be closed on the following dates: Labor Day, Christmas Day, and New Years Day. Any other holidays not mentioned in this contract, may also be observed. We will cooperate on providing meals for these holidays and special arrangements including additional cost to be determined. Special meals will be provided as needed with sufficient notification from Monday through Friday only. Special meals may be Box Lunches. The food will be transported in thermos containers in order to maintain the proper temperature required by law. As a reminder, we are a current food vendor or supplier for Miami-Dade County. The cost per meal will be $3.40 per person for up to 70 clients receiving 2 weekend meals every week. Food quality is to be nutritional and of a good quality. Portion sizes are standard adult portions and labeled as often as practicable on the menus. All meals will be prepared and guaranteed in accordance with Miami-Dade County Bid # 9372-0115. Payment plans are as follow: Payments are due on the 1st day of each month and will not exceed a total of S 18,400 for the length of the agreement. This contract will be effective from October I, 2012 on a month to month basis and is not to exceed 8 months. Accepted on this bound. _____ day of ____ 2013, with the intent to be legally 1 ess (Authorized Representative) Witness (Authorized Representative) 2472 NW 21 TERRACE Miami, FL 33142 (305) 633-5668 FAX (305) 633-1489 City of South Miami \ CB AGREEMENT 13-SMIA-CB FY 2012-2013 County General Funds Ordinance # 12-70 AND 12-72 ..-:::::;? Sf-l~ This Agreement made and entered into as of this , .... .:>l day oC , by and between Miami-Dade County,. a political subdivision of the State of Florida (hereinafter referred to as "County"), having its principal office at 111 N.W. 1st Street, 19th Floor, Miami, Florida 33128 and City of South Miami, a municipality existing within Miami-Dade under the laws of the State of Florida, having its principal office at 6130 Sunset Drive, South Miami, Florida 33143 (hereinafter referred to as "Provider"), states conditions and covenants for the rendering of human and social services (hereinafter referred to as "Services") for the County. WHEREAS, the Provider provides or will develop services of value to the County and has demonstrated an ability or desire to provide these services; and WHEREAS, the County is desirous of assisting the Provider in providing those services and the Provider is desirous of providing such services; and 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 otherwise specifically noted, d) The word "Deliverables" shall mean all documentation and any items of any nature submitted by the Provider to the County's Contract Manager for review and approval pursuant to the terms of this Agreement. e) The words "directed", "required", "permitted", "ordered", "designated", "selected", "prescribed" or words of like import to mean respectively, the direction, requirement, permission, order, designation, selection or prescription of the County's Contract Manager; and similarly the words "approved", acceptable", "satisfactory", "equal", "necessary", or words of like import to mean respectively, approved by, or acceptable or Page 1 of23 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) "HIPM" 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 sale 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 B. 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 fetter. 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 Agreernent 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 of23 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 attomeys' 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 ali 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 shalf 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. 1st Street, Suite 2340 Miami, Florida 33128 8. 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 "8" 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 50f23 eB 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. L 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 sale 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 child care, day care, nursing homes, and boarding homes. . If the Provider fails to furnish the County with the licenses or certificates required under this Section, the County shall not disburse any funds until it is provided with such licenses or certificates. Failure to provide the licenses or certificates within sixty (60) days of execution of this Agreement may result in termination of this Agreement at the County's discretion. B. Background Screening. The Provider agrees to comply with all applicable laws, regulations, ordinances and resolutions regarding background screening of employees, subcontracted personnel, and volunteers. Provider's failure to-comply with any applicable laws, regulations, ordinances and resolutions regarding background screening of employees, subcontracted personne!, and volunteers is grounds for a material breach and termination of this contract at the sale 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 60f23 CB 13-SMIAwCB In the event criminal background screening is required by law, the state of Florida and/or the County, the Provider will permit only employees, subcontractors, and volunteers with a satisfactory national criminal background check through an appropriate screening agency (i.e., the Florida Department of Juvenile Justice, Florida Department of Law Enforcement or Federal Bureau of Investigation) to work in direct contact with vulnerable persons. The Provider agrees to ensure that employees, subcontracted personnel, and volunteers who work with VUlnerable persons satisfactorily complete and pass Level 2 background 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 (Confllct 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 pers(lnal financial interest, direct or indirect, in this Agreement. C. No person, including but not limited to any officer, member of a board of directors, manager, or supervisor employed by the Provider, who is in the position of authority, and who exercises any function or responsibilities in connection with this Agreement, has at the time this Agreement is entered into, or shall have during the term of this Agreement, received any of the services funded under this agreement, or direct or instruct any employee under their supervision to provide such services as described in this Agreement. Notwithstanding the before mentioned provision, any officer, member of a board of directors, manager or supervisor employed by the Provider, who is eligible to receive any of the services described herein may utilize such services jf 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 11A of the Code of Miami-Dade County ("County Code"), as amended, which prohibits discrimination in employment, housing and public accommodations on the basis of race, creed, religion, color, sex, familial status, marital status, sexual orientation, pregnancy, age, ancestry, national origin or handicap; Title VII of the Civil Rights Act of 1968, as amended, which prohibits discrimination in employment and public 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 seq., 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 § 11A-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 herd confidential; 5. Making Protected Health Information (PHI) available to'the customer; 6. Making PHI available to the client for review and amendment; and incorporating any amendments requested by the client as may be required by law; 7. Making PHI available to Miami-Dade County for an accounting of disclosures; and 8. Making internal practices, books, and records related to PHI available to Miami-Dade County for compliance audits. PHI shall maintain its protected status regardless of the form and method of transmission (paper records and/or electronic transfer of data). The Provider must give its clients written notice of its privacy information practices, including specifically, a description of the types of uses and Page 8 of 23 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 JKorth@southmiamifl.gov Either party may at any time designate a different mail or email address and/or contact person by giving written notice as provided above to the other party. . ARTICLE 13. AUTONOMY Both parties agree that this Agreement recognizes the autonomy of the contracting parties and implies no affiliation between the contracting parties. It is expressly understood and intended that the Provider is only a recipient of funding support and is not an agent or instrumentality of the County. Furthermore, the Provider's agents and employees are not agents or employees of the County. ARTICLE 14. SURVIVAL The parties acknowledge that any of the obligations in this agreement, including but not limited to Provider's obligation to indemnify the County, will survive the term, termination, and cancellation hereof. Accordingly. the respective obligations of the Provider under this agreement, which by nature would continue beyond the termination, cancellation or expiration thereof, shall survive termination, cancellation or expiration hereof. Page 9 of23 CB ARTICLE 15. BREACH OF AGREEMENT: COUNTY REMEDIE§. 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, rep<2rt~ 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 ~ny 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 c,i'b6ve. 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 oetermined. 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. p~YMENTPROCEOURES 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 sale 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. Payment 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 OMS must receive the Monthly Summary of Expenditures Report and the Monthly Performance Report no later than the 21st day of the month following the month in which services were provided. The Monthly Summary of Expenditures Report shall reflect the expenses incurred by the Provider for the 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 OMS 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 OMS staff reviews and approves the payment request, the OMS 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 performance, 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 sale 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 eB 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, fiscar, 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 OMS 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 aU 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 shat! 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 J 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 exeir~tion 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, sign"ed 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 shaH furnish the OMB with monthly progress/performance reports in accordance with the activities and goals detailed in Attachments A and F of this Agreement. The reports shall explain the Provider's progress for the month and, in the event that its activities are seasonal, must clearly indicate when specific services and related expenditures will occur. The data should be quantified when appropriate. A corrective action plan must accompany all progress reports that indicate that the Provider is not meeting its expected service goals or expected performance levels. The final progress report shall be due no later than thirty (30) days after the expiration or termination of this Agreement. M. Monitoring: Management Evaluation and Performance Review. The Provider agrees to permit County authorized personnel to monitor, review and evaluate the program/work which is the subject of this Agreement. The OMS shall monitor both fiscal and programmatic complianCe with all the terms and conditions of the Agreement. The Provider shall permit the OMS to conduct site visits, client assessment surveys, and other techniques deemed reasonably necessary to fulfill the monitoring function. A report of the OMS'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 cllent chart for each clienUfamily 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 Pian/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 n() later than January 1 sl 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 JG for inspection and copying. The IG shall have the power to report and/or recommend to th~ 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 sale 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. Notwithstandlng, 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), Sectlon 2-8.1.4 of the Code of Miami-Dade County, Administrative Order No. 3-19, and the Florida Prompt Payment Act, payments must be made within thirty (30) days of receipt of a proper invoice. Failure to issue prompt payments to small business subcontractors or adhere to dispute resolution procedures may be groundS for suspension or termination of this Agreement or debarment. ARTICLE 22. LOCAL, STATE, AND FEDERAL COMPLIANCE REQUIREMENTS Provider agrees to comply, in accordance with applicable professional standards, with the provisions of any and all applicable Federal, State and the County orders, statutes, ordinances, rules and regulations which may pertain to the Services required under this Agreement, including but not limited to: a) Miami-Dade County Florida, Department of Business Development Participation PrOVisions, as applicable to this Agreement. b) Miami-Dade County Code, Chapter 11A, Article 3. All Providers and subcontractors performing work in connection with this Agreement shall provide equal opportunity for employment and services without regard to race, creed, 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 FAR. 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 0: 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 of23 CB IN WITNESS WHEREOF, the parties have executed this Agreement effective as of the contract date herein above set forth. MIAMI-DADE COUNTY By: Name: Name: Title: Title: Date: Date: ~ f L~3;111~--"--- Attest; Attest: HARVEY RUVIN, Clerk /,dd --Soard of County Commissioners - .. " .. -.""-,"'"''"~ Print Name: Maria M. Menendez By: Title: Print Name: Corporate Seal OR Notary Seal/Stamp: Page 23 of 23 ATIACHMENT 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,; __ ,~.§!l1rufer 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: $18AOO 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. cultur£!t_ educationalt-.Elld recreational opportunities for seniors residing in the City of South MiamI. In adqition, the_PI9ilr~m will create S! 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 b@ Rrovided to re~nts at the HUD ~enlor Center for [?,articipants regardless of race, reliqion, 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 Pe.rks and Recreation Department. the City ()L~>-(;uJth.MjE_mi wi!! provide preQarect meals to sixty-threELL<?3) residents that participate in activities at the HUD Senior Center located in Soutlt 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) Th~ Senior Meals Progrqm~ilLp'£9vide two (2Lgfe-packaqed mealsJ:.cantina-style) to aPRt~qximately sixty-three (63) residents at the HUD Senior Center every Friday Thl?program will provide 12.§..rneals per week (63 seniors X 2 m~~§ .. ~er week) for 43 weeks, which totals 5 ....... 418 meats (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 t7guals lli18,421.20 The aeneral unit cost was calculated as follo'l1l8: $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 Clli of South Miami Senior Center is located at 6701 S.'ilLg?-nd !Wenue. South Miami. Florida 33143. The hours of QQ!2falion are Monday-Friday from 7:00 am -3:00 pm. SECTION IY: STATEMENT OF OBJECT!VES: (Define measurable and specific program objectives. Please quantify and note timeframe for completion of each objective [i.e.,75% of children attending after school tutoring program will increase their reading score by a full letter grade as measured by pre and post-testing during the contract year]). • 100% of the elderly particiQants that receive weekend meals wi!! satisfy one of their basic needs. • 90%~f the3IdEill:Lparti.9Pants will gain sufficient nutrltion 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 annOUl]9.?ments 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. Page 2 of 2 ;'2:: ~~.~::-¢ .. \ [t,,;~.~~:~.'~~~·~:m;;:v~:::. 'P~~·N~.";~~~ ~~.<' ,', ~ ::';' "...:,\ :·.·.:Otga·niiatlorr·Name:;O' ".;--;~~-:~ ~'::".';~ ::'.:. '\'.. ~ I City of South Miami Par~ and Recreation DeE!l..rtment I ····;,c:--··· .. ·.C':·-:;l'i~lfram·'t~al'M .. ;':.'.' .... ;:,~:.:.; ".?;i·' : ..•• ",,'.: '1 '-_______ S~uth Miami Senior Meals 1 Attachment 8 (A) pi: '~1'~~:12': "'j ' .... !;lud§etPeri~;l Oct. 1, 2012-Sept. 30. ~~~ ,..,.....,.,.....".,...,.,..".,.._....,.....,...".,.....,.,......,... __ ...,.,.......,.===_..,-".,.....".,..."......,=.,' ... · •• 0-11.;41 •• ' ... "",11 ....... VF Bli ) l\1'4U"'I!IINM~_!l"·m li6ie~tCl~~:~~irl~; :'.'Y'; >,:i~:':' .. ;Jt:;,<:,·:I.~i;·:;~ This Award Counw All o::~1 C~stt¢ ~= by R~VGnUe ;i~:~~te L A~~~~er _. ::~i::~:~~:{~~:; pe~~~~~!~ital iCIRECT·.COS-TS." ..... <.:;:.c· .. · .< i·c" ': ...... ,.. ' .•.• ; .:·:c· .• ' County Funding I County Funding 1 Fed~ral Fundlng 1 ~iwJState Funding I Other Funding This Award Personnel lii.OSiticnF-····"'=r ········l-----IS ! Fnn.ges 2. Position ·-l-·---··'-.~:: __ s Fringes I _ .... __ ... I~. I :3. Position -ll'-------+-----f-:S:..-----.:.....f--------l I Fringes +-1 ____ . _____ ~ ___ +_---_....j-----_+-_--_; -----+------1.-------+--------1 '4. Posttion -I Frrn,ges 5. Position --F~g~e~S~----------------------------------------1_-------------;------------i--------------r_--------------5, Pc.sltSo~ Fringes 7: Position Fnnges ;TraveI (describi? in narrative) lSuppHes {tit'.-scribe in narrative) !Iguipmont (d<lscrlb .. in.!:'_~cr:atlve) ! IContractuat Services {Con.struction Catering. Inc., S 'Other Direct Costs (d,:s~ribe in ""native) ! I Other Direct C<>sts (rle!!eribe in nam:::-:iv"'''''') ____ _ Other Direct Costs {descdb€ I.~n.:.~:::3.:.:rrc:n:::ti~ve~)~-------------!--_____ + Other Direct Costs (d':>'Jcribto in namltfve) IN01RECr.coSTS: .' . '.; ., .. Personnel !~wpOsition Fringes --1 12 Position--~-i Fringes !indirect Costs (describe in narrative) Indirect Costs (deS~rib. In narrative) .. TOTAL AWAAO:! $ 16.400 I . Is Is -1$ 18.400 I 11f712012 Date fL Reviewed By: ' ~{~' ,>" OMS Cvnt-acts Office1'iS~gnaturf! Date App~edBy: __________________________________________ ___ Board Pro$iclent I Vice Pre:Sid~nt Name Board President I Vice President Signature Approved By: ______________ _ OMS Co.tracts & Grnnis Admlni.trotor Date Date Fiscal Approva[ (if needed) fAccc'Jtdan.t Supervisor: DIRECT COSTS Contractual Services Senior Meals ($18,400.00): City of South Miami South Miami Senior Meals Program Miami-Dade County October 1,2012 -September 30,2013 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 (B) MIAMI-DADE COUNTY OFFICE OF MANAGEMENT AND BUDGET GRANTS COORDINATION SCOPE OF SERVICE NARRATIVE SECTION I: GENERAL INFORMATION Name of Organization: City of South Miami, Parks & Recreation Department Address: 61~Q~[lset Drive, South Miami, Florida 33143 Program Contact Person: Jennifer E. Korth, Grants and Sustainable lnitiabves Administrator Phone Number: 305-668-2514 Fax Number: 305-663-6345 E-mail Address: ;korth@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: $26,775 Contract Period: October 1, 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-cSchoo! House Program is to provide positive social. cultural. educational, and recreational opportuI1ities for children residing in the City of South Miami. The program will also create a friendly environment and essei1tia! after-school services to patiicipants regardless of race, religiol1 gender, family income, and/or abilitY.J.QJ.;illy for children ages 5 -16 years. Describe the program and services and hoW program funding will be used: The After-school HOJ,Lse Prow'am oQgrates from October ~ September excluding a ten week Summer Camp Pr9grarrUJlIne -Aupust).:.EuncHng will be used to provide tutoring services which will include reading qruJ~mat..h . curricula, homework assistancst.. .. a,ng .... te~t ,_ Qreparation for the Florida Comprehensive _~§.§essment Test (FCAD. Funding will also be used to provide age approQri~te socialization aosLcultural activities'osuch 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) [i.e., 3 hours of after school care for twenty-five (25) children ages 5 -10, one home delivered meal for 50 seniors every day (18,250 meals)]: Page 1 of 2 ATTACHMENT A (8) The prog@.m takes place 39 weeks thrQughout the year and two hundred (200) children wades 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 s~rve. two hundred participr.mts (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 Pm.9I£lmjs located. at the Gibson-Bethel Community Center, Murrc\y Park -5800 SW 66th Street, South Miami, Florida 33143. • Hours of Ope[<;!tiQnlgr the Cente~ are Mond<;l}f_-Friday, 5:00 am -10:00 pm, Saturday. 9:00 am -6:00 p!Ih..~n9 Sunday, 1.Q;OO_ii!I11. -6:.Q.Q_pm and servicQs will be grovided from 2:00 pm - 6;00 pm, Monday -Fridav. SECTION IV: STATEMENT OF OBJECTIVES: (Define measurable and specific program objectives. Please quantify and note timeframe for completion of each objective [i.e.,75% of children attending after school tutoring program will increase their reading score by a full letter grade as measured by pre and post-testing during the contract year]). • 80°/(1 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. • 95% of the children will pa~ate in eguc.ational activities as measured by the parth:;jpation m 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 pubHc announcements during televi®J! 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. ~ijL-=s _,,- 77t'l=lre~an'd Title of Person Completing Form Print Name and Title if Oty KS ~ llCYe.~1H)V! Page 2 of 2 e )8 ~E!Xi(.e.~~'l ~gt&1ri.,mp~q.~1:"l·· i.I.> ~ ,:1 p;~,.*;fi:.:Ai1~:~2,:·' A L' > ~ > ~Otganiti~idn:t':ame ".:- Ci!,Y of South Miami Parks and Recr~atlo!1 Depart!T!."'."'n:.t ___ _ Attachment B (8) . >;;LlNEITei.i:!i!.iPGtif.oy;.rll '.; .. ':'.:~ /.... .... '11~;~~1~> . J ; ',' ';'.Prdiiiiin Nam'k:';:;~; : . .i .. ~ Afterschool HouselTut£ring Program 'en.. _1,.1 ""_i.lM§B!!II"!iN'4~ Revenue Source Total Cost to A en == % of Totai 1--:=--:_-;:::.'!::r:!.....-:-:-.-::-;:-__ +_-!.~7!;~ __ -+ ___ C~lty!!.fS~la~l~e __ + __ ,AI! Other Of Each Lmeltem Percent of Total I Total Tolal Forth& Budget Period Charged to b.:;;,:-:=:::-;::'~=~..;.;~.;,.;;;~":"'"::'-'-'-" ...... ':-i-~...;.+":-":"';;:.,...;.;..;.;.,,;;,;,;-l Federal Funding CltyfSlate Funding Other Funding __________ Thi':-'~~rd ! Personnel ---l! $,925 I B,925 100% p. Position TeachersJInstructors $ $ 1 Fringes~ $ 12. Position TecachersJlostnJctors $ -'---8,925 $ 8,925 100% j ;:::rir;g=~ : 3:, Position Teachersllnstructors h 8,9251 s Is 8.925 100% Frinpes I I $ :4. Pasitio!' ____ 1 s Fringes i I :5. Posifon I I Frin2es 16. Position i Fringes s s $ $ s '7. Position $ Frinaes $ I Travel (descrlbe In narrative) 1 $ ISuPPlles (describe in narrative) $ I EqUipment (describe in narrative) $ IContractual Services ~I~:~:~ ~::: ~:::~:::~::: :~ ~::~::: -: i __ -\t...:F~:...····_·_···"_" ------'1-+------------1 9th"r Direct Cos.!" (describe in narrative) L_. ___ I' s I Other Direct Co5t$ (describe in namllive) I $ Personnel 11. POsiti\_n ______ 1 I I Fringes __ ~_.L_._ .. __ .__ 1 ______ _ 12 Poshien .1 I rnnges I.. '-------- Iindire<:t Costs (describe in narrative) i ... 1$ TOiALAWARO;1 $ 26,7751 .. I $ I . Requested By: AlfrqrliJ Riverol.. ~ £r.,i:. , ~ Approved By: :~_, _____________________ _ ~~c:~lN.~b !' .... ---} I !, RevieWed By: :; .. C ' .0::..... _-"'-__ _ OMS Corilracts'Offlcer Signature f 111712012 Date Date Board President ( Vice President Name Board President I Vice President Signature Approved By: ______________ _ OMS Contracts &. Grants Administrator Date Date Fiscal Approval (if needed) V\ccountarrt: I Supervisor. DIRECT COSTS Personnel: Salaries City of South Miami After-School House Program Miami-Dade County October 1, 2012 -September 30, 2013 Teachersllnstructors ($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: $26.715 Page 1 of 1 COLLUSION AFFIDAVIT [ Attachment c J BID NO.: BID TITLE: (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 S!:tl/O(J A1e"()Jy:~a.f who being duly sworn states: (Insert name of affiant) I am over 18 years of age, have personaf knowfedge of the facts stated In this affidavit and I am an owner, offfcer, director, principal shareholder and/or I am otherwise authorized to bind the bidder of this contract. I ~te that the bidder of this contract: ;6 is not related to any of the other parties bidding In the competrtive 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. QB o is related to the following parties who bid in the solicItation which are Identified and listed below: Note: Any person or entity thaI 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 9iroot"tlr indirect ownershIp interest in another bIdder or proposer for the sam~/",g(eement Bids or proposals found to be cotrusive shall be rejected. _,/ By: / ---,-I +-,.1 :->+11 __ 20 2 Oa\e . Printed Name of Firm \)f\~,{t Dn ¥(4_:~~(}\clv\ ill'.D=,n-,-'1 l,-+-,---"",-_-,,--,,--,---,--?_'_ Address of Firm • SID NO.: BID TITLE: /1 f) 7 • .. / SUBSCRIBED AND SWORN TO (or affirmed) before me this ~ day O~}LC:"'ki ,:£pAtJ ~~I~;>. .... i)! (/ / H~/She is RQrsonally knownto'rne or has presented ----.---:o:c:----:-:-:-........,,,,,.--:-:--~- '_.-' as idelltif~J{rd(1: ' ./ ", Type of Identification / /i/ '. ",? /' / ",,:~\Yit Ie ~i'~~~~i~f~,~~~4 ' i, /7!l£LY:! ;(, J..~;.c'Ll1. Print or Stamp Name of Notary Notary Public -State of' -;';1761 """,k • Serial Number Expiration Date Notary Seal MARIA L GARCIA MY COMMISSION # OD 697582 l! EXPIRES: October 2,2013 ;-' Bonded Tnru Notary Public Und9lWritefS /YItaml-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,m;i!midade.govLdpm The completion of the Vendor Affidavits Form allows vendors to comply with affidavit req(llrf>mf'nt.~ (Jlltlinp.ci In Ser.t/on 7.-8.1 of thft "orift 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 afl affidavit information up to date and accurate by submittIng any updates to the Department of Procurement Management, Vendor Services Section. ____ L~h:tjLt ;:},e01Y1 \~A!C~\.IY1~ A) NJmc of Enflty, Indlvldvpl(s), Partners or CorpororiOlL _, .. __ t~~{0J) StJ():;l.tf2~L~_q~ __ "'m_m_ _~tJ, Street Address (P.O. Box Number Is not permitted) City J. MIAMI-DADE COUNTY OWNERSHIP DISCLOSURE AFFIDA VIT (Sec. 2-8.1 of the Miami.Dode County Code) FEDERAL EMPLOYER IDENTIFICATION NUMBER (FEIN) In order to establish a file for your firm, you must enter your firm's FEIN. This number becomes your "County Vendor Number". Please enter your Federal Employee Identification Number (FEIN) 9L If none, then enter the owner's Social Sewrlt1 Number (SSN). lS1 FEIN ,e:;~,~,(f~VILYjt ______ _ NORTH AMERICAN INDUSTRY CLASSIFICATION SYSTEM (NAICS) The North American Industry Classification System (NAleS) is tho standard used by the federal statistical agencies In classifying business establishments for the purpose of col/ectlng, analyzing and publishing statistical datI' related to the U.s. business econDmy. o NAICS Code Firms registered to do business with Miami-Dade County, sholl require the person contracting or transacting such business with the County to disclose under oath his or her full legal name, and business oddress. Such contract or tramactlon sholl also require the dlsclowre under oath of the full legal name ond business address of all individuals having ony Interest (legal, eqLJitable, 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 corporotTon the foregoing Infonnation sholl be provided for eoch officer and director and each stockholder holding, directly or Indirectly, frve (5) percent or more of the outstondlng slock Tn the corporation. If the contract or business transoctlon Is with a partnership, the foregOing information shall be provided for each partner. If the contract or business transactlon Is with a trust, the foregoing InformatIon sholl be provided for the trustee and each beneficiary of the trust. The foregoing dIsclosure requirements sholl not apply to contracts with publicly-traded corporations, or to contracts with the United States or any deportment or agency thereof, the State or any political subdivision or agency thereof, or any municipality of thls State. Use dupl1cate page If needed for additional names. IF no o((l<;er, clireclor or stockholder OWIIS (5%) or more of stock, please write "None" below. PRINClPAlS FULL LEGAL NAME nnE ADDRESS .---------- .... ,,----------------- OWNERs-------l-.. CHECK BOXES BELOW FULL LEGAL NAME TITLE % 01 oWNmsMrt ---_·_-------------1----;1-- GENDER _~A~IJ ~ICITY ADDRE'SS M F 1---------------------·------·---+---+--11----· I-~. ----t--_______ ~ ___ ,_ .. __ ....... _ ....... " .......... _____ . __ ....... _ I /I a perc@ntf1ge of 'he firm i. oWlled by a p<JbJicly traded corporalion or by another (orporal/on, indicale below in the space "Other Corporallons". OTHER CORPORA TJONS ~ :r s: m z -I o ~~=o.:~,.[:=.---~=--JO~lUJ= ___ ,t. _______ ._ . _. ____ j ,[1 __ 0=1= ____ .L-J 9/28/2011 Pogo I -----------------------------~-~--.------ 2. MIAMI-DADE COUNTY EMPLOYMENT DISCLOSURE AFFIDAVIT (County Ordinance No. 90-133, amending Section 2.8-1 (d)(2) of the Miami-Dade County Code) The following information is for compliance with all items in the aforementioned Section: 1. Does your firm have a collective bargaining agreement with Its employees? .~ No 2. Does YOlJr flrm provide paid health care benefits for its employees? ::: -··7-·····-_······· No 3. Provide a current breakdown (number of persons) in your firm's work force Indicating race-;notionaTOrlgln and g';~d;;::--. -----------------_ .. _ .•.•.... _ •....•..•.... _ .. 3. MIAMI-DADE COUNTY EMPLOYMENT DRUG-FREE WORKPLACE CERTIFICATION (Section 2-8. J .2(b) of fhe Miami-Dade Counly Code) Total Employees All persons and entitles that contract with Miami-Dade County are required to certify that they wlll maintain (I drug·free workplace and such persons and enllties are required to provide notice to employees and to Impose sanctlons for drug violations occurring In the workplace. In compllcmce with Ordinance No. 92-15 of the Code of Miami-Dade County, the obove named firm is providing a drug-free workplace. A written statement to each employee shall inform the employee about; 1. Danger of drug abuse In the workplace 2. The fIrms' policy of maintaining a drug-free environment at all workplaces 3. Avallabillty of drug counseling, rehabilitation and employee assistCInce programs 4. Penalties that may be imposed upon employees for drug abuse vIolations The firm shall olso require an employee to sign a statement, 0$ a conditIon of employment that the employee will abIde by the terms of the drug-free workplace polley and notify the employer of any criminal drug conviction occurrIng no later than fIve (5) days after receiving notice of such conviction and impose approprIate personnel action against the employee up to and including termination. Firms may also comply with the County's Drug Free Workplace Certification where a person or entity is required to have a drug-free workplace policy by another local, state or federal agency, or maintCIins such a policy of lt~ own accord and such policy meets the Intent of this ordinance. ------------.~---.. "'"---------------.----. 4. MIAMi·DADE COUNTY DISABILITY AND NONDISCRIMINATION AFFIDA Vir (Article 1, SectIon 2-8.1.5 Resolution R182-00 Amending R-3B5-95 of the Miami-Dade County Code) Firms transacting business with Mlami·Dade County sholl provide an affidavit indkating compliance with all requirements of the Americans with Disabilities Act (A.DA). 1, stote that this firm, is in compliance with and agrees to continue to comply with, and assure that any subcontractor, or third party contractor sholl comply with all applicable requirements of the laws Including, but not limited to, those provisions pertaining to employment, provision of programs and services, transportation, communications, access to facilities, renovations, and new construction. Tne American with DIsabilIties Act of 1990 (A.DA), Pub. L 101-336, 104 Stat"'317, 42 U.S.c. Sections 225 and 611 including Titles I, II, III, IV ond 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 os amended, 42 U.S.c. Section 3601·3631 I. hereby affirm thot f am in 5=Omp/iqllce wifh fhe below sections, Section 2-1 0.4 ( 4)(0) of the Code of Miami-Dade County (Ordinance No. 82-37), which requires that all properly licensed architecfural, engineering, landscape architectural, and land surveyors have an affirmative action plan on file with Mlami-Dode County. Section 2·8.1.5 of the Code of Miami-Dade County, which requires thot firms thot have annual gross revenues ;n excess of five (5) million dollars have on afffrmative action plan and procurement policy on file with Miami-Dade County. Firms thaI have a Board of Directors that are representative of the population make-up of the notion 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 Counly must certify that its contractors, subcontractors, officers, princlpals, stockholders, or affiliates are not debarred by the County before submitting a bid. I, confirm that none of this firms agents, officers, principals, stockholders, subcontractors or their affiliates ore debarred by Miaml- Dade County. 6. MIAMI-DADE COUNTY VENDOR OBLIGATION TO COUNTY AfFIDAVIT (Section 2-8.1 of the Miami-Dade County Code) Firms wishing to transact busIness with Mfwnl-Dade County must certlfy thai all de/[nquent and currently due fees, taxes and parking tickets have been paid cnd no indIvidual or entity In arrears In any payment under a contract, promIssory note or other document with the County shall be allowed to receive any new business. I, confIrm that all delinquent and currently due fees or taxes including, but not ilmited to, real and personal property taxes, convention and tourIst development taxes, utility taxes, and Local Business Tax Receipt collected In the normal course by the Miami-Dade County Tax Collector and County I~sued parking tickets for vehicles registered in the nome of the above firm, have been paid. 7. MIAMI-DADE COUNTY CODE OF BUSINESS ETHICS AFfiDAVIT (Arficle 1, Section 2-8.) (i) and 2-11 (b) (l) of Ihe Miami-Dade County Code through (6) and (9) of the County Coda and County Ordinance No 00-j amending Section 2-11.) (e) of Ihe Counly Code) Finns 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 Busrness Ethics shall apply to all busIness that the contractor does with the County , and shall, at a minimum; require the contractor to comply with all applicable governmental rules and regulations. I confirm that this firm has adopted a Code of business ethics whIch complies with the requirements of Sections 2-8.1 of the County Code, and that such code of business ethics shall apply to all business that this firm does with the County and shall, at a mInimum, require the contractor to comply with all applicable governmental rules and regulations. 8. MIAMI-DADE COUNTY fAMIL Y LEA VE AFFIDA VJT (Article V of Chaptor 11 t 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 thb 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, thi. firm complies with ArtIcle V of Chapter 11 of the County Code, which requires that firms contracting business with Mlaml,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 oro required to certify that they provide family leave to thelr employees. -------------------- 9. MIAMI-DADE COUNTY UVING WAGE AFRDAVIT (Sedion 2-8.9 af the Miami-Dade County Code) All applicable contractors entering into a contract with the County shall agree to pay the prevoiling Jivlng 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 (Q,oe: which reqvires that 011 applicable employers entering a contract with Miami-Dode County shall pay the provolling living wage required by the section of the Counly Code. 10. MIAMI-DADE COUNTY DOMESTIC l.EA VE AND REPORTING AFFIDAVIT (Article 8, Section 11 A-60 -11 A-67 of the Miami-Dode County Code) 9/28/201 J Firms wishing to transact business with Mlaml-Dode County must cerllfy that It Is In compliance with the Domestic Leave Ordinance. I confirm that if opplkable, this firm compUes wIth the Domestic Leave Ordinance. This ordinance applies to employers that have, In tho 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 /, being duly sworn, do attest under penalty of perlury that the entity Is Tn compliance with all requirements outlined In these Miami-Dade County Vendor Affidavits. I also attest that I will comply with on;:l.-1<ccpcurcol;' 011 statements sworn to in the above affidavits ond registration application. I will notify fhe Miami-Dade County, Vendor ji,;,.r;1c;,;s Section immediately if any of the statements attested hereto are no longer valid. ---7", -::~ ?~s/.;<~" ~'~:";~f~-A'-f#f'I"-'j" .••••• :~.~~.~~ .•••. --. __ I L (I /20 t3(D ) .J-rgll,,!-Iv(o 0 ant ate (\1 .// 1:' XflV 2 IL~d . :l1L) if' NOTARY PUBLIC INFORMATION SUBSCRIBED AND SWORN TO (or affirmed) before me this _.:r:.:..I'_' __ _ day of 20 "_....,..l. __ _ 9/28/2011 P<lOO 4 Or has produced identiFication 0 '" ~~.-------""""'-.<"'~---'---'--'~~--(Serial Number) MY COMMISSION ~ 00897582 EXPIRES: October 2, 2013 Bonded Thru Notary Public und~~.fS_ 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 l. This sworn statement is submitted to Mi !1\1'li~ Oru:t~ C€l\k)'j i Qf{1<L & tII.rf t~ bU{0 tt , , > F\) I ,.. j ~ by ,~:)l g. V Ul II r ( K {~yl(i1e(, ( "AHA }v\ 0, i) il (fly (Print iftd'~i-'-viL.dLu[-'<:~fi:-s-"n--"a'.l..mJ!,;;e~a"'-rH":r.itit'-le-)----------- for () kl1 S:~; vth A-A Iftt-'ll 1 __ _ . (Print Name of entity submitting sworn statement) whose business address is jQ 13D J u,f)j, tt 1M V t I \'b ctr. hAt ~vY\ i J ~ -1.i~i -13 and if applicable its Federal Employer Identification Number (FEIN) is lj{J'} f1;Or)O ~~; j 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 Qeen 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 1 of 2 person who has been convicted of a public entity crime in Florida during the preceding 36 months shall be considered an affiliate. 5. 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.) _6either the entity submitting this s~orn 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 ~T!;~i:; F~R ~~~~~~~~~g ~~f~:~::r?ci~~~TWE~~ci~~Ai:g:~~~~~~~~ IN THIS FORM. r "".' .?~::~~~;)w~---.. ~--... -.. " .......... . /.<~::~/' ,. . (Signature) /"./ Sworn to and subscribed before me this d<----..,--day of . /" /' I'? ~7--~~--- 20 J'?> . Personally known S0~"-~,~ (~. <t.LO~ ( OR Produced Identification Notary Public -State of _--L~~--=';'---':;.;-= . __ -,--..,,--__________ My commission expires ______ _ (Type of Identification) 1'11/)12;4-. ... L C·~·~~.U1. ___ _ (Printed typed or stamped commissioned name of notary public) 20(2 ATTACHMENT F MIAMI·DADE COUNTY OFFIc'E OF MANAGEMENT AND BUDGET COSt·SASE:D CONTRACT MONTHLY SUMMARY OF EXPENDITURES REPORT Agency Nama: ---------+._-_._------ Reinlt to Address; Contact Person; Telephone': Program Name; Actual operating' expllnsos covering the MOnth of; . >,.g~~~oV~;i S\;d~[;t :U~;~it~~~ . b·iR'~dt· Cd.$ts"L" ~~";';;" .. " ,: :"(,,\ : .' : .. ;.: ::.; ~ >~.' ::~/.' ;., Personnel 1. Posi.~ti.:o:onc:..... __ Frin. es f-:--'---"-"""'-'---•••.... --.----... -.....• -.------- 2. Position Fringes 3. Position Fringes AUocailOJ1 Amount: Contract Num'ber; , Agreement Perlod~ 10/1/2012·9/30/2013 Ordinance Number! 0-12-70 and 0·12-72 Today's Date: December 10, 2012 -.-----------.---.-----'------.. ~-.-.-.- Print Month nUl(>\'/; Approved Budget Amount ~to otililned in Column II below: Monthly Expenses \',OMG Use Onty .. ~:" "JDo;,o(wih~lnthis·i:oftlfTi!1l·. '. ---1--------_ .. -------- 4. Positlo~I __________________ _ Frin9.5'·.;cs ______ _ Position Frinaes _ .. ~.~~'>f.,._. ________ ,".H"' .. N .. >"~._..,.~ __ "', 9.!l1~~ Dime! Q£~t~(~~~c!.ibe l_n_n_u_r_Ta.ctc.;iv-,c.,.l ____ _ Ot~~ Direct QE§l!' .. '<cl.~~!:ribe in narrative) Other Dire~'!'9osts (describe in narrative) Other Dir~~t Costs {describe in ri;;lrralive} 91her Direct Costs (describe In narrallve} .other Direct Costs (describe in narrative) Othqr QJr.:,ect Costs (~!!"::>Q@~lI1D~r!~tl'::~1 Other Direct Costs (describe In narrative) INDIRECT COSTS; " . ... _fri.f1~_ ........... . Indirect Costs J.f2<S!i3.s:ri9.t::ll}.f1arrafiveL-) ______ _ It]~!r~t Co~~sjdescribe in narrative) IJ]jirect Costs (describe in narrative} Indirect Costs (describe in narrative) --+--_ .... _-_ ...... TOTALS:~$~ __________ ~$ __________ ~ ______________ ~ CB (rev. 11/16/09) Page 1 of 2 AUTHORIZA nON I hereby cerlify Ihal this expense report RubmiUed by Ihe undersigned "onstitules approved budget expenses during the period listed above, ~l1d that 110 expenses for which reimbursement is requested he, been or will be reimow.ed by 'II1Y other fltnding sources. P..tlltTHle COl)ntylDeparlment Use Only C.O.NOTE: I VOUCHER#: FISCAL PREPARED BY; INVOICE#: PATE: VENDOR II: ----.---~.---------_l INDEX COD!':: FISCAL APPROVED BY: SUB-OBJECT: DATE: AMOUNT TO PAY: CB (rev. 11116/09) Page 2 of 2 MIAMI ~w Agency' Address 1.-, " "", ',' Teiephone: lCoihp!etedBy "1 ItNamemtteY: " ; .•.. ".,' .•. "', i !program Name:'1 <The questions below are sample questions (#1-9), specific rePorts will be emailed later.> 1. If applicable, total number of participants transferred from previous contract year. . 2. Total Number of new participants served this reporting \ period. 3. Total number of participants served this reporting period. 4. Total number of participants served to date, 5. Total number of staff. 6. How many radiofTV spots were used this reporting period. 7. How many participants completed a consumer satisfaction survey, 8. Of those completing the survey, what percentage were Attachment G PFFI9~ ~~~~6;~~~TN~~~~UDG~T . I": p~q~~~?S,~REPORT' A!lp<:~ti~r;f\molfrii: ',' J~,~~tra·~t.~U~bbE:1 I 'c6ritr:act~peri§d:> " 10/1/2012 -9f30f2013 l ~~Ptlr1i!Jgph'ridCl:.· '." .••. ',' Oct·121 Nov-12 !~~~~~;l~an.131 Feb-13T~:;-131 A~;-1;I~aY-13 Jun-1 3 1 JUI-13 1 Aug-1 3 1 Sep-13ITota!sITarget I I I I 0.0' 0.0 ! .. " i "iloO . J , 0:0;' with the services provided. lo~~ 9. How many promotional brochureslflyers were distributed to -I' -t I . ..... I jpromote services throu houtthe commun' . I· OJ)' 1·0.0 . "·0.0. I " o.o·'d ,. p-;O; (}.o~ I 0;0 ··.0.0., .... 1'0;0 I···· .. Page 1 of2 OGe 025 (rev. 10/19}09) Attachment G Program Problems Encountered this Month: "-;." "j, ,'. ; Authorized Personnel {Print Name & Title Authorized Sicmature Date Page 2 of2 OGe 025 (rev. 10/19/09) . MfAMI,OAOE. COUNTY ,.' , OFFICEOF~'ANAGEMENT AND B.UOGET .' .FISCAL YEAR Z012.13 CLOSEOUT REPORT' LINE ITEi'II nUDGEr RF.:FLECTING ACTuAi..exPENblTtiRES .~~--~~~,----------------- Agoncy Nilme:'" .. ' ; "/ ~ .. ,: ATTACHMENT H MIAMI, ~ .. ------'------------I-~~---*~,+-------- cori:act~{!rsow ....••. Agre."nientP6rloQ: • 0-12-69~O:12-70, 'f,;I"pho.'o: O(dlnanco Numlwn -'~_"'_' _, _C:: __ ' _, :_ .. , __ ,, __ . "_,_, __ ,,,_,,,,,, __ f--'--,'-..,---'..,---'~---,:"-,-+_~0-1?::I1§' 0-11-72 Appro,/¢d ai,dUfli bn~, Il~~s . mR~¢rCOSTi:,,· ' Approved Budget Amount IDnt~: 11/27/2012 Actual expenses from Oct. 1, 2012 th rough Sep. 30, 2013 Ciosoolitl F,iiiaiAnli)tiriF ..... ' .' .• '. O~;'I{ us;;' qiilY , , .. '.; (0(.> 'lQiVfhi~irl1111~'c9t\lrnnr Personnel 1--', ""P=.o:c:S""lt.;.:io:;.:..n-----·,,--... ---... ·---'------t---·-------· --.---,,-----,,-,,-"''''''----",- -"""------·-""""--+---"----,-"" ... _""--·,,,----1-------------" Frin, es ._--,,----,------,-,,---'''----- Frio, os 3, Position Fringes 4, Position Frin, es 5. ;::;;..,;:::..::..::=-=-==....\.::.=c:.:..::;~c.:.::..:::..:.::=::.J --1------.,--------,----+--------; ==~==:..::..L-·l·-----"' .. -------- .--1--....... ----... ----+---- Personnel '1 1. Position "'.... 1-----.--~--+--------- Frif1~£.. ______ " ______ '"' __ ''' ------.l=========~~~_-_+_=~~~_-_-_ -_ -_ .... _-=.-=.==~ ~._Position ____ 1 __ ...... Fn~Q~~ ________________ +_-__ ---------+----------.-.. _,~---------~---____ I Indirect Costs (describe In narrative) Indire_ct Costs (describe in narrative) Indirect Cost?_,,{9.~scribe In narrative) Indirect Costs (describe in narrative) TOTALS;~$~ __________ ~$~ __________ ~ ____________ ~ I hereby certify that this expense report SUbmitted by the undersIgned constitutes approved budget expenses during the parlod listed above, and that no expenses for which reimbursement is requested has been or will be reimbursed by other funding EX~-;'utlve Olrector 1 Agency Deslgne;';-Slgn;ture CLS 09/10 (rev. 11116109) Page 1 of 2 Print Title ... __ ........ _ .... _ .. __ 1;",,;1c..:/2:::-7:;:f2:;:0..;..:12:::............_ Dale ILZ F; : * rew• 1& CountylDepartment Use Only CONTRACTS & GRANTS MANAGEMENT UNIT SECTION C.O. AL" ___ _ BG c _________ _ EHc ___ _ AFc ___ _ MLc ___ _ /\Nc ___ _ 00o _____ _ NRc ___ _ DGc SJo ____ _ C.O. NOTE: fiSCAL UNIT SECTION PREPARED BY: VOUCHER 11: DATE: INVOICE#: APPROVED BY: ____ _ VENOOR#: DATE: INDEX CODE: SUB.OBJECT: AMOUNT TO PAY: CLS 09110 (rev. 11116/09) Page 20f2 SSe TBc ___ _ YMc OTHERc OTHER c OTHERc OTHER c OTHERc 1------------------1 .---------------.- ATTACHMENT I PROVIDER'S DISCLOSURE OF SUBCONTRACTORS AND SUPPLIERS (Ordinance 97-104) Name of Organization: (I frO," I!I ft ' ( Lt!lJ Wi ,\Uv'l11 ~\i\.( Orvl ( Address: j ! --~~~~~~~~~~- t 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~CONSUL TANT 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 !' ~ .:-" ~I p P L ~ ( .:; ".0 < \ \ L.e v'::., f cI i / i 2i f C ? Page 1 of 1 AUTHORIZED SIGNATURE FORM DATE: 1/11/2013 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 Grants Coordination (OGC) 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 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 OGC. NAME (please type) TITLE (please type) SIGNATURE L Prime Contracts and Subcontracts Steven Alexander City Manager Alfredo Rivero) Chief Financial Officer II. Checks (List amount limits) Steven Alexander City Manager Alfredo Riverol Chief Financial Officer III. Budget Revision Requests Steven Alexander Cit;,; Manager Alfredo Riverol Chief Financial Officer IV. Payment Requests Steven Alexander City Manager Alfredo Riverol Chief Financial Officer South Miami 1001 6130 Sunset Drive South Miami, Florida 33143-5093 • Tel: (305) 663-6338· Fax: (305) 663-6345 www.cityofsouthmiami.net